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This study identifies those techniques most often utilized by pediatric dentists practicing in the Southeastern United States. It also assesses how the utilization pattern may have changed within the last five years, and identifies those factors that may have influenced the changes as perceived by the practicing dentists.A questionnaire was mailed to 528 pediatric dentists who were members of the American Academy of Pediatric Dentistry, or The Southeastern Society of Pediatric Dentistry, or both.The response rate after one mailing and one reminder was 64%. The majority of dentists utilized less aversive behavior management techniques (e.g., parents in the operatory and nitrous oxide oxygen) and had decreased or discontinued use of such controversial techniques as Hand-Over-Mouth-Exercise (HOME) and Hand-Over-Mouth-With-Airway Restriction (HOMAR). The majority of dentists reported that their reasons for changes in the utilization pattern for most techniques were parental influences and legal and ethical concerns.Chi square analysis indicated significant differences (P0.05) in the frequency of use of behavior management techniques and age of practitioner, American Board of Pediatric Dentistry status, type of specialty training, and type of practice.

Both assimilating into another culture and developing an understanding of our own culture require a process of several stages. With the goal of assisting in the cultural awareness training of home care staff, the author offers some academic theories concerning cultural transitions.

Oral sedation remains a common method for managing uncooperative and/or extremely fearful pediatric patients requiring dental treatment. The purpose of this retrospective review is to report on the adverse reactions associated with the use of two oral sedation drug regimens commonly employed in pediatric dental patients. Of a combined total of 73 different patient records, 112 sedation cases from the pediatric dental program at the University of Alabama School of Dentistry were reviewed for this report. The two drug regimens were (1) chloral hydrate/promethazine and (2) meperidine/promethazine. Documentation was taken from the sedation cases, which included the following: (1) age, (2) weight, (3) the drug regimen and dosages, (4) the use of nitrous oxide, (5) the effectiveness rating of each sedation, and (6) adverse reactions. The adverse reactions included emesis and oxygen desaturation (hypoxemia) the latter being determined by the use of a pulse oximeter. The results of the study revealed that approximately 48 percent of the sedation cases with pulse oximetry recordings experienced mild to moderate hypoxemia, and in 6.2 percent of the cases, emesis occurred. The review and statistical analysis of the sedation ratings using the nonparametric analog of the t-test indicated no significant difference of effectiveness between the two drug regimens. This study shows that oxygen desaturation occurs frequently in pediatric dental patients being treated with conscious oral sedation techniques and that the prevalence of adverse reactions was similar for the drug regimens evaluated.

A retrospective study was conducted at the University of Alabama in Birmingham Medical Center on patients diagnosed as having BE from the years 1969 to 1979, with emphasis on dental involvement. A major finding of this report revealed that 16 percent of the cases of BE had a history of recent dental care or pathology. Other results of this investigation included the following: (1) Streptococcus viridans was the predominant microorganism associated with BE; (2) the mortality rate relative to predisposing heart disease was highest for patients with prosthetic heart valves; (3) chronic valvular heart disease was the heart problem most susceptible to BE; (4) chronically abscessed teeth and periodontal disease may be initiating factors of BE.

Laboratory-scale biotreaters were used to study the effects of NH/sub 3/-N and PO/sub 4/-P nutrients on the activated sludge treatment of a chemical waste containing soluble calcium (1300 mg/L). Units receiving high or low levels of NH/sub 3/-N and PO/sub 4/-P were similar in their ability to remove organic compounds from the waste. Adaptation of sludges to low PO/sub 4/-P levels (

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