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Everyone must accept a certain measure of responsibility for dealing with personal stresses. This article suggests various active, constructive, self-help strategies. It specifically focuses on the advantages of adopting positive attitudes, maintaining a sense of humor, engaging in a variety of activities, identifying and relabeling stresses, and using multiple, active coping techniques. Demonstrating how professional psychologic counseling may help the individual in effectively dealing with personal problems, the article also defines and delineates counseling. It explains why one should seek professional help, tells how to select a counselor, describes the types of counseling available, advises ways to best utilize the counseling process, and discusses the length and costs of treatments.

This is the second part of a two-part series reviewing the published literature of smokeless tobacco in the United States. The article explores smokeless tobacco as a pharmacologically addicting substance, educational interventions designed to prevent use or help users quit, and outlines areas of future research.

Tongue scraping and brushing have been practiced for hundreds of years but are still little appreciated or used by the public. Throughout the centuries, tongue scrapers have been constructed of thin, flexible strips of wood, various meals, ivory, mother-of-pearl, whalebone, celluloid, tortoiseshell, and plastic. Recent scientific evidence has validated the need to practice habitual and thorough tongue brushing as part of daily home oral hygiene procedures.

Oral gonorrhea is not a commonly reported entity. A case of stomatitis associated with an oral Neisseria infection and concomitant with a trichomonal vaginitis in a sexually-promiscuous 30-year-old Caucasian woman is described. A second case of gonococcal pharyngitis in a 21-year-old Caucasian man is also reported. The clinical and laboratory findings, differential diagnosis, and treatment of gonococcal infections are briefly reviewed.

Alcoholic dental patients are commonly encountered by the practicing dentist. This chapter was written to help the practitioner understand the nature of this highly complex, progressive illness and how to recognize these patients prior to treatment. Dental personnel must understand how alcoholism affects the individual systemically and how this serious condition affects routine dental care. Oral problems commonly experienced by these patients were discussed, with suggestions being given on how to adjust treatment modalities. Furthermore, the dentist must become acutely aware that alcoholism is a problem suffered by many fellow dental professionals as well.

A double-blind clinical trial was conducted to determine whether the use of a chewing gum containing 2.0 mg nicotine (as an adjunct to a stop-smoking program) had any effects upon oral health. A total of 193 adults who smoked cigarettes volunteered with informed consent, were given routine dental prophylaxes, and were examined for the presence of plaque, stained pellicle, gingivitis, calculus, and general oral pathosis. The subjects were then randomly assigned to use either a nicotine-containing or a placebo chewing gum. After 15 weeks the subjects were recalled and re-examined. Smoking cessation was determined through questionnaire and analysis of the carbon monoxide content of alveolar air. At the completion of the study, 79 subjects had used the placebo gum and 78 had used the nicotine gum. Data analysis indicated that the nicotine chewing gum had no significant influence on any of the oral health parameters graded, as compared to the placebo gum. The continuation of smoking, however, was associated with significant increases in gingivitis and calculus rates.

A social network support system consists of a set of dynamic, ongoing relationships between the individual and significant others from one's immediate family, relatives, friends, work associates, or others. Through meaningful human interaction, these supportive individuals help meet a person's basic social needs by providing socioemotional aid (acceptance, affection, emotional understanding, empathy, and esteem), instrumental aid (advice, information, help with family or work responsibilities, financial aid), or both. This article provides an in-depth review of social support, explains the dynamics and importance of a viable social network system, and discusses its limitations. A number of selected topics receive special consideration: the social isolation of dentists, social support provided by one's spouse, some social aspects of female dentists, the individual's need for privacy, and personal space and loneliness.

The use of smokeless tobacco (ST) within the United States has increased greatly in recent years, especially among adolescent boys and young men. Recent national data completed from several large scale studies indicate that 10-12 million Americans use some form of ST. Representing a significant systemic and oral health risk, ST usage can produce a wide range of negative effects on both soft and hard oral tissues. These oral conditions include bad breath, discolored teeth and restorative materials, excessive tooth surface wear (abrasion), decreased ability to taste and smell, gingival (gum) recession, advanced periodontal soft and hard tissue destruction, tooth loss, soft tissue erythema and leukoplakia. Long-term ST usage is directly correlated to an increased risk of cancer of the mouth, larynx, throat and esophagus. Much of the destruction of oral tissues is related to the localization of the tobacco quid; i.e., it is habitually held in only one spot in the mouth. Nicotine from ST can activate the sympathetic nervous system thereby significantly increasing heart rate, blood pressure, cardiac stroke volume and output and coronary blood flow. A common misconception is that ST is a 'safe' alternative to smoking cigarettes. Several recent Surgeon General's Reports list ST as being addictive. It is highly possible that ST users will 'graduate' to cigarettes if they eventually conclude that these products are socially unacceptable, inconvenient or out of vogue. Health professionals, educators, parents and schoolchildren need to be informed about the significant health risks associated with ST use.

This study represents the first, comprehensive baseline survey of dental needs conducted in the US Air Force. The air force population was stratified by command, base, and grade, and 5,805 active duty air force members, aged 17 to 57 years (mean, 27.83), were examined at random to determine their overall oral health status. Data were collected from 42 air force bases, representing 11 worldwide commands, which comprised 90% of all active duty members. This article presents the methodology for the study, a summary of the findings, and a comparison of dental needs among recruits and all other grades of active duty air force personnel. Results indicate a significant level of unmet dental needs in the US Air Force. For example, the average active duty individual presently serving in the air force would require eight hours and 48 minutes of chairside care to provide comprehensive treatment. Each entry level recruit would need an average of ten hours and 23 minutes of dental treatment.

This study evaluates the impact of a pipeline assessment (salivary cotinine determination) on the accuracy of self-reported use of cigarettes and smokeless tobacco by 160 rural seventh- and eighth-grade males ranging in age from 12 to 16. Half of them were randomly assigned to complete a questionnaire on tobacco use prior to revealing the biochemical validation materials and collecting samples. The others had the samples collected prior to receiving and completing the questionnaires. The questionnaire-first group reported significantly greater smokeless tobacco use than did the pipeline-first group. Only for the latter were their self-reports significantly corroborated by the cotinine results. These results suggest that the utilization of a biochemical pipeline not only can improve self-reported tobacco use but also may help identify perceptions about the social desirability of using harmful substances.

Snuff dipping and tobacco chewing are rapidly gaining popularity in the United States. They are being heavily promoted through mass media advertising. Advertising spots on radio, television, and in the printed media use well-known sports personalities and entertainers to act as spokesmen for smokeless tobacco. Despite the esthetic drawbacks of these social acceptance. This is being accomplished, at least in part, through a skillful manipulation of the public by the tobacco industry. Use of smokeless tobacco is rapidly increasing, especially among young male athletes and students in high school and college. Advertising implies that smokeless tobacco habits are innocuous and safe. They are not. Smokeless tobacco products have shown that potential for causing cancer of the oral cavity, pharynx, larynx, and eophagus. A review of the medical and dental literature has shown 646 cases of cancer associated directly with smokeless tobacco. Smokeless tobacco can produce significant effects on the soft and hard tissues of the mouth, including bad breath, discolored teeth and restorations, excessive wear (abrasion) of the incisal and occlusal surfaces of the teeth, decreased ability to taste and small, gingival recession, advanced periodontal destruction of the soft and hard tissues, erythema of the soft tissues, leukoplakia, and cancer. Health professionals are urged to advise their patients concerning the hazards of using smokeless tobacco and to take a strong public stance in opposition to the current advertising campaigns aimed at youth. The professions should demand that smokeless tobacco products print health warning labels on the packages and in advertising copy. Finally, patients should be taught how to recognize signs of breakdown of the soft and hard tissues.

One hundred six edentulous subjects were given nicotine-containing chewing gum to evaluate the ability to chew the gum, to observe the adherence of the gum to denture-base materials, and to evaluate the effect of gum chewing on denture-bearing tissues. Prior to the 13-week study, the denture-bearing ridges and the tissue and polished surfaces of the denture were evaluated clinically and photographed. Questionnaires were used to elicit personal habits of the subjects. Of the 59 subjects completing the study, most could manipulate and chew the gum effectively, three-fourths reported that gum adherence was not a problem, and no adverse reaction to oral tissues was observed.

At least in part, through a skillful manipulation of the public by the tobacco industry, the use of smokeless tobacco is rapidly increasing, especially among young male athletes and students in high school and colleges. Advertising implies that smokeless tobacco habits are innocuous and safe, but existing scientific evidence indicates that dipping and chewing are potentially harmful to one's health. Health professionals are urged to advise patients and students concerning the potential hazards of using smokeless tobacco. Further, health professionals should take a strong public stance in opposition to the current dipping and chewing advertising campaigns aimed at youth. These advertisements totally ignore the possible health hazards of smokeless tobacco. If the tobacco companies are allowed to continue to advertise smokeless tobacco in the same manner that they use to promote cigarette smoking, then some effort should be directed to require health warnings in these advertisements. In fact, some serious consideration should most likely be given to banning this new wave of tobacco marketing in the interest of public health, just as was the case with cigarette advertisements, especially in light of the fact that these ads are primarily targeted to young boys and men.

Dentists should be aware that snuff dipping or chewing is increasing in southern states and perhaps in other sections of the United States. These habits can lead to clinical leukoplakia, gingival recession, tooth abrasion, and periodontal bone destruction. The possibility also exists that a malignant transformation of leukoplakia can develop in persons who use snuff and other forms of tobacco.

This study was designed to compare various salivary parameters between smokers and non-smokers and to determine the influence of a nicotine-containing chewing gum (used to aid in quit-smoking efforts) upon these same parameters. At the baseline examination, subjects were assigned to one of three groups: non-smokers who did not utilize any gum, smokers provided a nicotine-containing gum, and smokers provided a placebo gum. Saliva was collected from all subjects and analyzed for acidogenicity and buffer pH as well as for levels of thiocyanate, lactoperoxidase, lysozyme, lactoferrin, and secretory IgA. After 15 weeks of gum usage, saliva was again collected from each subject and the identical analyses performed. Significant differences were observed between smokers and non-smokers with regard to three parameters: The saliva of smokers contained greater concentrations of thiocyanate and lower concentrations of lactoferrin, at the baseline examination and after the 15-week test period. In addition, the CO content of alveolar air was higher in smokers at both examination periods. In contrast, the use of the nicotine gum per se had no effect on any of the test parameters.

In the late 1960's, preventive health care began to gain in popularity in the United States and the movement carried over into the 1970's. During this time, sizable decreases in deaths from heart disease, strokes, and accidents have been noted. As a result, the lowest death rate in the history of this country (8.9 per 1000) occurred in both 1975 and 1976. Since 1970, an increase in longevity has been documented and it can be said that Americans are living longer--not just longer but hopefully better! People are beginning to learn that "it is not so much that we die, we kill ourselves!" With proper weight, diet, and exercise, avoiding tobacco, early detection and treatment of high blood pressure, use of seat belts, and control of stimulants and drugs, thousands of lives are being saved annually. In today's busy and demanding society, success in any field requires more than just education and hard work. It requires good health, both mental and physical. Pursue these goals vigorously and remember, "It is always cheaper and much easier to maintain good health than it is to regain it once it is lost!"

Fifty private practitioners and their office staff members were randomly assigned to one of four groups: participants received a protocol for smoking management and a lecture on the consequences and management of smoking, or in addition, had nicotine gum freely available to patients, had stickers attached to their charts, or had gum and reminders. The percentage of patients in each group who had quit smoking a year later was 7.7, 16.3, 8.6, and 16.9, respectively, indicating a significant main effect for the gum conditions. The availability of nicotine gum also significantly increased the amount of time that patients reported they received smoking cessation counseling from the dentists and office staff.