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1.
J Oral Implantol ; 44(4): 313-324, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29457932

RESUMO

The objective of this systematic review was to determine the effect on oral health-related outcomes from mandibular implant-retained dentures opposing maxillary complete dentures in edentulous middle-age and older adults, compared with complete removable dentures in both arches. Randomized controlled trials included participants with an average age of 65 years or older. The Cochrane Library, MEDLINE, and Web of Science were searched. A total of 228 abstracts were reviewed for inclusion criteria, with 14 trials included and analyzed for risk of bias. Eleven of these studies were assessed as being at an unclear risk of bias, and 3 were at high risk. Mandibular implant-retained overdenture therapy showed statistically significant improvements in the patients' general satisfaction ( P = .003), oral health-related quality of life ( P < .001), and chewing ability ( P < .001), over the patients with complete dentures. There were no significant differences in the percentage of patients who were satisfied with their overdentures vs complete dentures for comfort, retention, esthetics, or chewing ability; however, only 2 studies reported these outcomes. In terms of nutritional status 1 year after treatment, vitamin B12 blood levels increased significantly in the implant-retained group ( P = .003), but not the other nutritional values. Implant-retained mandibular overdentures are an option for middle-aged and elderly edentulous patients as they significantly improve some of the outcomes; however, the quality of the evidence was moderate/low, due to the small number of studies included and the risk of bias. Future research should include objective outcomes such as masticatory performance, chewing efficacy, and muscular coordination.


Assuntos
Prótese Dentária Fixada por Implante , Prótese Total Inferior , Saúde Bucal , Qualidade de Vida , Idoso , Prótese Total , Revestimento de Dentadura , Humanos , Pessoa de Meia-Idade , Satisfação do Paciente
2.
Home Health Care Serv Q ; 33(4): 177-93, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25256717

RESUMO

Our study assesses changes in students' knowledge and attitudes after participation in an interprofessional, team-based, geriatric home training program. Second-year medical, physician assistant, occupational therapy, social work, and physical therapy students; third-year pharmacy students; and fourth-year dental students were led by interprofessional faculty teams. Student participants were assessed before and after the curriculum using an interprofessional attitudes learning scale. Significant differences and positive data trends were noted at year-end. Our study suggests that early implementation, assessment, and standardization of years of student training is needed for optimal interprofessional geriatric learning. Additionally, alternative student assessment tools should be considered for future studies.


Assuntos
Educação Profissionalizante/organização & administração , Geriatria/educação , Conhecimentos, Atitudes e Prática em Saúde , Serviços de Assistência Domiciliar , Relações Interprofissionais , Equipe de Assistência ao Paciente , Idoso , Currículo , Educação Profissionalizante/normas , Feminino , Humanos , Masculino , Estudantes de Ciências da Saúde , Inquéritos e Questionários
3.
Clin Geriatr Med ; 39(2): 235-255, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-37045531

RESUMO

Older adults have multiple morbidities that can impact oral, systemic, and psychological health. Although each disorder requires consideration from the provider before treatment, by assessing the common phenotypic presentations of older adults, we can better understand, select, and coordinate treatment modifications that would need to be considered and implemented for dental care.


Assuntos
Saúde Bucal , Polimedicação , Humanos , Idoso
4.
Spec Care Dentist ; 43(3): 346-358, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36717976

RESUMO

AIMS: This paper reviews the oral health services which were available for early (1945-1955) and late (1956-1964) baby boomers, as well as predicts their future oral healthcare needs. METHODS AND RESULTS: The knowledge, beliefs, and attitudes of the parents of the baby boomers toward dental hygiene and oral healthcare, are reviewed. The introduction of dental health screenings occurred from 1910 to early 1970s, the creation of the first dental hygiene school and the introduction of water fluoridation influenced oral healthcare. Technology introduced in the dental offices in the 1960s included the high-speed handpiece, followed by intraoral suction in 1979. Baby boomers are keeping their teeth at higher rates than preceding generations due to improved prevention and advances in the treatment of periodontal disease, and overall lower rates of smoking in older adults, when compared to younger adults. However, access to dental care remains an issue for many. Advances in prevention and treatment of periodontal disease, early detection of root caries, new restorative techniques, and improved technologies to replace teeth are also discussed. CONCLUSIONS: Early detection of periodontal disease, oral, and oropharyngeal cancer, risk factors for tooth loss and untreated caries are needed to improve the oral health for baby boomers. Access to oral healthcare is still an issue due to socio-economic disparities in America.


Assuntos
Cárie Dentária , Doenças Periodontais , Cárie Radicular , Humanos , Idoso , Saúde Bucal , Cárie Dentária/prevenção & controle , Doenças Periodontais/prevenção & controle , Assistência Odontológica
5.
Am J Public Health ; 102(9): 1729-34, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22813093

RESUMO

OBJECTIVES: We measured the impact of dental diseases on the academic performance of disadvantaged children by sociodemographic characteristics and access to care determinants METHODS: We performed clinical dental examinations on 1495 disadvantaged elementary and high school students from Los Angeles County public schools. We matched data with academic achievement and attendance data provided by the school district and linked these to the child's social determinants of oral health and the impact of oral health on the child's school and the parents' school or work absences. RESULTS: Students with toothaches were almost 4 times more likely to have a low grade point average. About 11% of students with inaccessible needed dental care missed school compared with 4% of those with access. Per 100 elementary and high school-aged children, 58 and 80 school hours, respectively, are missed annually. Parents averaged 2.5 absent days from work or school per year because of their children's dental problems. CONCLUSIONS: Oral health affects students' academic performance. Studies are needed that unbundle the clinical, socioeconomic, and cultural challenges associated with this epidemic of dental disease in children.


Assuntos
Escolaridade , Saúde Bucal/estatística & dados numéricos , Populações Vulneráveis , Absenteísmo , Adolescente , Criança , Cárie Dentária/epidemiologia , Feminino , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Humanos , Los Angeles/epidemiologia , Masculino , Pais , Fatores Socioeconômicos , Inquéritos e Questionários , Odontalgia/epidemiologia
6.
Clin Oral Implants Res ; 23(8): 958-62, 2012 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-21806685

RESUMO

OBJECTIVES: This study investigated the association between denture status [implant-supported fixed dentures (IDs) and removable partial dentures (RPDs)] and oral health-related quality of life (OHRQoL). MATERIALS AND METHODS: Consecutive patients with IDs and RPDs were recruited from the Prosthodontics Departments at Showa University and Tokyo Medical and Dental University. The Japanese version of the Oral Health Impact Profile (OHIP-J-49) was administered to each subject. For each OHIP-J-49 question, the subjects were asked to indicate the frequency with which they had experienced a dental problem during the last month. Responses were recorded on a 5 point Likert rating scale, with 0 being never and 4, very often. Summary scores were calculated and regression analyses conducted to investigate the association between denture status and OHIP-J-49 summary score. RESULTS: In total 79 ID subjects (mean age±SD of 51.7±12.4 years, 44.3% men) and 109 RPD subjects (mean age of 66.5±8.6 years, 30% men) participated after giving informed consent. The regression analysis between the type of treatment and the OHIP-J-49 summary score revealed a significant association with a coefficient of 17.0 (Confidence interval, CI: 10.9-23.1). When age and duration of denture usage, which had significant associations with OHIP-J-49, were included in this model, the regression coefficient remained virtually unchanged at 17.4 (CI: 9.75-25.0), thus indicating little potential confounding by them. CONCLUSIONS: OHRQoL in patients with implant-supported fixed dentures is generally less impaired than it is in those patients with RPDs.


Assuntos
Prótese Dentária Fixada por Implante , Prótese Parcial Removível , Saúde Bucal , Qualidade de Vida , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise de Regressão , Reprodutibilidade dos Testes , Inquéritos e Questionários , Resultado do Tratamento
7.
Spec Care Dentist ; 42(5): 445-455, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35279860

RESUMO

AIM: To examine self-reported opioid prevalence at a dental school clinic for patients ≥65 years old as compared to national data, comparing gender, ethnicity/race and older adult age groupings. METHODS AND RESULTS: Self-reported prescription opioid medication use was extracted from the medical record for dental patients ≥65 years old who visited the school's general dental clinic (GDC) in 2012 or 2017. This data was compared to the National Health and Nutrition Examination Survey (NHANES) data for 2011-2012 and 2017-18. There was a significant increase in prevalence of opioid use in adults ≥65 between 2012 (4.5%) and 2017 (6.5%) and for ages 65-79 (from 4.7% to 6.3%) and ≥80 (3.4% to 7.9%), women (4.8% to 7.0%), and African Americans (4.7% to 8.4%) in the GDC. Older adults at the GDC reported less opioid use than the NHANES national average for both periods no matter the gender or the age with variable results for race/ethnicity. CONCLUSION: The prevalence of older adults taking opioids in our general dental school clinic population increased significantly in 2017 as compared to 2012 but was lower than the national average for the respective periods. Awareness of existing opioid usage in older adult patients and its higher adverse risk potential is critical when prescribing analgesics for dental pain for this age group.


Assuntos
Analgésicos Opioides , Transtornos Relacionados ao Uso de Opioides , Idoso , Analgésicos Opioides/uso terapêutico , Feminino , Humanos , Inquéritos Nutricionais , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Prevalência , Estados Unidos/epidemiologia
8.
J Prosthodont Res ; 66(2): 208-220, 2022 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-34261845

RESUMO

PURPOSE: To evaluate whether poor oral health is associated with a higher risk of malnutrition based on the Mini Nutritional Assessment (MNA) or MNA-SF (short form) in older adults. STUDY SELECTION: For this meta-analysis, cohort and cross-sectional studies with adults 65 years and older, reporting oral health outcomes (i.e. edentulism, number of teeth) and either the MNA or MNA-SF were selected. Four electronic databases were searched (Medline via PubMed, Web of Science, Cochrane Library and EMBASE) through June 2020. Risk of bias was assessed with the checklist by the Agency for Healthcare Research and Quality scale. RESULTS: A total of 928 abstracts were reviewed with 33 studies, comprising 27,559 participants, aged ≥65 being ultimately included. Meta-analyses showed that the lack of daily oral hygiene (teeth or denture cleaning), chewing problems and being partially/fully edentulous, put older adults at higher risk of malnutrition (p<0.05). After adjustment for socio-demographic variables, the included studies reported lack of autonomy for oral care, poor/moderate oral health, no access to the dentist and being edentulous with either no dentures or only one denture were risk factors significantly associated with a higher risk of malnutrition (p<0.05). CONCLUSION: These findings may imply that once elders become dependent on others for assistance with oral care, have decreased access to oral healthcare, and lack efficient chewing capacity, there is increased risk of malnourishment. Limitations of the study include heterogeneity of oral health variables and the observational nature of the studies. Further studies are needed to validate our findings.


Assuntos
Desnutrição , Avaliação Nutricional , Idoso , Humanos , Estudos Transversais , Avaliação Geriátrica , Desnutrição/etiologia , Estado Nutricional , Saúde Bucal
9.
J Public Health Dent ; 71(3): 194-201, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21972459

RESUMO

OBJECTIVES: The purpose of this study is to investigate the oral health-related quality of life (OHRQOL) in the US population by sociodemographic factors, perception of dental needs, reported dental visits, and saliva indicators. METHODS: Data from the National Health and Nutrition Examination Survey (NHANES) 2003-2004 were used. NHANES measured OHRQOL by a modified version of the Oral Health Impact Profile. RESULTS: The study had 6,183 subjects who averaged an OHRQOL score of 2.8 points. About 40% had painful aching in the mouth during the last year on at least one occasion. Perceived need to relieve dental pain was the strongest risk factor for poor OHRQOL (resulting in a higher score by 5.2 points), followed by perceived need for a denture or feeling of dry mouth (each resulting in a higher score by about 2 points). CONCLUSIONS: OHRQOL is the poorest among those with perceived dental needs especially those with the perceived need to relieve dental pain.


Assuntos
Serviços de Saúde Bucal , Necessidades e Demandas de Serviços de Saúde , Saúde Bucal , Qualidade de Vida , Humanos , Estados Unidos
10.
Dent Clin North Am ; 65(2): 285-305, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33641754

RESUMO

Older adults have multiple morbidities that can impact oral, systemic, and psychological health. Although each disorder requires consideration from the provider before treatment, by assessing the common phenotypic presentations of older adults, we can better understand, select, and coordinate treatment modifications that would need to be considered and implemented for dental care.


Assuntos
Saúde Bucal , Idoso , Humanos , Fenótipo
11.
Spec Care Dentist ; 41(2): 251-270, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33438306

RESUMO

AIM: The objective of this systematic review was to evaluate the efficacy of denture adhesives (DAs) in completely edentulous denture wearers compared to not using DAs. METHODS AND RESULTS: PubMed, Web of Science, Cochrane Library, and EMBASE were searched from the database inception up to 6 February 2020 for Randomized Controlled Trials (RCTs) involving patients with complete dentures in both arches where the use of DAs was compared to no use of DAs. A total of 497 abstracts were reviewed, resulting in inclusion of 10 RCTs. Outcomes reported in the included trials were thoroughly reviewed and tabulated. The Cochrane risk of bias tool was used. All 10 studies were assessed at unclear (10%) or high risk of bias (90%). Studies showed DAs improved mainly retention/stability, and masticatory/chewing ability/performance, compared to no adhesives. CONCLUSION: Most studies showed favorable results for DAs on retention and stability of complete dentures, masticatory performance, patient's comfort and satisfaction. Due to the heterogeneity of the outcomes, unclear/high risk of bias and small sample sizes, the quality of the evidence was very low. More high-quality research is needed with improved blinding and use of standardized methods to evaluate the efficacy of DAs.


Assuntos
Cimentos Dentários , Boca Edêntula , Prótese Total , Humanos , Mastigação , Satisfação do Paciente
12.
Community Dent Oral Epidemiol ; 49(2): 192-200, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33135179

RESUMO

OBJECTIVE: To describe CHAMP (Children's Oral Health Promotion Program) evaluating the impact of two motivational methods in increasing dental care access. METHODS: CHAMP is a multi-dimensional oral health promotion programme that recruited and screened underprivileged children/families from community sites in Los Angeles County between 2012 and 2018. A randomized clinical trial (RCT) enrolled children/families into one or more motivational interventions (intra-oral camera and/or social work consultation) designed to impact subsequent scheduling of dental appointments. RESULTS: CHAMP served 24 535 families. RCT had 418 families with 68.5% scheduling appointments by second follow-up (P < .001). Excluding children with scheduled appointments by first follow-up, children experiencing both interventions were 4.1 (95% CI 1.5-11.2) times more likely to schedule appointments by second follow-up than were the controls (P=<.01). When experiencing both interventions and had never previously been to the dentist, 68.3% scheduled dental appointments; this was significantly higher than the controls (46.7%) (P = .04). The best predictor for families to have scheduled appointments was a dental visit within the last six months [OR = 3.8 (95% CI 2.2-6.6), P < .001]. CONCLUSIONS: Outreach health promotion programmes are important and should consider utilizing various motivational techniques to encourage enrolment and treatment at dental homes.


Assuntos
Saúde da Criança , Relações Comunidade-Instituição , Agendamento de Consultas , Criança , Promoção da Saúde , Humanos , Saúde Bucal
13.
J Calif Dent Assoc ; 38(2): 115-22, 2010 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-20232690

RESUMO

OBJECTIVES: To investigate the oral health status, access, and the role of mobile dental clinics in improving the oral health of migrant children. METHODS: Parents attending University of Southern California's Mobile Dental Clinics completed a questionnaire about their children's access to dental care. RESULTS: 54 percent of children were unable to access needed care, and prevalence of untreated decay was 87.4 percent. CONCLUSION: Dental needs are high among migrant children. Mobile clinics provide a safety net for them.


Assuntos
Assistência Odontológica para Crianças/organização & administração , Unidades Móveis de Saúde , Migrantes , California/epidemiologia , Criança , Assistência Odontológica para Crianças/estatística & dados numéricos , Cárie Dentária/epidemiologia , Feminino , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Humanos , Masculino , Prevalência , Inquéritos e Questionários , Odontalgia/epidemiologia , Migrantes/estatística & dados numéricos
14.
J Calif Dent Assoc ; 38(9): 681-8, 2010 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-20961031

RESUMO

The aim of this study is to evaluate a community health project serving the homeless and to assess their oral health. Clinical charts of 1,088 patients were evaluated. The prevalence of untreated caries was 58 percent among adults with a mean of 6.3 decayed teeth. Homeless individuals are in great need of restorative, surgical, and periodontal dental procedures. Community health projects are important in assessing and improving the oral health of the underserved homeless population.


Assuntos
Serviços de Saúde Comunitária/estatística & dados numéricos , Assistência Odontológica/estatística & dados numéricos , Cárie Dentária/epidemiologia , Pessoas Mal Alojadas , Doenças Periodontais/epidemiologia , Adolescente , Adulto , Idoso , Distribuição de Qui-Quadrado , Criança , Pré-Escolar , Relações Comunidade-Instituição , Doenças da Polpa Dentária/epidemiologia , Feminino , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Pessoas Mal Alojadas/estatística & dados numéricos , Humanos , Los Angeles/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Missões Religiosas , Faculdades de Odontologia , Estatísticas não Paramétricas , Adulto Jovem
15.
J Calif Dent Assoc ; 37(11): 804-10, 2009 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-19998657

RESUMO

Just as aging successfully requires a multifaceted approach that includes full engagement in life, maintenance of high physical and cognitive function, and avoidance of disease and related disability, so does the care of adult patients. This geriatric treatment model suggests that understanding the psychosocial, behavioral, and medical presentation of the older patient may prove to be the key to the ultimate success of the dental/oral treatment arrived at collaboratively by the dentist and the older patient.


Assuntos
Envelhecimento/fisiologia , Envelhecimento/psicologia , Assistência Odontológica para Idosos , Idoso , Idoso de 80 Anos ou mais , Doença Crônica , Interações Medicamentosas , Humanos , Vida Independente , Equipe de Assistência ao Paciente , Polimedicação
16.
Spec Care Dentist ; 39(3): 287-297, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30811076

RESUMO

AIMS: To evaluate the efficacy of saliva substitutes and stimulants compared to placebo in improving findings of dry mouth not caused by SjÓ§gren's. METHODS AND RESULTS: Four databases were searched (PubMed, Web of Science, Cochrane Library, and EMBASE) through March 2018. Only randomized controlled trials (RCT) using placebo interventions with dry mouth patients were included. Outcomes included salivary flow and self-reported patient improvement. The Cochrane Collaboration's tool for assessing risk of bias was used. A total of 348 references were reviewed, resulting in 7 RCTs with 257 dry mouth patients with 5 studies at high risk of bias, 1 unclear and 1 low risk being included. Topical spray of 1% malic acid increased unstimulated (Difference in Means [DM] = 0.096, 95% CI = 0.092-0.100; P < 0.001) and stimulated (DM = 0.203, 95% CI = 0.106-0.300; P < 0.001) salivary flow in 2 studies. Patients using 1% malic acid topical spray were 5.4 times more likely to report improvement compared to placebo (95% CI = 2.634-11.091; P < 0.001) in 2 studies. No significant improvements were found with other products when compared to placebo. CONCLUSION: Use of 1% malic acid topical spray seems to improve dry mouth compared to placebo. Quality of the evidence was low due to risk of bias and imprecision.


Assuntos
Saliva , Xerostomia , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Saliva Artificial
17.
Spec Care Dentist ; 39(2): 188-200, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30719739

RESUMO

To broaden the availability of human immunodeficiency virus (HIV) testing, we offered rapid HIV screening tests to 811 patients attending a dental school for routine dental hygiene care. Study design is a prospective cross-sectional study. The 319 (39.3%) agreeing to test, self-identified as: Hispanic (34.4%), White (25.8%), African American (13.1%), Asian (8.3%), Native American/Pacific Islander (0.9%), more than one race/ethnicity (1.1%) or declining to state (16.5%). Over 35% (n = 113) were first time HIV test takers, with another 2.2% (n = 7) unaware of their testing history. Approximately 60% of the decliners choose "just don't want test today" as the reason. Following a strictly structured algorithm, four possible undiagnosed infections were initially identified, with one completing the algorithm to case confirmation. In conclusion, the confirmed incidence rate finding of HIV seropositivity of 0.31% found through initial screening at the dental clinic, compared with the 0.018% incidence rate of HIV with confirmed diagnosis in Los Angeles County, indicates that a rapid HIV screening test offered in a dental school clinic can potentially play an important role in discovering undiagnosed HIV individuals.


Assuntos
Clínicas Odontológicas , Infecções por HIV/diagnóstico , Programas de Rastreamento/métodos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Faculdades de Odontologia , Estudos Transversais , Feminino , Humanos , Los Angeles , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
18.
Spec Care Dentist ; 28(2): 43-52, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18402616

RESUMO

The aim of this interdisciplinary study was to survey the oral health among persons with developmental disabilities (PDD), and to evaluate the impact of the routine referral process at a regional center in Los Angeles, California. This study evaluated the subjects' oral health, access to care, oral health behaviors, and adherence to referrals. The study recruited 102 subjects (74% were African American or Hispanic). Among them, 24% reported brushing their teeth less than once a day, and 68% had dental insurance. The prevalence of leukoplakia was 4% and the prevalence of temporomandibular joint (TMJ) clicking and pain were 11% and 9%, respectively. Their decayed, missing, filled (DMF) equaled 14 points with 7 missing teeth. The subjects' DMF index was poorer compared to the general population. The routine referral process was not effective in improving the subjects' access to dental care. More sophisticated referral systems need to be developed for this population.


Assuntos
Assistência Odontológica para a Pessoa com Deficiência/estatística & dados numéricos , Deficiências do Desenvolvimento , Pessoas com Deficiência Mental , Programas Médicos Regionais/organização & administração , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Índice CPO , Assistência Odontológica para a Pessoa com Deficiência/organização & administração , Prótese Dentária , Feminino , Acessibilidade aos Serviços de Saúde , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Humanos , Los Angeles/epidemiologia , Masculino , Anormalidades Maxilofaciais/epidemiologia , Pessoa de Meia-Idade , Equipe de Assistência ao Paciente , Doenças Periodontais/epidemiologia , Encaminhamento e Consulta , Transtornos da Articulação Temporomandibular/epidemiologia
19.
J Periodontol ; 77(5): 773-9, 2006 May.
Artigo em Inglês | MEDLINE | ID: mdl-16671868

RESUMO

BACKGROUND: The Women's Interagency HIV Study (WIHS) is the largest, most detailed, controlled longitudinal collection of data to evaluate the influence of human immunodeficiency virus (HIV) disease and its therapies on the periodontium. METHODS: This report evaluates periodontal probing depth (PD), attachment loss (AL), and tooth loss from 584 HIV-seropositive and 151 HIV-seronegative women, recorded at 6-month intervals from 1995 to 2002. Using the random split-mouth method, PD and AL were recorded from four sites per tooth: mesial-buccal, buccal, distal-buccal, and lingual. Influence of viral load, CD4 count, race, smoking, drug use, low income, and level of education were evaluated. RESULTS: At baseline, AL was 1.6 versus 1.1 mm (P = 0.003) and PD was marginally deeper (2.1 versus 2.0 mm; P = 0.02) in HIV-seropositive versus HIV-seronegative women. Adjusted longitudinal analysis showed that HIV infection did not increase the mean PD (rate ratio [RR], 1.00; 95% confidence interval [CI], 0.96 to 1.04), worst PD (RR, 1.03; 95% CI, 0.98 to 1.09), mean AL (RR, 0.97; 95% CI, 0.96 to 1.02), worst AL (RR, 1.01; 95% CI, 0.94 to 1.07), or tooth loss (RR, 1.02; 95% CI, 1.0 to 1.05). CONCLUSIONS: CD4 count and viral load had no consistent effects on PD or AL. Among HIV-infected women, a 10-fold increase in viral load was associated with a marginal increase in tooth loss. The progression of periodontal disease measured by PD and AL did not significantly differ between HIV-infected and HIV-uninfected women. The HIV-seropositive women lost more teeth. Race, smoking, drug use, income, and education level did not influence the results for either group.


Assuntos
Terapia Antirretroviral de Alta Atividade , Retração Gengival/etiologia , Soronegatividade para HIV , Soropositividade para HIV/complicações , Bolsa Periodontal/etiologia , Adolescente , Adulto , Progressão da Doença , Métodos Epidemiológicos , Feminino , Soropositividade para HIV/tratamento farmacológico , Humanos , Pessoa de Meia-Idade , Perda de Dente/etiologia , Carga Viral
20.
J Dent Educ ; 70(8): 857-68, 2006 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-16899445

RESUMO

The Pacific AIDS Education and Training Center (PAETC) developed and tested over time a curriculum to meet the changed HIV/AIDS-related needs of dental health professionals. The objective of this study was to evaluate the HIV-related knowledge, attitudes/beliefs, and behaviors among the participants of a CE training course based on this curriculum, both before and six weeks after the completion of the course. The project recruited 106 participants who were dental health professionals over a ten and a half year period (1992-2003). The dental participants consisted of 79 percent dentists and 21 percent dental hygienists or dental assistants. The sample was 67 percent male, 33 percent female, 45 percent Caucasian, and 24 percent Asian. An adapted questionnaire was used before and after the training to assess the educational needs of the participants and evaluate the success of the program in meeting those needs. Approximately 81 percent of the participants completed both questionnaires. After the course, the participants significantly changed their knowledge, attitudes/beliefs, and behaviors (65 percent, 86 percent, 55 percent respectively, all at p=.0001). Overall, the educational program was successful in increasing and promoting the HIV/AIDS-related knowledge and attitudes/beliefs of the participants and enhancing their commitment to infection control and HIV risk screening behaviors.


Assuntos
Assistência Odontológica para Doentes Crônicos , Educação Continuada em Odontologia , Infecções por HIV , Conhecimentos, Atitudes e Prática em Saúde , Adulto , Currículo , Assistentes de Odontologia/educação , Higienistas Dentários/educação , Odontólogos , Feminino , Humanos , Controle de Infecções Dentárias , Masculino , Avaliação das Necessidades , Inquéritos e Questionários
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