DOCSLIB.ORG

Determining the Sensitivity and Specificity of Two Questionnaires When Comparing Odontogenic Pain with Temporomandibular Disorders-Related Pain

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Determining the Sensitivity and Specificity of Two Questionnaires When Comparing Odontogenic Pain with Temporomandibular Disorders-Related Pain View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by University of Minnesota Digital Conservancy Determining The Sensitivity and Specificity of two Questionnaires when comparing Odontogenic Pain with Temporomandibular Disorders-related Pain A THESIS SUBMITTED TO THE SCHOOL OF DENTISTRY UNIVERSITY OF MINNESOTA BY Barbara Fonseca Alonso IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF TEMPOROMANDIBULAR DISORDERS AND OROFACIAL PAIN MASTER OF SCIENCE Advisor: Donald Robert Nixdorf February 2016 © Barbara Fonseca Alonso 2016 Acknowledgements I would like to express my special appreciation and thanks to my advisor Professor Dr. Donald Nixdorf, you have been a tremendous mentor for me. I would like to thank you for your patience, for encouraging my research and for allowing me to grow as a research scientist. Your advice on both research as well as on my career have been priceless. I would also like to thank my coadvisor Professor Dr. Justin Durham for his patience and help with the statistical analysis and for letting me use a part of the data of his parent study. I would also like to thank my committee members, Professor Dr. Mike John, Professor Dr. Alan Law for serving as my committee members even at hardship. I also want to thank you for letting my defense be an enjoyable moment, and for your brilliant comments and suggestions, thanks to you. I would especially like to thank Dr. Sarah Shueb, Dr. Hina Mittal and Dr. Pathamas Chantaracherd, my fellow residents, for being there to support me when I recruited patients and collected data for my Master’s thesis. i A special thanks to my family. Words cannot express how grateful I am to my mother and father for all of the sacrifices that you have made on my behalf. I would also like to thank all of my friends who supported me in writing, and incented me to strive towards my goal. At the end I would like express appreciation to Javier who was always my support in the moments when there was no one to answer my queries. ii Dedication To Javier, for his unconditional support over the distance, for his love, his light and his friendship during this period of my life. To Antonio, Anna and Alba; my family in Minnesota. To Manuel, Marta, Marta and Sara. Because you are always there. iii Abstract Objectives: Two common types of orofacial pains that are clinically important to distinguish are odontogenic pain and temporomandibular disorders (TMD) pain. The aim of this study was to determine the sensitivity and specificity of two screening instruments in distinguishing patients with odontogenic pain from patients with TMD pain. Methods: A convenience sample of patients seeking care at an Endodontist’s office and at an Orofacial Pain Clinic was recruited. The 14-item Dental Pain Questionnaire (DePaQ) (Pau et al., 2005) was used to screen for odontogenic pain and the 6-item TMD-screener (Gonzalez et al., 2011) was used to screen for TMD pain. Sensitivity and specificity calculations, with 95% confidence intervals, were performed for both instruments. Results: Thirty-four patients with odontogenic pain and 37 patients with TMD pain were enrolled. Both groups had comparable age distribution (49±12 vs. 45±18 years) and gender composition (53% vs. 86% females). Results of the sensitivity and specificity are provided in the table below with determination of diagnostic accuracy of these measures evaluated using published guidelines. Odontogenic Pain versus TMD Pain (95% confidence interval) Sensitivity 85% (69% to 95%) DePaQ Specificity 11% (3% to 25%) Sensitivity 92% (78% to 98%) TMD-screener Specificity 59% (41% to 75%) Conclusion: The point estimates for both the DePaQ and TMD screener were “acceptable” in identifying patients who had the pain condition in question (i.e., sensitivity), although the point estimate for appropriately identifying patients who did not have the pain condition when they did not have it (i.e., specificity) was “non-acceptable” neither for the DePaQ nor for the TMD screener. The potential for high amounts of false positive responses with the DePaQ limits its use as a screening instrument when patients are suspected as having TMD pain. iv Table of Contents Acknowledgements ........................................................................................................ i Dedication .................................................................................................................... iii Abstract ........................................................................................................................ iv Table of Contents .......................................................................................................... v List of Tables .............................................................................................................. vii List of Figures ............................................................................................................ viii Introduction ................................................................................................................... 1 Aim ............................................................................................................................... 7 Methods ......................................................................................................................... 8 Participants ................................................................................................................ 8 Enrollment criteria .................................................................................................... 9 Inclusion Criteria .................................................................................................. 9 Exclusion Criteria: ................................................................................................ 9 Sample Size ............................................................................................................. 10 Screening questionnaires used ................................................................................ 11 Dental pain screening questionnaire ................................................................... 11 TMD screening questionnaire ............................................................................. 12 Statistical analyses .................................................................................................. 12 Results ......................................................................................................................... 15 Description of patients ............................................................................................ 15 Analysis of the DePaQ Screener ............................................................................. 16 Analysis of the TMD Screener ............................................................................... 17 Discussion ................................................................................................................... 18 Participants’ enrollment: ......................................................................................... 19 v Questionnaires: ....................................................................................................... 19 Item analysis ........................................................................................................... 21 Limitations: ............................................................................................................. 23 Future studies .......................................................................................................... 24 Conclusion .................................................................................................................. 24 References ................................................................................................................... 26 Tables .......................................................................................................................... 31 Figures ......................................................................................................................... 42 Appendix 1: Dental Pain Questionnaire ...................................................................... A Appendix 2: TMD screener ......................................................................................... D vi List of Tables Table 1: Pulpal and apical diagnostic terminology ................................................. 31 Table 2: Non odontogenic tooth pain ...................................................................... 32 Table 3: Patterns of pain referral to teeth and associated regions ........................... 33 Table 4: Diagnostic criteria for the patients recruited ............................................. 34 Table 5: Characteristics of the 71 patients enrolled in the study ............................ 36 Table 6: AIM 1.0: DePaQ: Odontogenic pain versus all TMD pain ...................... 37 Table 7: AIM 1.1: DePaQ: Odontogenic pain versus TMD pain not referring to teeth only ............................................................................................................................... 37 Table 8: AIM 1.2: DePaQ: Odontogenic pain versus TMD pain referring to teeth only ............................................................................................................................... 38 Table 9: AIM 2.0: TMD Screener: All TMD pain versus Odontogenic pain ......... 38 Table 10: AIM 2.1:
Load more

Recommended publications
  • Oral Diagnosis: the Clinician's Guide
    Wright An imprint of Elsevier Science Limited Robert Stevenson House, 1-3 Baxter's Place, Leith Walk, Edinburgh EH I 3AF First published :WOO Reprinted 2002. 238 7X69. fax: (+ 1) 215 238 2239, e-mail: [email protected]. You may also complete your request on-line via the Elsevier Science homepage (http://www.elsevier.com). by selecting'Customer Support' and then 'Obtaining Permissions·. British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging in Publication Data A catalog record for this book is available from the Library of Congress ISBN 0 7236 1040 I _ your source for books. journals and multimedia in the health sciences www.elsevierhealth.com Composition by Scribe Design, Gillingham, Kent Printed and bound in China Contents Preface vii Acknowledgements ix 1 The challenge of diagnosis 1 2 The history 4 3 Examination 11 4 Diagnostic tests 33 5 Pain of dental origin 71 6 Pain of non-dental origin 99 7 Trauma 124 8 Infection 140 9 Cysts 160 10 Ulcers 185 11 White patches 210 12 Bumps, lumps and swellings 226 13 Oral changes in systemic disease 263 14 Oral consequences of medication 290 Index 299 Preface The foundation of any form of successful treatment is accurate diagnosis. Though scientifically based, dentistry is also an art. This is evident in the provision of operative dental care and also in the diagnosis of oral and dental diseases. While diagnostic skills will be developed and enhanced by experience, it is essential that every prospective dentist is taught how to develop a structured and comprehensive approach to oral diagnosis.
    [Show full text]
  • Dental & Oral Health
    Dental & Oral Health RESEARCH REVIEW™ Making Education Easy Issue 5 – 2016 to the fifth issue of Dental and Oral Health Research Review. In this issue: Welcome This issue begins with a review of the latest advances in saliva-related studies in which the potential value of Saliva in the diagnosis of saliva for early diagnosis of oral and systemic diseases is discussed. A meta-analysis of analgesics for pain of disease endodontic origin concludes that NSAIDs are the agents of choice (in the absence of contraindications). Colleagues from Australia have reviewed and provided guidelines for reducing the risks associated with radiation exposure in dental practices. The final issue for 2016 concludes with a report on the use of TCMs (traditional Chinese Treatment failure in medicines) by US-residing Chinese parents and their children for oral conditions. endodontics We hope you have enjoyed Dental and Oral Health Research Review this year, and we look forward to returning in 2017. Treating permanent teeth Kind regards with deep dentine caries Dr Colleen Murray Associate Professor Jonathan Leichter NSAIDs: first-line in [email protected] [email protected] endodontic pain relief? Management of dens Saliva in the diagnosis of diseases invaginatus Authors: Zhang C-Z et al. Summary: Saliva is a hypotonic solution of salivary acini, gingival crevicular fluid and oral mucosal exudates Oral care for pregnant with multiple functions: mouth cleaning, by washing away bacteria and food debris; digestion, as salivary patients amylase catalyses the hydrolysis of starch into maltose and sometimes glucose in the mouth; antibacterial effects provided by salivary lysozymes and thiocyanate ions; and saliva secretion contains risk factors for some diseases by excreting or transmitting potassium iodide, lead and mercury, and viruses such as rabies, polio and Hypophosphatasia in HIV infection.
    [Show full text]
  • The Role of Unfinished Root Canal Treatment in Odontogenic Maxillofacial Infections Requiring Hospital Care
    Clin Oral Invest (2013) 17:113–121 DOI 10.1007/s00784-012-0710-8 ORIGINAL ARTICLE The role of unfinished root canal treatment in odontogenic maxillofacial infections requiring hospital care L. Grönholm & K. K. Lemberg & L. Tjäderhane & A. Lauhio & C. Lindqvist & R. Rautemaa-Richardson Received: 16 November 2011 /Accepted: 4 March 2012 /Published online: 14 March 2012 # Springer-Verlag 2012 Abstract 60 % were males. Unfinished root canal treatment (RCT) was Objectives The aim of this study was to evaluate clinical the major risk factor for hospitalisation in 16 (27 %) of the 60 and radiological findings and the role of periapical infection cases (p0.0065). Completed RCT was the source only in 7 and antecedent dental treatment of infected focus teeth in (12 %) of the 60 cases. Two of these RCTs were adequate and odontogenic maxillofacial abscesses requiring hospital care. five inadequate. Materials and methods In this retrospective cohort study, we Conclusions The initiation of inadequate or incomplete pri- evaluated medical records and panoramic radiographs during mary RCT of acute periapical periodontitis appears to open a the hospital stay of patients (n060) admitted due to odonto- risk window for locally invasive spread of infection with local genic maxillofacial infection originating from periapical abscess formation and systemic symptoms. Thereafter, the periodontitis. quality of the completed RCT appears to have minor impact. Results Twenty-three (38 %) patients had received endodontic However, a considerable proportion of the patients had not treatment and ten (17 %) other acute dental treatment. Twenty- received any dental treatment confirming the importance of seven (45 %) had not visited the dentist in the near past.
    [Show full text]
  • Coding Guidelines for Dentists
    246 > COMMUNIQUE Coding guidelines for dentists SADJ July 2014, Vol 69 no 6 p246 - p248 M Khan ICD-10 coding remains confusing for some dentists and their persists for a very long time and seeks relief from the pain. personnel. We have recently heard from the administrators The patient agrees that you can take a periapical radiograph that they had to reject R18 000 worth of claims on one day of the tooth. The radiograph shows an interproximal cari- as a result of incorrect ICD-10 coding. This article attempts ous lesion on the distal of tooth 21, extending deep into the to provide some clarity on this issue. dentine, but not yet into the pulp. The lamina dura in rela- tion to the apex of the root appears to be normal. The tooth The biggest misconception about ICD-10 responds with a sharp pain following a percussion test. You The most common question asked about the system is: “What document the following diagnosis on your records: “21 se- is the ICD-10 code for this procedure code?” Please note that vere interproximal caries (distal) with an irreversible pulpitis ICD-10 coding does not work like this. There is no standard or and an acute periapical periodontitis”. You explain the diag- fixed ICD-10 code related to any procedure code. nosis, the required follow-up procedures and the estimated costs to the patient who agrees to a root canal treatment Basic principle of ICD-10 coding and further radiographs. ICD-10 coding is a diagnostic system and dental procedures The invoice after treatment is as follows: can be performed as result of various different diagnoses.
    [Show full text]
  • Differential Diagnosis for Orofacial Pain, Including Sinusitis, TMD, Trigeminal Neuralgia
    OralMedicine Anne M Hegarty Joanna M Zakrzewska Differential Diagnosis for Orofacial Pain, Including Sinusitis, TMD, Trigeminal Neuralgia Abstract: Correct diagnosis is the key to managing facial pain of non-dental origin. Acute and chronic facial pain must be differentiated and it is widely accepted that chronic pain refers to pain of 3 months or greater duration. Differentiating the many causes of facial pain can be difficult for busy practitioners, but a logical approach can be beneficial and lead to more rapid diagnoses with effective management. Confirming a diagnosis involves a process of history-taking, clinical examination, appropriate investigations and, at times, response to various therapies. Clinical Relevance: Although primary care clinicians would not be expected to diagnose rare pain conditions, such as trigeminal autonomic cephalalgias, they should be able to assess the presenting pain complaint to such an extent that, if required, an appropriate referral to secondary or tertiary care can be expedited. The underlying causes of pain of non-dental origin can be complex and management of pain often requires a multidisciplinary approach. Dent Update 2011; 38: 396–408 Management of orofacial pain can only be To establish a differential expanded and grouped in more recent effective if the correct diagnosis is reached diagnosis for orofacial pain we must first years.2 Questions include: and may involve referral to secondary consider the history, examination and Onset; or tertiary care. The focus of this article relevant investigations. Frequency; is differential diagnosis of orofacial pain Although both may co-exist, Duration; (Table 1) rather than available therapeutic the more rare non-dental pain must be Site; options.
    [Show full text]
  • Management of Periodontitis Associated with Endodontically Involved Teeth: a Case Series
    Management of Periodontitis Associated with Endodontically Involved Teeth: A Case Series Abstract The pulp and the periodontal attachment are the two components that enable a tooth to function in the oral cavity. Lesions of the periodontal ligament and adjacent alveolar bone may originate from infections of the periodontium or tissues of the dental pulp. The simultaneous existence of pulpal problems and inflammatory periodontal disease can complicate diagnosis and treatment planning. The function of the tooth is severely compromised when either one of these is involved in the disease process. Treatment of disease conditions involving both of these structures can be challenging and frequently requires combining both endodontic and periodontal treatment procedures. This article presents cases of periodontitis associated with endodontic lesions managed by both endodontic and periodontal therapy. Keywords: Endodontic-periodontic, periodontitis, pulp, periapical periodontitis, combined lesions Citation: Anand PS, Nandakumar K. Management of Periodontitis Associated with Endodontically Involved Teeth: A Case Series. J Contemp Dent Pract 2005 May;(6)2:118-129. © Seer Publishing 1 The Journal of Contemporary Dental Practice, Volume 6, No. 2, May 15, 2005 Introduction It has long been recognized that an intimate relationship exists between the pulp of a tooth and the surrounding periodontium.1 Much of the focus has been on the possible pathways for the spread of inflammation and infection from one component to the other. The periodontium communicates with pulp tissues through many channels or pathways. These channels may be involved in extending pulpal infections to the periodontium and vice versa. Thus, lesions of the periodontal ligament and adjacent alveolar bone may originate from infections of the periodontium or tissues of the dental pulp.
    [Show full text]
  • Role of S100A4 in the Pathogenesis of Human Periapical Granulomas
    in vivo 35 : 2099-2106 (2021) doi:10.21873/invivo.12479 Role of S100A4 in the Pathogenesis of Human Periapical Granulomas TAKAHITO TAMURA 1,2 , TAIKI MIYATA 1,2 , KEISUKE HATORI 1,3 , KAZUMA HIMI 1, TAKESHI NAKAMURA 1,2 , YURIKA TOYAMA 1,2 and OSAMU TAKEICHI 1,3 1Department of Endodontics, Nihon University School of Dentistry, Tokyo, Japan; 2Nihon University Graduate School of Dentistry, Dental Research Center, Tokyo, Japan; 3Division of Advanced Dental Treatment, Dental Research Center, Tokyo, Japan Abstract. Background/Aim: S100A4 expression is periodontitis is to eliminate the source of root canal infection associated with the pathology of chronic inflammatory that causes lesions of apical periodontal tissue and has a high diseases. In this study, we investigated the role of S100A4 success rate (4). However, despite proper treatment by the and four inflammatory mediators (IL-1 β, IĸB, IL-10, and dentist, apical periodontitis may not heal and tooth extraction TNF- α) in human periapical granulomas (PGs). Materials may be required (4). Cytokines and growth factors play an and Methods: S100A4 expression in PGs obtained by important role in the development of periapical lesions and apicoectomy was examined by immunohistochemistry. associated tissue damage (5). Notably, these inflammatory Further, the expression of S100A4 and four inflammatory mediators increase lymphocyte activation, inflammatory cell mediators was compared between PGs and healthy gingival migration, and osteoclast activation in the lesions (3, 6-8). tissues (HGTs) using real-time PCR. Results: In the PGs, Although various studies have investigated the mechanisms S100A4 was found to be expressed in endothelial cells and underlying the development of periapical periodontitis (1-8), fibroblasts.
    [Show full text]
  • The Importance of Viral Detection in Oral Fluids in Patients with Periodontal Disease
    Romanian Journal of Medical and Dental Education Vol. 9, No. 4, July - August 2020 THE IMPORTANCE OF VIRAL DETECTION IN ORAL FLUIDS IN PATIENTS WITH PERIODONTAL DISEASE. REVIEW. Alexandru Flondor1, Irina-Georgeta Sufaru2*, Maria-Alexandra Martu2, Ionut Luchian2, Liliana Pasarin2, Vasilica Toma3, Silvia Martu2 1DMD, PhD, Private Practice, Iasi, Romania 2University of Medicine and Pharmacy “Grigore T. Popa”, Faculty of Dental Medicine, Department of Periodontology, Iasi, Romania 3University of Medicine and Pharmacy “Grigore T. Popa”, Faculty of Dental Medicine, Department of Pediatric Dentistry, Iasi, Romania *Corresponding authors: Sufaru Irina-Georgeta. E-mail: [email protected] #All authors had equal contributions with the first author Abstract The direct involvement of herpesviruses in the evolution of periodontitis can change the concepts of pathogenesis and disease management. A double periodontal infection of herpesviruses and pathogenic bacteria tends to be associated with more severe periodontitis than a periodontal infection involving only bacteria. Classical techniques in viral diagnosis use cell culture or antigenemia. These diagnostic techniques have been largely replaced by DNA and / or RNA-based tests, which possess superior technical performance and cost advantages. False-negative and false-positive PCR results are an inherent concern. Poor design of the PCR test, without optimization or validation of the PCR methodology, may lead to inaccurate findings and incompatible with those of other studies. The concept of viral infections of the diseased periodontium may introduce a new level of understanding of the importance of preventing and controlling periodontal disease for medical purposes. Keywords: viruses, periodontal bacteria, saliva, crevicular fluid, PCR Introduction The etiopathogenesis of Gingivitis and periodontitis are periodontitis includes specific bacteria and infectious diseases that tend to be viruses [2], protective and destructive particularly severe in immune responses of the host [3], immunocompromised individuals [1].
    [Show full text]
  • Investigation of Bacteriophages As Potential Sources of Oral Antimicrobials
    Investigation of bacteriophages as potential sources of oral antimicrobials By: Mohammed I. Abud Al-Shaheed Al-Zubidi A thesis submitted for the degree of Doctor of Philosophy December 2017 The University of Sheffield Faculty of Medicine, Dentistry and Health School of Clinical Dentistry ii Abstract Bacteriophages are natural viruses that attack bacteria and are abundant in all environments, including air, water, and soil- following and co-existing with their hosts. Unlike antibiotics, bacteriophages are specific to their bacterial hosts without affecting other microflora. The use of bacteriophages and phage endolysin based therapies to kill pathogens without harming the majority of harmless bacteria has received growing attention during the past decade, especially in the era where bacterial resistance to antibiotic treatment is increasing. The aims of this study were to characterise a putative prophage (phiFNP1) residing in the genome of the periodontal pathogens Fusobacterium nucleatum polymorphum ATCC 10953, investigating the possibility of prophage induction, examining its presence in clinical plaque samples taken from patients with chronic periodontitis cases, and purify its putative lysis module genes to examine their potential antimicrobial activity. In addition, attempts will be made to catalogue phages that are presents in samples from the oral cavity of patients with chronic periodontitis and in wastewater, followed by isolation of lytic phages targeting endodontic and oral associated pathogens, characterisation of the isolated phages, evaluation of the efficiency of phage towards biofilm elimination, and established an animal model to study phage-bacterial interaction in order to develop them for treatments. The results revealed that phiFNP1 prophage are common in subgingival plaque of patients suffering from chronic periodontal disease but attempts to induce phiFNP1 using Mitomycin C were inconclusive, indicating that it might be defective.
    [Show full text]
  • Detection of Epstein–Barr Virus in Periodontitis: a Review of Methodological Approaches
    microorganisms Review Detection of Epstein–Barr Virus in Periodontitis: A Review of Methodological Approaches Lilit Tonoyan 1,* , Marlène Chevalier 1,Séverine Vincent-Bugnas 1,2, Robert Marsault 1 and Alain Doglio 1,3 1 MICORALIS, Faculté de Chirurgie Dentaire, Université Côte D’Azur, 5 rue du 22ième BCA, 06357 Nice, France; [email protected] (M.C.); [email protected] (S.V.-B.); [email protected] (R.M.); [email protected] (A.D.) 2 Pôle Odontologie, Centre Hospitalier Universitaire de Nice, 06000 Nice, France 3 Unité de Thérapie Cellulaire et Génique (UTCG), Centre Hospitalier Universitaire de Nice, 06101 Nice, France * Correspondence: [email protected] or [email protected] Abstract: Periodontitis, an inflammatory condition that affects the structures surrounding the tooth eventually leading to tooth loss, is one of the two biggest threats to oral health. Beyond oral health, it is associated with systemic diseases and even with cancer risk. Obviously, periodontitis represents a major global health problem with significant social and economic impact. Recently, a new paradigm was proposed in the etiopathogenesis of periodontitis involving a herpesviral–bacterial combination to promote long-term chronic inflammatory disease. Periodontitis as a risk factor for other systemic diseases can also be better explained based on viral–bacterial etiology. Significant efforts have brought numerous advances in revealing the links between periodontitis and Epstein–Barr virus (EBV), a gamma herpesvirus ubiquitous in the adult human population. The strong evidence from these studies may contribute to the advancement of periodontitis research and the ultimate control of the disease.
    [Show full text]
  • Vascular Endothelial Growth Factor: a Translational View in Oral Non-Communicable Diseases
    biomolecules Review Vascular Endothelial Growth Factor: A Translational View in Oral Non-Communicable Diseases Sven Niklander 1 , María José Bordagaray 2,3, Alejandra Fernández 2,4 and Marcela Hernández 2,5,* 1 Unit of Oral Pathology and Medicine, Faculty of Dentistry, Universidad Andres Bello, Viña del Mar 2520000, Chile; [email protected] 2 Laboratory of Periodontal Biology, Faculty of Dentistry, Universidad de Chile, Santiago 8380544, Chile; [email protected] (M.J.B.); [email protected] (A.F.) 3 Department of Conservative Dentistry, Faculty of Dentistry, Universidad de Chile, Santiago 8380544, Chile 4 Unit of Oral Pathology and Medicine, Faculty of Dentistry, Universidad Andres Bello, Santiago 8320000, Chile 5 Department of Oral Pathology and Medicine, Faculty of Dentistry, Universidad de Chile, Santiago 8380544, Chile * Correspondence: [email protected]; Tel.: +56-929-781-833 Abstract: Vascular endothelial growth factors (VEGFs) are vital regulators of angiogenesis that are expressed in response to soluble mediators, such as cytokines and growth factors. Their physio- logic functions include blood vessel formation, regulation of vascular permeability, stem cell and monocyte/macrophage recruitment and maintenance of bone homeostasis and repair. In addition, angiogenesis plays a pivotal role in chronic pathologic conditions, such as tumorigenesis, inflam- matory immune diseases and bone loss. According to their prevalence, morbidity and mortality, inflammatory diseases affecting periodontal tissues and oral cancer are relevant non-communicable diseases. Whereas oral squamous cell carcinoma (OSCC) is considered one of the most common cancers worldwide, destructive inflammatory periodontal diseases, on the other hand, are amongst the most prevalent chronic inflammatory conditions affecting humans and also represent the main cause of tooth loss in adults.
    [Show full text]
  • The Performance of a Screening Test for Urgent Dental Treatment Need In
    The performance of a screening IN BRIEF • Highlights the diffi culties in undertaking RESEARCH research in prisons. • Screening prisoners for dental conditions test for urgent dental treatment in ‘high turnover’ prisons is not effective. • Details the reasons why prisoners are a need in a prison population high need, diffi cult to engage population. K. M. Buchanan,1 K. M. Milsom,2 L. Zoitopoulos,3 A. Pau4 and M. Tickle5 Objective To compare the performance of a questionnaire-based assessment of dental pain delivered by non-dental prison nursing staff against a clinical examination performed by an experienced prison dentist (gold standard). Set- ting The research fi eldwork took place in the healthcare department at HMP Brixton located in South London. Methods The cohort were those who had complained of dental/facial pain to the prison authorities and were therefore placed on the waiting list for emergency dental care. Subjects were asked to complete the screening test and were then clinically examined by trained and calibrated dentists. The screening test was in the form of a 12-item questionnaire designed to categorise a population reporting dental pain into one of three groups. The screening test results were compared with the diagnosis of a clinical examination. Results Ninety-six subjects were recruited during the 16-week study period. Of the 96 prisoners recruited, 27 of those failed to complete the screening test and/or the diagnostic examination even though they had reported pain previously . When sensitivity and specifi city values were calculated for the 96 prisoners recruited, the sensitivity was fairly high (81%) and the specifi city was poor (33%).
    [Show full text]