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A dental team-care concept that incorporates the problem-oriented system has been instituted at The Medical College of Pennsylvania. The program, as described, is designed to achieve the following goals: 1) to enhance communication between doctors and auxiliaries and thus maintain continuity in patient care and improve the quality of care; 2) to identify all problems related to the care of a patient; 3) to evaluate the educational and technical ability of the residents and students; 4) to achieve an effective dental auxiliary utilization program; 5) to increase faculty involvement in the delivery of patient care; 6) to organize an effective system of peer review; 7) to maintain complete, accurate and systematic medical-dental records; and 8) to encourage an interdisciplinary approach to health care delivery.

The purpose of this research was to develop further information relevant to the problem of utilization of dental services at neighborhood health centers. The research objectives were: (1) A descriptive assessment of the utilization trends of the population served by a neighborhood health center; (2) Some determination of any possible correlation between failed appointments and patients' satisfaction with dental care; and, (3) Some exploration of possible reasons for non-utilization of scheduled dental appointments by a sample of patients from the neighborhood health center who report a history of previous dental treatment. From dental clinic daily appointment sheets, an assessment of utilization trends of a neighborhood health center population for a seven-month period (jon trends of a neighborhood health center population for a seven-month period (June 1, 1973 to December 31,1973) was obtained. In addition, analyses of patient treatment records and information obtained from personal interviews with 40 individuals from the health center population facilitated the completion of the second and third research objectives. The results indicated: (1) Compared to the findings of earlier research,-3 the reported ratio of broken to total appointments scheduled for this study population was substantially lower; (2) There is a rather strong relation between satisfaction with care and the utilization of dental services at the neighborhood health center studied; (3) Satisfaction with care is dependent upon a number of factors; and (4) Reasons given for nonutilization of scheduled dental services are practical ones, of which some are also reflected in the reasons given ofr dissatisfaction with dental care.

With increasing frequency, dentists are being called upon to assist in the identification of victims of mass disasters. The fundamental procedure in dental identification is the comparison of teeth filled and teeth missing, between the ante-mortem and post-mortem dental records. When fragmentation occurs this procedure is time-consuming and arduous. Theproposed program will sort and store all ante-mortem dental information. On demand, any post-mortem record can be compared to all the ante-mortem records. The computer will eliminate all impossible matches and print a list of possible candidates for dental identification. This program can be used at a remote site by using a telephone/ teletype connection to the computer. Suitable ante-mortem and post-mortem record charts are also presented. Although the dentist remains in complete control of the actual identification procedure much of the tedious filing, sorting and comparing can be done efficiently and quickly by a computer. This computerized identification package was tested on data from an actual air disaster.

The planning, development, and implementation of a limited dental care program for indigent children in a 13-county region of Tennessee and Georgia are reviewed. Indigent children in a 13-county bistate region are receiving dental care from dentists participating in the Georgia-Tennessee Dental Project. Treatment including an oral examination, preventive services, and remedial dental care is offered to 6 year olds; the initial group of children enrolled in the project receive care on a maintenance basis. Children are treated by private dentists in their offices, salaried dentists in fixed clinics, and salaried dentists in mobile units. The project has begun a dental health education program and has made progress toward school and community water fluoridation.

The various possible types of identification of the victims of air accidents are considered, and the disadvantages of some are discussed. The frequency with which dental identifications can be made is considered and the various factors affecting the number of dental identifications in particular air accidents are described. The contributions that a forensic dentist may make in an air accident are mentioned.

The importance of reorganization for intravenous dental procedures, involving not only premises and equipment but also the dentist and his staff, is emphasised. These matters are discussed in detail with special emphasis on certain essential factors and psychologic aspects.

The development of a standardized method of collecting data from a questionnaire and a simplified, yet relatively complete, occlusal and temporomandibular examination form has been described. The questionnaire and clinical examination form have evolved from earlier forms developed by the author1 which have been used in numerous private offices and institutions for a period of five years. These earlier forms have now been augmented and modified as a result of personal consultation with users of earlier forms and numerous clinical and academic authorites.2-27 The selection of information to be obtained through the use of the questionnaire and clinical examination forms was further influenced by the work of numerous authors.28-63 Part II of this report deals with (1) the development of a companion Data Processing Form and a method of transcribing to this form the data from the Patient Questionnaire and clinical examination forms, as well as (2) key-punch instructions consistent with data processing requirements.

This paper describes the basic principles underlying the development of a computer program for the analyses of dental caries data. A data structure is described which is based on a definition of each tooth or tooth surface in the dentition, using a multi-dimensional co-ordinate system. The basic process for the computer to perform is to count the number of locations which fulfill certain predefined criteria. Programs developed according to these principles will yield exactly the output the individual user is asking for, no more and no less.

Dental identification of 78 victims of an air disaster was attempted. The procedures for examining the dental material, for obtaining dental charts and for the transmission of dental information are briefly discussed. Positive dental identification was possible in 50 cases, identification by dental exclusion in 8 cases, and identification by other means in 14 cases, leaving five cases unidentified. Various types of dental identification and dental evidence are considered, using evidence from conservation, prostheses, racial characteristics, age estimation, and identification by exclusion.

Assessment of the medical status of patients in general dental practice. A comparative survey of a questionnaire and verbal inquiry

The new recording system for the Danish Child Dental Services is based on registrations of clinical examination findings for all children receiving public dental care in pursuance of the Act on Child Dental Health. During the school year 1972/73, dental information was derived from about 84,000 children in 127 municipalities. Recordings applying to the children in the first grade were obtained from all participating dental services, some of which also reported the findings for earlier age groups or higher grades. National statistics, comprising def-s and DMF-S indices and plaque and gingivitis indices are presented. Similar statistics applying to the individual dental services have been made available to the participating services, and certain applications of this annual documentation are emphasized. No working time in the dental services was used solely for the purpose of obtaining the statistics, the examination findings for the individual children being used routinely in the clinic.

SYNOPSIS IN INTERLINGUA OCCLUSION IN JUVENILES CON PARALYsE CEREBRAL.—Esseva studiate comparativemente le occlusion de 124 juveniles con paralyse cerebral e de 141 juveniles sin ille defecto physic. Le incidentia de bruxismo inter le juveniles con paralyse cerebral esseva 44 pro cento, i.e., un incidentia plus que duo vices plus alte que in le gruppo de controlo. Morsura antero-aperte esseva presente in ambe gruppos, sed iste condition esseva plus sever in le gruppo con paralyse cerebral. A base de iste studio, on pote concluder quo malocclusion e factores afficiente le occlusion negativemente non se trova plus frequentemente in juveniles con paralyse cerebral.

M uch has been written recently about the impending flood of orthodontic patients expected when the various third-party programs of dental care are in full operation. Many states which provide dentistry under Title XIX legislation have already experienced an increased public demand for orthodontics. At the present time a cutback in federal funds has caused a reduction in most state dental programs under Medicaid. This condition is no doubt temporary, since it would be almost impossible to permanently curtail a social program so popular with the voting public. As economic conditions permit, we must expect a re-establishment and even an expansion of federally funded dental programs. In addition to Medicaid, there is another potential source of orthodontic patients which, over the near term, may prove even more expansive. This is the field of private prepaid dental plans. In this category are the commercial insurance companies, Blue Cross and Blue Shield, and the dental service corporations. It has been estimated that by 19’75, more than 50,000,OOO persons will be covered by some form of dental health insurance, which probably will include orthodontic treatment. Faced with the prospect of an increasing demand for orthodontic care, and realizing that funds for treat,mcnt as well as professional personnel may be inndeqnate, dental administrators have been searching for dependable ways to tncasu~u~‘c, record, ii~alyzc, i~~tl classify tlcntofaeial deviations on an epidemiologic basis. If predictions rclgardirig orthodontic dcmand are accurate, a priority system of treat.ment will be necessary. Obviously, it would be impossible to provide qualit,g orthodontic care for such vast numbers of children, even if adequate funds were available. The task of setting ol*thodontic treat,rnent priorities requires a system of measurement. or assessment of malocclusion which, for large-scale use, must be as objective as possible with clearly defined terms. It should furnish the necessary data without being so complex that t.raining examiners in its use t,akes long

Good denture service demands careful, systematic evaluation of existing conditions and recording of findings on a simplified but adequate chart. An intelligent plan of procedure cannot be formulated nor can effective treatment be provided if mouth examination is slighted. Favorable conditions cannot be weighed nor can unfavorable conditions be modified if they are not known. Patient evaluation is never neglected by a dentist with a sincere desire to succeed. All edentulous or partially edentulous patients cannot be treated successfully by the dentist alone. Many mouth conditions indicate a systemic disfunction. Therefore, consultation between the dentist and the physican is not only recommended but, for many patients, is mandatory. The dentist and the physician are striving for the same goal—total health care for the patient. This goal cannot be realized if the knowledge and experience of both the dentist and the physician are not fully utilized.

– The results of an evaluation of the W.H.O. recommendations for the assessment of dental caries confirmed that the method and the criteria are satisfactory. Attention is drawn to the limitations of df and DMF indices for predicting requirements for dental treatment, and the efficacy of a simple system for collecting information on requirements for care is described.

A need was recognized for a recording system to evaluate a patient’s oral hygiene performance. In a system developed to satisfy five requirements, plaque retention and bleeding points are used as the criteria for evaluation. Because the performance of the patient can be measured, parameters for an effective level of oral hygiene can be established.

A Brazilian dentist develops, trys out, and presents a simplified index of dental caries-experience.

Fundamental professional responsibility dictates the preservation of records of the features of the anterior part of the dentition and the facial contours. The cameo cast and profile card provide a patient with effective, valuable, and impressive records which are expressions of the dentist's concern for his natural esthetics and normal facial contours. Past performance indicates that an all-out effort is critically needed to make the preparation of such records routine procedure in the prosthodontic care of patients.

Clinical problems resulting from drug interactions are being seen with increasing frequency. The dentist must know what prescription and non-prescription drugs a patient is taking and be familiar with the properties of those drugs to prevent and detect interactions. Communication and cooperation between the dentist, physician, and pharmacist are essential in the provision of the most effective and the safest therapy for the patient. Potential interactions involving analgesics, antibiotics, and sedatives—the agents most commonly prescribed by dentists—are discussed.

Five methods for making pre-extraction records of the occlusal vertical dimension and three methods for making pre-extraction records of the maxillary incisor point were investigated to determine their reliability. The occlusal vertical dimension could be reproduced with a mean accuracy of 1.1 to 1.4 mm. The maxillary incisor point could be reproduced with a mean accuracy of 1.7 to 2.1 mm. There was no statistically significant difference between the methods. The potential for variation was much less for all of these methods than for the rest vertical dimension and interocclusal distance method now in common use. All methods were within limits of clinical usefulness, and each dentist should choose the most convenient method.

In this program for plaque control in the dental office, indexes are used to monitor the ability of patients to control the formation of plaque. The indexes are charted on graphs that already have predetermined goals indicated as a reference base. The graphs then serve as a long-term record to monitor the achievement of plaque control levels by patients.

Complete records of medical and dental characteristics and other personal data are being compiled for positive identification of lost in action personnel. Sources for the data include full-face photographs, dental health records, radiographs, and photographs of the dentitions.