Influence of professional dental hygiene on oral and general health of retirement home residents: A comparative study

Objectives: The oral status of nursing home residents is poor. This could compromise general health. The controlled study investigated the influence of quarterly professional dental hygiene interventions on oral and general health of elderly. Material and Methods: 152 participants (mean age 84 years) of two residents' homes were examined. Parameters of general health, a questionnaire for caregivers, and oral parameters were evaluated at baseline and after 1 year. All caregivers were given one lesson on oral hygiene at baseline. In one home professional oral hygiene was performed every 3 months. Statistical analyses were done by Chi(2) test for nominal data and t-test for numeric data. Results: There were no significant differences between both homes regarding general health. Some oral parameters-if any-may be positively influenced by the intervention such as pocket depth, and Denture Hygiene Index and alterations of the mucosa. Conclusions: A quarterly professional hygiene is not able to influence general health and has-if any-little effect on oral health. This underlines the necessity for frequent interventions. An optimization of the health policy framework is necessary to allow caregivers more time for oral hygiene and to establish the accessibility of frequent professional health care for inhabitants in residents' homes

Untersuchungen zur Diskusverlagerung ohne Reposition am Kiefergelenk

Die vorliegende Arbeit fasst 4 Studien zusammen, die konservative Behandlungsstrategien und Folgeerscheinungen an Kiefergelenken mit bestehender Diskusverlagerung (DV) ohne Reposition evaluieren. Studie 1 beurteilt die Therapie mit Äquilibrierungsschienen in Form einer Anwendungsbeobachtung. Die Schmerzsymptomatik und die Kieferöffnungsweite werden über einen Beobachtungszeitraum von 13 Monaten positiv beeinflusst. Studie 2 zeigt als randomisierte, kontrollierte Doppelblindstudie, dass sich die Symptomatik der DV ohne Reposition sowie der aktivierten Arthrose während eines Beobachtungszeitraums von 4 Monaten signifikant verbessert, unabhängig von der durchgeführten Therapie bzw. der Behandlung mit einem Placebogerät. Somit erzielt die Pulsierende Signaltherapie keinen spezifischen therapeutischen Effekt. Die Studie 3 beurteilt die Kaueffektivität bei vorliegender DV ohne Reposition im Vergleich zu einer Kontrollgruppe. Die Kaueffektivität nimmt in Abhängigkeit von der Dauer des Krankheitsbildes deutlich zu, erreicht jedoch nicht die Effizienz der gesunden Vergleichsgruppe. Die Studie 4 stellt eine MRT-gestützte Nachuntersuchung von Patienten mit DV ohne Reposition dar. Das Krankheitsbild geht mit deutlichen degenerativen Veränderungen der Gelenkstrukturen einher, die sich aber über einen Beobachtungszeitraum von ca. 2 Jahren hinweg nicht signifikant verändern. Entzündungszeichen nehmen jedoch signifikant ab und die Translationsbewegung der Kondylen verbessert sich. Die DV ohne Reposition kann somit als Krankheitsbild mit morphologischen Veränderungen und funktionellen Beeinträchtigungen gewertet werden, dessen subjektive Beschwerden sich auch ohne Intervention verbessern. Morphologische Veränderungen unterliegen sich selbst limitierenden Adaptationsmechanismen.This work presents four studies dealing with disk displacement without reduction, its treatment and long-term effects. Study 1 evaluates the treatment effects of stabilization splints. The study has a prospective follow-up design. Thirteen months after the baseline examination pain relieves and mouth opening reached a significant larger extend. Study 2 is randomised controlled and double blinded and evaluates pulsed electromagnetic fields (PEMF) as a new conservative treatment method. After a period of 4 months the pain relieves significantly and mouth opening is significantly larger in patients with anterior disk displacement or activated arthrosis, independent to active or mock treatment. PST has no specific effect on disk displacement without reduction or activated arthrosis. Study 3 tests the chewing efficiency of patients with disk displacement without reduction in comparison to a control trial. The chewing efficiency improves according to the time since onset of the disorder but is nevertheless reduced compared to a control group without TMJ-disorders. Study 4 is a MRI-controlled study, evaluating morphologic changements. Over an average time of 2 years no significant ongoing of degenerative changements accur, only high signal areas disappear and the translation of the condyle improves significantly. Anterior disk displacement is therefore a TMJ-disorder accompanied by limitation of joint function and degenerative changements of joint structures, which improve without treatment and can be interpreted as a self limiting adaptative process

The development of the Standardised Tool for the Assessment of Bruxism (STAB): An international road map

This paper summarises the background reasoning and work that led to the selection of the items included in the Standardised Tool for the Assessment of Bruxism (STAB), also introducing the list of items. The instrument is currently being tested for face validity and on-field comprehension. The underlying premise is that the different motor activities included in the bruxism spectrum (e.g. clenching vs. grinding, with or without teeth contact) potentially need to be discriminated from each other, based on their purportedly different aetiology, comorbidities and potential consequences. Focus should be on a valid impression of the activities' frequency, intensity and duration. The methods that can be used for the above purposes can be grouped into strategies that collect information from the patient's history (subject-based), from the clinical assessment performed by an examiner (clinically based) or from the use of instruments to measure certain outcomes (instrumentally based). The three strategies can apply to all aspects of bruxism (i.e. status, comorbid conditions, aetiology and consequences). The STAB will help gathering information on many aspects, factors and conditions that are currently poorly investigated in the field of bruxism. To this purpose, it is divided into two axes. Axis A includes the self-reported information on bruxism status and potential consequences (subject-based report) together with the clinical (examiner report) and instrumental assessment (technology report). Axis B includes the self-reported information (subject-based report) on factors and conditions that may have an etiological or comorbid role for bruxism. This comprehensive multidimensional assessment system will allow building predictive model for clinical and research purposes

The development of the Standardised Tool for the Assessment of Bruxism (STAB) : An international road map.

This paper summarises the background reasoning and work that led to the selection of the items included in the Standardised Tool for the Assessment of Bruxism (STAB), also introducing the list of items. The instrument is currently being tested for face validity and on-field comprehension. The underlying premise is that the different motor activities included in the bruxism spectrum (e.g. clenching vs. grinding, with or without teeth contact) potentially need to be discriminated from each other, based on their purportedly different aetiology, comorbidities and potential consequences. Focus should be on a valid impression of the activities' frequency, intensity and duration. The methods that can be used for the above purposes can be grouped into strategies that collect information from the patient's history (subject-based), from the clinical assessment performed by an examiner (clinically based) or from the use of instruments to measure certain outcomes (instrumentally based). The three strategies can apply to all aspects of bruxism (i.e. status, comorbid conditions, aetiology and consequences). The STAB will help gathering information on many aspects, factors and conditions that are currently poorly investigated in the field of bruxism. To this purpose, it is divided into two axes. Axis A includes the self-reported information on bruxism status and potential consequences (subject-based report) together with the clinical (examiner report) and instrumental assessment (technology report). Axis B includes the self-reported information (subject-based report) on factors and conditions that may have an etiological or comorbid role for bruxism. This comprehensive multidimensional assessment system will allow building predictive model for clinical and research purposes

Standardised Tool for the Assessment of Bruxism

Objective: This paper aims to present and describe the Standardised Tool for the Assessment of Bruxism (STAB), an instrument that was developed to provide a multidimensional evaluation of bruxism status, comorbid conditions, aetiology and consequences. Methods: The rationale for creating the tool and the road map that led to the selection of items included in the STAB has been discussed in previous publications. Results: The tool consists of two axes, specifically dedicated to the evaluation of bruxism status and consequences (Axis A) and of bruxism risk and etiological factors and comorbid conditions (Axis B). The tool includes 14 domains, accounting for a total of 66 items. Axis A includes the self-reported information on bruxism status and possible consequences (subject-based report) together with the clinical (examiner report) and instrumental (technology report) assessment. The Subject-Based Assessment (SBA) includes domains on Sleep Bruxism (A1), Awake Bruxism (A2) and Patient's Complaints (A3), with information based on patients' self-report. The Clinically Based Assessment (CBA) includes domains on Joints and Muscles (A4), Intra- and Extra-Oral Tissues (A5) and Teeth and Restorations (A6), based on information collected by an examiner. The Instrumentally Based Assessment (IBA) includes domains on Sleep Bruxism (A7), Awake Bruxism (A8) and the use of Additional Instruments (A9), based on the information gathered with the use of technological devices. Axis B includes the self-reported information (subject-based report) on factors and conditions that may have an etiological or comorbid association with bruxism. It includes domains on Psychosocial Assessment (B1), Concurrent Sleep-related Conditions Assessment (B2), Concurrent Non-Sleep Conditions Assessment (B3), Prescribed Medications and Use of Substances Assessment (B4) and Additional Factors Assessment (B5). As a rule, whenever possible, existing instruments, either in full or partial form (i.e. specific subscales), are included. A user's guide for scoring the different items is also provided to ease administration. Conclusions: The instrument is now ready for on-field testing and further refinement. It can be anticipated that it will help in collecting data on bruxism in such a comprehensive way to have an impact on several clinical and research fields

Standardised Tool for the Assessment of Bruxism

Objective: This paper aims to present and describe the Standardised Tool for the Assessment of Bruxism (STAB), an instrument that was developed to provide a multidimensional evaluation of bruxism status, comorbid conditions, aetiology and consequences. Methods: The rationale for creating the tool and the road map that led to the selection of items included in the STAB has been discussed in previous publications. Results: The tool consists of two axes, specifically dedicated to the evaluation of bruxism status and consequences (Axis A) and of bruxism risk and etiological factors and comorbid conditions (Axis B). The tool includes 14 domains, accounting for a total of 66 items. Axis A includes the self-reported information on bruxism status and possible consequences (subject-based report) together with the clinical (examiner report) and instrumental (technology report) assessment. The Subject-Based Assessment (SBA) includes domains on Sleep Bruxism (A1), Awake Bruxism (A2) and Patient's Complaints (A3), with information based on patients' self-report. The Clinically Based Assessment (CBA) includes domains on Joints and Muscles (A4), Intra- and Extra-Oral Tissues (A5) and Teeth and Restorations (A6), based on information collected by an examiner. The Instrumentally Based Assessment (IBA) includes domains on Sleep Bruxism (A7), Awake Bruxism (A8) and the use of Additional Instruments (A9), based on the information gathered with the use of technological devices. Axis B includes the self-reported information (subject-based report) on factors and conditions that may have an etiological or comorbid association with bruxism. It includes domains on Psychosocial Assessment (B1), Concurrent Sleep-related Conditions Assessment (B2), Concurrent Non-Sleep Conditions Assessment (B3), Prescribed Medications and Use of Substances Assessment (B4) and Additional Factors Assessment (B5). As a rule, whenever possible, existing instruments, either in full or partial form (i.e. specific subscales), are included. A user's guide for scoring the different items is also provided to ease administration. Conclusions: The instrument is now ready for on-field testing and further refinement. It can be anticipated that it will help in collecting data on bruxism in such a comprehensive way to have an impact on several clinical and research fields