Volume 9, Number 1.       March 2008

Editorial 2

An investigation into the oral health status of male prisoners in the UK
E Heidari, C Dickinson and J Fiske                                                       3

Extensive dental caries in unerupted permanent teeth of a disabled child with phenytoin-induced gingival overgrowth
Jumpei Murakami, Ichijiro Morisaki, Tomoko Tanaka, Shigehisa Akiyama, Atsuo Amano and Clive S. Friedman                                                           13

Current concepts in the pathogenesis and management of oral mucositis as a complication of cancer therapy
Karwan A Moutasim and Anwar R Tappuni                                          17

Factors influencing the decision to perform dental treatment under general anaesthesia in children with intellectual disability
Bojan Petrović, Dejan Marković, Igor Babić and Duska Blagojevic       27

Dental management of a child with congenital rubella syndrome
Ana Claudia Coutinho, Fernanda Campos Machado, Áurea Simone Barrôso Vieira and Lucianne Cople Maia                                                              31

Prisoner and lay opinions of a prison-issue oral health kit
E Heidari, C Dickinson and J Fiske                                                       35

EDITORIAL

At this time I feel happy, honoured and privileged to have the opportunity to write this editorial.

In my capacity as President of the International Association of Disability and Oral Health (IADH), it is my duty to fulfil the IADH mission: being concerned about those with disabilities and disadvantages, working together with those in their community, professional society and social or service organisation, to improve the oral health and quality of life for persons with special needs.

One of the major tools to guarantee improvement in knowledge, and consequently in care, is continuing education based on evidence based reports. Within the context of a world association with almost exclusively countries (i.e. societies) as membership, communication of knowledge is not easy. Newsletters and magazines are useful and necessary but can never reach the level of a scientific journal.

It has been the ambition for many years for the IADH to have its own journal. After the congress in Yokohama 1998, and with the support of Professor Susumu Uehara, the Japanese Society donated US$ 1,000 in order to fund a potential journal. Now, 10 years later we have been able to achieve that goal. The IADH Executive has negotiated an agreement with the publisher of the Journal of Disability and Oral Health, together with the encouragement and support of the Editor and a former IADH President, Professor June Nunn, to have this journal as the official journal of the IADH. The IADH logo and the claim ‘Official Journal of the IADH’ are now on the front cover.

The IADH Executive has taken out a one year blanket subscription, starting 1 January 2008, which will allow all bona fide members of the Association to have complete online access to the full texts of all the papers published in the journal since Vol. 1 No1 2000, in addition to papers published in 2008 (www.jdohonline.org). For this access it is necessary to be a member of the Special Care Dentistry Society in your own country (or an “Individual Member” if there is no national society) and that your IADH council representative provides the membership list to the JDOH publisher. However, in the event that access is not granted, please email a request for access to support@shancocksltd.co.uk together with details of your affiliation/permissive membership to the relevant society/organisation.

I am sure you will agree this is a wonderful development for all our members and a milestone for IADH. It will be possible for our worldwide membership not only to read online the excellent articles, but also to submit interesting papers for future publication. The print version of the journal will be published as normal and is available to IADR members at a very
advantageous discount (details on website). The current agreement is at a very favourable rate, however, we will have to reconsider how individuals or countries pay for this access at the next Congress meeting in Santos Brazil in October 2008.

Finally I would like to express my deepest gratitude to the Editor Professor June Nunn, to the publisher Dr Stephen Hancocks, and to our dedicated IADH secretary Dr Roland Blankenstein. It was great to collaborate with them and to change our ambition of having our own journal into reality!

Luc C. Martens
IADH president  

An investigation into the oral health status of male prisoners in the UK

E Heidari1 MFDS, MSc, C Dickinson2 BDS, LDS, DDPH, MFDS, MSc  and
J Fiske2 BDS,FDS, MPhil

1Tandlakare Gothenburg; 2Department of Sedation and Special Care Dentistry
King’s College London Dental Institute at Guy’s, King’s and St Thomas’s Hospitals, London, UK

Abstract

Conclusion: Prisoners have poorer general and oral health than the non-prison population. Remand prisoners reported a higher level of dental anxiety and were more likely to value their teeth, visit the dentist and opt for restoration of an anterior tooth than convicted prisoners. Convicted prisoners expressed more perceived need than their fellow remand prisoners, even though convicted prisoners normative need tended to be lower.

Extensive dental caries in unerupted permanent teeth of a disabled child with phenytoin-induced gingival overgrowth

Jumpei Murakami1 DDS, PhD, Ichijiro Morisaki2 DDS, PhD, Tomoko Tanaka3 DDS, Shigehisa Akiyama4 DDS, PhD, Atsuo Amano DDS, PhD and Clive S. Friedman6 DMD

1Assistant Professor; 2Professor and Chair; 3 Clinical Instructor; 4Associate Professor Division of Special Care Dentistry, Osaka University Dental Hospital.
5Professor, Department of Oral Frontier Biology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita-Osaka 565-0871 Japan
6Clinical Associate Professor, University of Western Ontario, 389 Hyde Park Road, London, Ontario, Canada

Abstract

The permanent teeth of a 9-year-old female with severe motor dysfunctions and intellectual disabilities had not yet fully erupted into the oral cavity due to being covered with overgrown gingival tissue, as a side effect of taking phenytoin. Dental caries was diagnosed in those teeth by a radiographic examination. These findings indicate that early dental examinations and preventive measures are useful for patients taking phenytoin.

Current concepts in the pathogenesis and management of oral mucositis as a complication of cancer therapy

Karwan A Moutasim BDS MFD RCSI1 and Anwar R Tappuni LDS RCS PhD2

1Centre for Tumour Biology, Institute of Cancer, Barts & The London School of Medicine and Dentistry Queen Mary University of London; 2King’s College London Dental Institute at Guy’s, King’s and St. Thomas’ Hospitals, London

Abstract
The ubiquitous nature of oral mucositis in patients undergoing chemotherapy, radiotherapy and bone marrow transplantation and its effect on patient quality of life, coupled with notable recent advances in better understanding of the pathobiology of mucositis, have brought about a shift from the symptomatic approach in management to a preventive one. This has been reflected in the literature over the past five years or so, and has culminated in the introduction of a variety of new medications, the majority of which are still being investigated. A universal management scheme for oral mucositis is far from being realised, but the current management guidelines as developed by the Multinational Association of Supportive Care in Cancer is invaluable for clinicians of all disciplines involved.  The introduction of the recently-approved human recombinant keratinocyte growth factor (palifermin) is perhaps one of the most notable achievements in mucositis research; the possibility of a topical preparation and its potential in other disease conditions have not been tapped into as yet.

Factors influencing the decision to perform dental treatment under general anaesthesia in children with intellectual disability

Bojan Petrović1, Dejan Marković2, Igor Babić1 and Duska Blagojevic1
1Dentistry Clinic of Vojvodina, Novi Sad, 2Paediatric and Preventive Dentistry Clinic, School of Dentistry, University of Belgrade, Serbia

Abstract

Aim: To investigate and describe the factors determining why people with intellectual disability are referred for dental treatment under general anaesthesia. Design of the study: Retrospective audit. of the hospital records of 75 patients treated under general anaesthesia at the Paediatric Department, Dentistry Clinic, Novi Sad, between 2005 and 2007. Main outcome measures: Data collected related to: demographics of patients, reasons given by referring practitioners for requesting general anaesthesia, reasons given by the attending clinician for general anaesthesia, the degree of intellectual disability, state of dentition, and the treatment undertaken. Results: The referral forms reported intellectual disability and the patient’s lack of cooperation as the main reasons for referral. Behavioural techniques could not be used in 42 (56%) patients due to severe intellectual disability. In 7 (9.3%) patients there was no time for the application of behavioural techniques because of the presence of acute dental conditions requiring urgent treatment. In 13 (17.3 %) patients, behavioural techniques failed because of the patient’s age and treatment necessitating multiple extractions. In 5 (6.6%) cases parents insisted on treatment under general anaesthesia. The prevalence of dental caries was 100%. The mean DMFT was 14.2. A mean of 2.2 teeth per patient were extracted.
Conclusion: General anaesthesia for dental treatment in children with intellectual disability in Vojvodina is mainly used for treating gross dental caries or its complications. Efforts should be made to integrate this type of dental treatment into the overall system of maintaining oral health, at a stage before urgent dental care necessitates recourse to general anaesthesia.

Dental management of a child with congenital rubella syndrome

Ana Claudia Coutinho DDS, MSD1, Fernanda Campos Machado DDS, MSD1, Áurea Simone Barrôso Vieira DDS, MSD2 , Lucianne Cople Maia, MD, PhD3

1Post Graduate Student, 2Staff member, 3Adjunt Professor; Pediatric Dentistry and Orthodontics Department, Federal University of Rio de Janeiro (UFRJ), Brazil

Abstract

Although Congenital Rubella Syndrome (CRS) can be prevented by vaccination, when it arises, it is still considered a challenge due to the complexity of its sequelae. This syndrome presents severe disorders, such as: ophthalmic and hearing, as well as cognitive and developmental problems. Consequently, there may be little concern about maintaining oral health, and the physical and intellectual limitations are greater obstacles to dental treatment. This paper presents the use of conscious sedation with nitrous oxide/oxygen as an alternative approach to dental treatment of a patient with CRS.

Prisoner and lay opinions of a prison-issue oral health kit

E Heidari1 MSC, BDS, MFDS RCS (Eng), C Dickinson2 MSc, BDS, MFDS, DDPH, LDS RCS (Eng), DipDSed, and J Fiske3 BDS, FDS RCS (Eng), MPhil

1Senior Clinical Teacher; 2Associate Specialist in Special Care Dentistry; 3Senior Lecturer and Consultant in Special Care Dentistry, Guy’s Campus, King’s College London Dental Institute at Guy’s, King’s and St Thomas’s Hospitals

Abstract

Research in prison populations has revealed poor oral health. In some cases prisoners have attributed their poor oral hygiene to the prison issue oral health kit of toothbrush and toothpaste. 
Aim: To describe the views of a prisoner population and a non-prison or lay population on the prison-issue oral health kit.
Method: Prisoners’ views on the prison issue oral health kit from a previous study by the same researchers were compared with those of a group of lay people. The sample size of lay people (48) was determined by the number of oral health kits made available by HMP Brixton. Lay participants were provided with an oral health kit containing one standard, prison issue toothbrush and a 50ml tube of toothpaste (1,000ppm F). They were invited to use them twice daily for a period of one week. A simple, eight-item questionnaire, based on the findings of the earlier prisoner study, was constructed to evaluate the lay population’s views on the prison-issue oral health kit.
Results: It was found that 81% of prisoners (99) and 66.7% (32) of lay people disliked the toothbrush. The toothpaste was disliked by 70% (85) of the prison population and 58.3% (28) of the lay group.
Conclusion: Prisoners had a more negative view of both the prison issue toothbrush and the toothpaste than did the lay population. However, the majority of prisoner and lay group members considered that the brush and paste were of poor quality. Improving the quality of the prison-issue toothbrush and toothpaste may improve prisoners’ motivation regarding oral health and hygiene and so influence their motivation and ability to clean effectively.

JDOH home

BSDH home