Tobacco use is a dental as well as a medical problem. When dental team members assist their patients in becoming tobacco free, they are eliminating a causative/contributing factor for a number of oral conditions including cancer and periodontal diseases. Studies have shown that brief tobacco use cessation interventions in the dental office can be effective in helping many patients to stop using tobacco. Interventions can be optimized through understanding the stage of change the tobacco user is in when an intervention is attempted. Only then can we use the appropriate intervention at the right time. This article discusses and demonstrates a protocol for tobacco cessation interventions that can be used in the dental office.
Edward B. Fowler,
Lawrence G. Breault,
COL Patrice D. Primack
Root perforations are significant complications of endodontic treatment. However, when teeth are of strategic value, perforation repair is clearly indicated. The successful utilization and placement of a subgingival resin-ionomer restoration to repair an endodontic root perforation is demonstrated. Sustained tissue health and minimal probing depths at the surgical site demonstrate clinical success.
In this series of articles, the author discusses the potential risks, benefits, and liabilities in using electronic communications and computer-based record keeping for patients’ medical data. Article #1 in this series reviews the foundations of privacy for personal information and the current practices of collecting disaggregated private personal and medical data made possible on the Internet by software and hardware configurations.
A great deal of new technology has been integrated into the modern dental office during the last several decades. However, no product can increase productivity and reduce stress and strain on the dental team as much as using the singular concept of four-handed dentistry. The research of the 1950s is undaunted in its impact on productivity. Combined with the practice of ergonomics in the workplace, this concept must be revisited by the dental profession. The young dentists of the 21st Century have had minimal exposure to true four-handed dentistry. This article, the first in a series, re-introduces the basic principles of a research-oriented concept.
Maggie C. Tantraphol,
How to cite this article:
Niederman R, Tantraphol MC, Slnin P, Hayes C, Conway S. Effectiveness of Dentist-Prescribed, Home-Applied Tooth Whitening, A Meta-analysis. J Contemp Dent Pract 1999; 1 (4):34-49.
Common clinical experience suggests that tooth whitening agents are 100% effective. This study uses meta-analysis of data from published randomized controlled clinical trials to determine the efficacy of tooth whitening agents.
A MEDLINE search strategy was developed and implemented to systematically identify clinical trials on dentist-prescribed, home-applied tooth whitening agents, using 10% carbamide peroxide, published between 1989-1999. Inclusion criteria (e.g., in English, human clinical trials) and exclusion criteria (e.g., not placebo controlled) were established and clinical trials that met these criteria were critically appraised for validity and clinical applicability. Meta-analysis was then used to quantitatively integrate the findings.
Seven studies were identified that met the inclusion and validity criteria. These studies indicated that:
Whitening results in a significant mean change of 6 4 shade guide units (p < 0.01), while the placebo control group exhibited little change (0.7 0.6, p > 0.05).
93% of the bleached patients exhibited 2 shade guide unit change, while 20% of the placebo control group exhibited this change.
The brand of bleaching agent had a significant effect on tooth whitening, but the daily application time and duration of treatment did not.
Whitening is maintained for 6 months for 1/2 of the people treated.
Neither gingival indices nor plaque indices were adversely or favorably affected by bleaching.
The data from the reviewed studies indicate that rather than being 100% effective, on average:
73% (93% for bleached group minus 20% placebo group) of people who whiten their teeth will exhibit a whitening that is 2 shade guide units greater than the placebo.
20% of the people who use dentist-prescribed, home-applied bleaching will achieve a mean whitening effect of 5 shade guide units.
Re-treatment for 50% of people may be necessary to maintain this effect longer than 6 months.
The methods used here are Internet applicable for other clinical topics.
Obtaining quality radiographs on pediatric patients can be a challenge. Suggestions for communicating with patients about radiation safety and the need for radiographs can facilitate the process. Guidelines for radiographic exposure intervals for young patients are key elements in the reduction of exposure to ionizing radiation and are presented in this paper. The child patient presents unique challenges for the dental professional and special techniques are presented in this article that may be helpful in the conducting radiographic examinations for this patient population.
How to cite this article:
White DJ, Gerlach RW. Anticalculus Effects of a Novel, Dual-Phase Polypyrophosphate Dentifrice: Chemical Basis, Mechanism, and Clinical Response. J Contemp Dent Pract 1999; 1 (4):59-70.
A primary patient motivation for oral hygiene is effective cleaning. Dentifrice serves this function by including ingredients such as abrasives, surfactants, and specialized cleaning ingredients such as anticalculus agents. This introductory article aims to introduce professionals, educators, and researchers on the rationale behind the development of an improved cleaning dentifrice formulation, Crest® Multicare Advanced Cleaning. This new dentifrice is based upon the application of an improved tartar control/cleaning ingredient that is a polymeric adjunct of a pyrophosphate anion commonly applied in tartar control and stain control whitening dentifrices. The polypyrophosphate anion, also referred to as sodium hexametaphosphate, produces superior activity and substantivity on oral surfaces as compared to both pyrophosphate and some other commonly used dental cleaning ingredients and cleaning/conditioning adjuncts. The increased activity and substantivity translate into significant improvements in the prevention of dental stains and supragingival calculus and in the non-abrasive removal of dental stains.
This article describes the structure of polypyrophosphate as compared to the parent pyrophosphate molecule, the rationale for its improved chemistry, and, in particular, its tartar control chemistry. In addition, the fundamental mechanisms of calculus formation and inhibition are reviewed. Lastly, a preliminary clinical study evaluating the improved efficacy of a polypyrophosphate dentifrice is described where the tartar control activity of the polypyrophosphate dentifrice is shown to be superior to that of a clinically established and marketed industry standard pyrophosphate dentifrice.