Special Care in Dentistry

Publisher: American Association of Hospital Dentists; Academy of Dentistry for the Handicapped; American Society for Geriatric Dentistry, Wiley

Journal description

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Other titles Special care in dentistry (Online), Special care in dentistry, SCD
ISSN 1754-4505
OCLC 60617777
Material type Document, Periodical, Internet resource
Document type Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details

Wiley

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    • Must link to publisher version with set statement (see policy)
    • If OnlineOpen is available, BBSRC, EPSRC, MRC, NERC and STFC authors, may self-archive after 12 months
    • If OnlineOpen is available, AHRC and ESRC authors, may self-archive after 24 months
    • Publisher last contacted on 07/08/2014
    • This policy is an exception to the default policies of 'Wiley'
  • Classification
    ​ yellow

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Describe the methodology used to construct tools for standardized data collection of head and neck cancer patients (HNCP). We constructed the Oral Health Evaluation Tool (OHET) and Panoramic Radiograph Evaluation Tool (PRET) for systematic collection of long-term oral clinical/radiographical complications, prevalence, and severity. Tools were pilot-tested in 50 chemoradiation-treated HNCP >6 months post-therapy. Tools allowed for collection of extensive clinical and radiographical data. A medium of 1.9 years had elapsed since chemoradiation completion. Patients had a median of 6 missing teeth, 32.7% had no decay and a medium of 30% had filled surfaces; 42.9% had moderate-to-severe decay. Reduced/thickened saliva was noted in 85.4% and dry mucosa in 93.9%. Gingival bleeding was present in 75.5% HNCP and attachment loss in 86%. Four patients had trismus. Tools were user friendly and provided comprehensive, reproducible, and inexpensive means to evaluate post-therapy oral health of HNCP. Validation testing is ongoing. © 2015 Special Care Dentistry Association and Wiley Periodicals, Inc.
    Special Care in Dentistry 07/2015; DOI:10.1111/scd.12125
  • Special Care in Dentistry 07/2015; 35(4):149-50. DOI:10.1111/scd.12119
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    ABSTRACT: This survey compared the status of oral health service access and needs for adult Physical Medicine & Rehabilitation (PM&R) patients over a 40-year period. This report compares two surveys (1974 vs. 2014) of Directors of PM&R residency programs in the United States. The same 14 survey questions used in 1974 survey were repeated in 2014, with four new questions added. The major comparative findings about oral health services were that while perceived need remained high and availability and adequacy of dental care remained low, program directors indicated a slightly lessened desirability, feasibility and overall support for the concept of integrating oral health services into their PM&R program in the 2014 survey. These findings show that 40 years has not brought better access to oral health care for adult PM&R patients, only a slightly lessened enthusiasm in the program directors. Future research should explore the reasons underlying these disappointing outcomes. © 2015 Special Care Dentistry Association and Wiley Periodicals, Inc.
    Special Care in Dentistry 06/2015; DOI:10.1111/scd.12123
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    ABSTRACT: To present a rare case of a male dementia patient in a nursing home who swallowed a partial denture which lodged in the airway. During breakfast, a patient with moderate dementia experienced a sore throat, labored breathing, and difficulty swallowing. Uncertainty about the cause of these problems was exacerbated by the patient's cognitive losses, his reduced oro-motor function, and awareness of caregivers that the possible involvement of a denture of this size was unlikely. At the beginning of the third day, he developed a low-grade fever and was placed on antibiotics. A chest x-ray was negative. On the fourth day, a flexible endoscopic evaluation of swallowing was performed, which revealed the partial denture resting in the hypopharynx on the patient's vocal cords. Along with pneumonia and viral bronchitis, a swallowed denture needs to be in the differential diagnosis of a dementia patient experiencing difficulty swallowing. Nursing home caregivers be aware that even a sizable partial denture can be swallowed and extra vigilance is essential in caring for dementia patients. © 2015 Special Care Dentistry Association and Wiley Periodicals, Inc.
    Special Care in Dentistry 06/2015; DOI:10.1111/scd.12121
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    ABSTRACT: Weaver syndrome is a rare condition characterized by accelerated growth, advanced osseous maturation, and distinct craniofacial features that can occur in both males and females. Etiology is unknown and no definitive oral characteristics have been established. The objective of this case report is to describe the oral and radiographic findings of a 14-year-old male with Weaver syndrome. A comprehensive dental examination was performed under general anesthesia. The clinical findings were: severe generalized heavy plaque with subgingival calculus, gingival edema, malocclusion and maxillary atresia, mild micrognathia of the mandible, enlarged tongue, and bifid uvula. Clinical and radiographic caries were not found. Out of over 40 possible cases of Weaver syndrome previously reported in the literature, only two were related to the oral cavity. Bifida uvula was not mentioned until now as clinical findings associated with the syndrome. Autism, macroglossia, and cleft palate were seldom mentioned. The oral manifestations in Weaver syndrome are not yet well known. Future studies will be required to improve the subject matter. © 2015 Special Care Dentistry Association and Wiley Periodicals, Inc.
    Special Care in Dentistry 06/2015; DOI:10.1111/scd.12122
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    ABSTRACT: Osteoradionecrosis (ORN) is an unfortunate complication of radiation therapy to the head and neck. Treatment has historically centered around hyperbaric oxygen therapy and surgical removal of necrotic bone. Recently, a new theory on the pathogenesis of ORN has proposed treatment with pentoxifylline (PTX) and tocopherol/vitamin E. The aim of this retrospective analysis was to evaluate the effectiveness of pentoxifylline and tocopherol in the management of patients with ORN. The hospital dentistry group managed 13 patients that presented to our service with exposed bone after cancercidal doses of radiation to the head and neck. The patients were prescribed PTX 400 mg bid and tocopherol 1,000 IU QD. Eleven of the 13 patients exhibited improvement and resolution. No adverse events were noted during treatment. This medical modality of treating ORN appears safe and effective, inducing bone and mucosal healing. © 2015 Special Care Dentistry Association and Wiley Periodicals, Inc.
    Special Care in Dentistry 06/2015; DOI:10.1111/scd.12124
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    ABSTRACT: This study aimed to understand how patients perceive their oral health and the resulting oral manifestations of antineoplastic chemotherapy, as well as to analyze the impact of these alterations on oral health-related quality of life. A total of 80 patients undergoing treatment participated in this study. A questionnaire was applied using the Oral Health Impact Profile (OHIP-14) index and open interviews. Items with the highest impact prevalence included "worsened taste of food sensation" (35.00%), "discomfort in eating food" (20.00%), and "feeling stressed" (17.50%). The outpatients showed the highest prevalence scores, whereas the inpatients presented higher quality of life impact severity. The ways in which the patients perceived how their oral alteration affected their quality of life were distinct and subjective. It is important that dentists act together with a multiprofessional team developing strategies to alleviate the impact of the disease and chemotherapy on oral cavity and patients' quality of life. © 2015 Special Care Dentistry Association and Wiley Periodicals, Inc.
    Special Care in Dentistry 05/2015; DOI:10.1111/scd.12113
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    ABSTRACT: The aim of this paper was to explore the experiences of adults with developmental disabilities (AWDD) in accessing and utilizing dental services in Vancouver, BC. Participants were either self-advocates or parents/caregivers who discussed their experiences in five focus group discussions with 20 participants in total (age range 17-60 years, 2 males). Each focus group lasted on average 40 minutes. Transcripts were coded for thematic analysis; the codes were organized into themes and finally into domains. Seven domains relating to the participants' experiences with dental care were identified, and included communication, trust, and respect as provided-based domains to the quality of the dental experience for AWDD and their parents, while financial issues, transitional services, and waiting times were system-based barriers to access to dental care for theses AWDD. Finally, what makes for a positive dental experience was shared in terms of acknowledging parent's role as advocates and making simple accommodations to see AWDD by the dental office. Access to a care provider did not necessarily equate to satisfaction with quality of experience. Efforts have to focus on establishing communication and trust with AWDD patients as key to a positive dental experience. We encourage a global discussion on the need to better incorporate dental care for special needs individuals within dental school curricula. © 2015 Special Care Dentistry Association and Wiley Periodicals, Inc.
    Special Care in Dentistry 05/2015; DOI:10.1111/scd.12115
  • Special Care in Dentistry 05/2015; 35(3):91. DOI:10.1111/scd.12111
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    ABSTRACT: PurposeTo present patient reported changes in oral symptoms in response to an open-label product trial conducted in patients self-identifying as having Sjögren's syndrome.MethodsA survey was conducted in conjunction with the Sjögren's Syndrome Foundation and 151 foundation members completed a survey rating their common oral symptoms, based upon the Vanderbilt Head and Neck Symptom Survey before and after use of the trial products, including rinse, ­lozenges, gel, and spray.ResultsSubjects reported multiple oral symptoms with the highest rated symptoms involving dry mouth with 80% of symptoms showing statistically significant reduction from pre- to posttest. The largest symptom reductions were in dry mouth symptoms and dietary problems.Conclusions Symptoms of dry mouth were improved with use of MedActive® products. Increased ease of taking oral medications also was reported. Improvement in mouth/throat pain was noted. Subjects reported considerable effect of the test product upon dry mouth and oral symptoms.
    Special Care in Dentistry 05/2015; DOI:10.1111/scd.12112
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    ABSTRACT: The scientific literature cites wide health disparities for people with intellectual disabilities compared to the general population. This study seeks to gain an understanding of the effects of income status on oral health in a global population of people with intellectual disabilities. Eighty-two thousand five hundred and seventy Special Olympics athletes were screened and eligible for inclusion in this study. The main exposure (income status) and selected oral health signs and symptoms (missing teeth, untreated decay, injury, gingivitis, and mouth pain) were used to conduct a cross-sectional analysis. Prevalence odds ratios were obtained through logistic regression. Study participants from low-income countries experienced adverse health outcomes at a lower rate than expected. Study participants from upper middle, lower middle, and low-income countries had higher odds of mouth pain and untreated decay, yet lower odds of missing teeth, injury, and gingivitis, than participants from high-income countries. Overall, a great number of individuals from every income group required maintenance or urgent care. Oral health problems are not exclusive to low-income study participants. Unexpectedly high odds of missing teeth, injury, and gingivitis in high-income countries may be attributed to the high proportion of participants from the United States, which is considered a high-income country but has large income disparities. Health-determining circumstances in low-income countries provide some protection from the hypothesized gradient of oral health for all measured outcomes. © 2015 Special Care Dentistry Association and Wiley Periodicals, Inc.
    Special Care in Dentistry 04/2015; DOI:10.1111/scd.12114
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    ABSTRACT: To explore factors that motivate and/or discourage use of dental care among low-income minority older adults METHODS: Participants were recruited from low-income senior housing in Hartford, CT. In-depth semistructured interviews were conducted to obtain data on demographics, oral health status, oral health knowledge, and factors that affected use of dental care. Seventeen participants completed interviews. The major perceived barriers to dental care were cost/lack of dental insurance, fear/mistrust of the dentist, and transportation problems. Other factors included having complex medical conditions, no perceived need for care, and lack of knowledge about the importance of dental care. Participants would like to have dental care provided on-site in the housing complexes. Improving communication between dentists and their older patients would help reduce fear and mistrust. Other health care providers could help educate older patients about oral health, conduct simple oral health screenings, and refer for acute and/or comprehensive care. © 2015 Special Care Dentistry Association and Wiley Periodicals, Inc.
    Special Care in Dentistry 04/2015; DOI:10.1111/scd.12109
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    ABSTRACT: The number of adults with developmental and acquired disabilities is growing and there are not enough general dentists treating special needs patients to meet the increased demand. In Oakland County, there are 140,160 persons registered with a developmental or acquired disability and only 36 dentists in the county that are indicated for treating patients with special needs. A survey was sent to 385 students, ages 3 to 26, at six special education schools and developmental centers in Oakland County. There were 117 responses. The most difficult barrier to oral healthcare that adult patients with special needs, encounter is finding a dentist willing to treat these complex patients. 20% of the surveyed population currently does not have a dentist. There is a correlation between decreased dental access and lower median income. There is a significant need for improving special care dentistry training and increasing the number of general dentists that are able and willing to treat adults with special needs. Adequate resources and a database can help caregivers, parents, and medical professionals locate dentists who treat special needs patients. Increased experience for general dentists through residency training and continuing education courses will help to increase confidence and knowledge in practice special care dentistry. © 2015 Special Care Dentistry Association and Wiley Periodicals, Inc.
    Special Care in Dentistry 04/2015; DOI:10.1111/scd.12110
  • Special Care in Dentistry 03/2015; 35(2):55. DOI:10.1111/scd.12108
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    ABSTRACT: Xerostomia is a common condition and can impair quality of life. Pilocarpine tablet ingestion can relieve dry mouth symptoms, but produces numerous adverse effects. We investigated the safety and efficacy of pilocarpine mouthwash. Forty elderly patients were randomly divided into a pilocarpine mouthwash or water rinse (control) group. Outcomes were assessed by visual analog scale (VAS) scores and stimulated salivary flow rate before and 1 month after treatment. Patients recorded all adverse effects. In the pilocarpine group, we evaluated safety in 24 patients and efficacy in 19 patients. In the water rinse group, we evaluated safety and efficacy in 14 patients. VAS scores were significantly reduced after pilocarpine mouthwash treatment (70 ± 12.9 to 47.9 ± 13.1, p < 0.05). Overall improvement was observed in 47% of the pilocarpine group compared to 14% of the controls (p < 0.05). Stimulated salivary flow rate significantly increased (0.71 ± 0.14 to 0.83 ± 0.12 mL/minute, p < 0.05) after pilocarpine mouthwash treatment. Five of 24 patients reported side effects after pilocarpine mouthwash use, predominantly limited to oral discomfort. Pilocarpine mouthwash relieved dry mouth symptoms and improved saliva production with minor side effects. © 2015 Special Care Dentistry Association and Wiley Periodicals, Inc.
    Special Care in Dentistry 02/2015; DOI:10.1111/scd.12105
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    ABSTRACT: The purpose of this study was to investigate perceived comfort levels, behaviors, and barriers reported by group home caregivers who provide oral hygiene measures to consumers with special health care needs (SHCN) who physically resist the care. A 24-item survey was sent to 884 caregivers employed at six care facilities in Iowa. Bivariate analyses and logistic regression models were used to analyze the data (alpha = 0.05). The overall response rate was 52%. An analysis of the data indicated that caregivers who felt more comfortable providing oral hygiene for consumers who physically resisted the care experienced a higher frequency of consumers not opening their mouths (p = 0.0003), pushing the caregiver away (p = 0.0002), moving their heads uncontrollably (p = 0.0004), spitting at (p = 0.0099), hitting and/or kicking the caregiver (p = 0.0011). Furthermore, these caregivers provided weekly direct care for a greater number of consumers (p = 0.0044), received oral care training from their current facility (p = 0.0424), brushed the teeth of uncooperative consumers at least 75% of the time (p < 0.0001), and felt “somewhat comfortable to very comfortable” flossing their teeth (p < 0.0001). The caregivers’ comfort level in providing oral hygiene measures to those consumers with SHCN who physically resist the care appears to be significantly associated with their training and experience working with this population.
    Special Care in Dentistry 01/2015; 35(3). DOI:10.1111/scd.12103
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    ABSTRACT: Aim: To determine effects of integrated dental care in older nursing home residents. Methods: In three nursing homes offering integrated dental care, we studied the oral treatment need of 355 residents older than 70 years. To determine effects of integrated care, we discriminated between short-stay residents (≤6 months) and long-term residents (>6 months). Results: Treatment need, determined intraorally by two dentists, remains high among short-stay residents (78%) and long-term residents (67%). The association between treatment need and length of stay was not significantly affected by indication for stay (somatic vs. psychogeriatric). All dentate residents needed oral treatment, except one long-term resident. However, among edentulous residents, particularly with a psychogeriatric indication for stay, treatment need appeared to reduce significantly in time, from 74% to 57%. Conclusion: Despite integrated dental care, oral treatment need remains in virtually all dentate residents and more than half of edentulous residents.
    Special Care in Dentistry 01/2015; 35(3). DOI:10.1111/scd.12104