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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Before public finance is committed to a particular public health measure it is essential that the project should be analytically evaluated. Cost-benefit analysis is one method of choosing between alternative programmes. It suffers from the disadvantage that, while costs can be accurately assessed, the benefit to an individual of freedom from pain, discomfort or inconvenience cannot be simply expressed in monetary terms. Such benefits may therefore be omitted from calculations of cost-benefit and a programme with valuable indirect or intangible benefits may not receive adequate consideration in competition with other alternatives. Futhermore, since benefits may only accrue some time after expenditure has been incurred, inflation distorts the significance of cost-benefit calculations. Cost-effectiveness analysis is an alternative method which enables one to determine the least expensive of several alternative methods of achieving a stated objective. The application of these concepts to preventive programmes against dental caries is described. Distinction must be made between the effectiveness of preventive measures during controlled clinical trials on limited numbers of subjects and their value when applied under field conditions to the whole community. Detailed comparisons are made between various methods of the application of fluorides caries prevention by community fluoridation water supply, school water fluoridation and topical application of fluorides. It is concluded that while completely accurate and valid analyses of cost-effectiveness are not possible, they do enable dentistry to view its activities more objectively and to indentify the real issues which should affect future decisions.
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PMID:Methods of assessing the cost-effectiveness of caries preventive agents and procedures. 11 Jul 4

A basic oral health survey was carried out on a random sample of first year African student teachers attending four teachers' colleges in Rhodesia. The number examined and interviewed was 309. Methods and criteria used are those described in the second (1977) edition of the World Health Organization manual Oral health surveys - Basic methods. Prevalences of dental caries were 31.0% for the 142 male students and 59.5% for the 167 female students. The difference is statistically significant (P less than 0.001). Mean DMFTs were 0.74 for men and 2.02 for women. The prevalences of "intense gingivitis" were 52.8% for male students and 34.7% for female students. This difference also is significant (P less than 0.005). The major treatment requirements are for one-surface fillings and prophylaxis with oral hygiene instruction. Dental service utilization is low. Less than 10% of the sample had obtained dental care in the previous 12 months. The main reason for seeking care was pain. Self-assessments of oral health needs were not valid. The stated desire for fillings is greater than for extractions. A need has been demonstrated for dental health education aimed at the prevention of disease and the encouragement, use and demand for quality care services.
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PMID:Oral health of Rhodesia African first year student teachers. 29 41

A special form and field manuals defining examination criteria were prepared for recording the following: 1. Number of teeth present both primary and permanent 2. Periodontal disease (a) Oral hygiene using the simplified oral hygiene index. (b) Periodontal condition using a modified P.I. index. (c) Periodontal treatment requirements. 3. Dental caries The DMF index was used with separate coding for filled or crowned teeth having additional primary or secondary decay. 4. Dento facial anomalies Both treatment need and treatment status were recorded. 5. Prosthetic status Possession and requirements for partial or full dentures and bridges were recorded for the age groups 13-14 and 35-44. 6. Oral pathology Pathological conditions of the gingiva and oral mucosa. 7. Need for immediate attention Conditions causing or likely to cause pain or danger to general health unless immediate treatment was given. The recording was carried out using fibre optic illumination, disposable mirrors and sickle probes. X-rays were not utilized. Two roving epidemiologists first established reproducible criteria and then calibrated the local examiners. Re-calibration took place at intervals and repeat examinations of a small sample population ensured reproducibility of recordings. The completed charts were sent to the WHO Oral Health Unit where they were edited and the data transferred to computer tape for analysis. For the present reports three variables--number of carious teeth, caries treatment/need ratio and number of teeth with gingivitis were selected for special study.
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PMID:Transactions of an international conference. Worldwide concern: better dental care for more people. An international collaborative study. How oral surveys were conducted. 78

Familial dysautonomia is an inherited autosomal recessive disease found almost exclusively in Ashkenazi Jews. It is characterized by selective damage to the sensory, motor, and autonomic peripheral nervous system. The main clinical features include decreased pain sensation, impaired temperature and blood pressure regulation, lack of tearing, absent tendon reflexes, and fungiform papillae on the tongue. The purpose of this study was to explore in depth and to verify the oral and dental status in familial dysautonomia. Twenty-two patients and 44 match-paired healthy persons of Ashkenazi descent were examined. Patients and parents had only little concern for their oral condition. Caries prevalence was lower than normal and plaque accumulation increased in all patients. Dental trauma was found in 59% of the patients, and 32% showed orodental self-mutilation. Dental age was within normal range, and dental arch measurements implied proportionally small jaws and little crowding. The low caries rate may be related to the known "hypersalivation" in familial dysautonomia and/or a possible change in the salivary composition and content, caused by chronic autonomic denervation.
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PMID:Dental and oral findings in patients with familial dysautonomia. 140 91

Indonesia is a developing country with few dental services and a population at risk to deteriorating oral health. Five hundred and ninety-one 12 and 15 year-old children drawn from a low fluoride (F- less than 0.1 ppm) urban area of Jakarta, Indonesia were examined for dental caries, fluorosis, and periodontal diseases. In addition, a questionnaire was administered investigating socio-demographic background, use of dental services, and preventive oral care. Although the severity of dental caries experience was moderate, untreated caries on the occlusal surface formed the highest proportion of the dental caries experience. CPITN examination revealed a large proportion of the subjects had calculus as their highest score, combined with a substantial number of sites which exhibited bleeding on probing. Questionnaire data revealed a high home use of fluoridated toothpaste by the subjects but a predominant use of dental services for pain relief. Findings from this study suggest a need for primary preventive programmes focusing on occlusal sealants and plaque control.
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PMID:The oral health status and health behaviour of 12 and 15 year-old adolescents in Jakarta, Indonesia. 150 83

The mechanisms by which pain develops in carious teeth are poorly understood. The variability of dentin and pulp responses to carious attack is probably the cause for the variations in the pain symptoms presented by patients. This article is a review of the available data regarding the changes that dentin and pulp undergo in carious teeth. Such changes are discussed in relation to their possible influence on intradental sensory nerve excitability. Special emphasis is given to the various bacterial metabolites produced and accumulated in carious dentin and their ability to modulate pain symptoms from carious teeth.
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PMID:Factors influencing the occurrence of pain in carious teeth. 150 71

This study examined the dental state of institutionalized elderly and their need for care. An oral examination was carried out on 479 elderly persons living in long-term care facilities with a mean age of 74.9 years. Results showed an overall DMF score of 27.0 and the average number of teeth in dentate subjects was 7.5. A large proportion of teeth (76.6%) was lost through dental caries and the loss increased significantly with age. Consequently, 56.1% of subjects were edentulous, of whom 78.8% were without dentures. Among the conditions that required urgent dental care, majority of subjects needed extractions of residual roots and loose teeth. A lesser proportion required treatment for gross caries (4.8%), periodontal disease (5.0%), suspected tumor (0.2%), as well as alleviation of pain and infection arising from mucosal lesions (4.8%), abscesses (3.3%) and TMJ problems (2.8%). The treatment needs for dentures and episodic care are high among institutionalized elderly and need to be addressed.
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PMID:Dental state and needs for episodic care of institutionalized elderly in an Asian community. 156 22

A six-month pilot emergency service for children was established at Glasgow Dental Hospital to provide care for patients in pain, offer preventive advice and ensure ongoing dental care. The service was staffed by experienced community dental officers. In the main study period 2965 patients were seen. The majority (54 per cent) were referred from general dental practitioners; however, 27 per cent came directly to the hospital without seeking dental advice in their locality. The most common problems were toothache (55 per cent), occasional pain (28 per cent) and swelling (14 per cent). Eighty per cent of the patients were directed to oral surgery for extractions under general anaesthesia and six per cent for extractions under local anaesthesia. Dental caries still causes pain and distress to a large number of Glasgow school children. Clearly water fluoridation would greatly improve dental health and in so doing reduce the proportion of children requiring extractions under a general anaesthetic. The emergency service is currently being reorganised so as to place more emphasis on following up those patients who do not have a dentist, or who presented for care without a referral letter.
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PMID:A report on the feasibility of establishing a paediatric emergency dental service at Glasgow Dental Hospital. 183 18

The dental treatment demands of 824 patients attending regional dental clinics were recorded. Overall 86% of the patients sought treatment for pain, ranging from 77% to 97% in the different clinics. Caries was the main cause of pain. The proportion of patients with demands for aesthetics was 5%, prosthetics 2%, and check up 3%. The data indicated a need for emergency care. The type of curative treatment needed, mainly extractions, could well be performed by dental auxiliaries. Since the data was collected from patients among whom many visited the clinics in the late stages of painful oral diseases, it is assumed that it reflects only the tip of an iceberg that represents a much larger dormant demand (want) for emergency care among the population. Any strategy aiming to be effective in improving oral health should at least meet the emergency dental needs of the population. Consequently there is a definite need of data on dental treatment demands and wants for adequate planning of dental health care systems in their infancy in countries with limited financial resources.
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PMID:Dental treatment demands among patients in Tanzania. 218 18

In the past, the primary focus of dentistry has been on the alleviation of pain and stopping the progression of disease. The reduction in the prevalence of dental caries, along with advances in adhesive technology, have combined to revolutionize the practice of dentistry today. The modern dentist, using the latest available cosmetic techniques, is now able to satisfy the emotional wants and needs of patients. The public, well informed about the possibilities for anterior esthetics, now desire tooth-colored restorations in the posterior. A new heat- and pressure-curing resin inlay/onlay material and the clinical and laboratory technique for its use are discussed.
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PMID:An esthetic, bonded inlay/onlay technique for posterior teeth. 219 56


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