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Bill Devine, DMD
What dentists should know about sickle cell disease.
Tex Dent J. 2013 Nov;130(11):1123-7
Authors: Devine BP
The medical history should be a communication between the patient and the dentist. A good history will reveal a patient's medical problems,concerns, ideas, and expectations. Understanding medical conditions on a patient's medical history is of up most importance in providing the patient with the best possible standard of care. Sickle cell disease is an inherited blood disorder that affects red blood cells. Normal red blood cells contain hemoglobin A. People with sickle cell disease have red blood cells containing mostly hemoglobin S, an abnormal type of hemoglobin. These mutated sickle cells do not have the smooth motion needed for oxygenation and deoxygenation. One of the main concerns in sickle cell disease is the reversible extreme pain episodes called “sickle cell crisis.”Pain episodes occur when sickle cells clog small vessels, depriving the body of adequate blood and oxygen. Treatment of the sickle cell patient should be a team approach between dentist,patient, and physician. Dental treatments should be conservative and stress free for the patient.Prevention of dental disease and infections are of the up most importance to the sickle cell patient.If your patient has sickle cell disease, know about it and talk to your patient about the disease.Maintaining excellent oral health to decrease the possibility of oral infections will ensure the best care for these patients.Key words: communication, sickle cell disease (SCD), sickle cell anemia (SCA), blood inherited disorder, sickle cell trait, crisis, African Americans, deoxygenation, hemoglobin,supporting dentist, prophylactic antibiotics, and infection.
PMID: 24400417 [PubMed - indexed for MEDLINE]
Are you ready for the betel nut?
Tex Dent J. 2012 Aug;129(8):767-9
Authors: Devine BP
As Texas becomes more diverse in its urban populations, dentists should educate themselves on their diverse patient base, including its cultures and cultural habits. The betel nut is chewed by more than 10% of the world's population and the oral care of these patients present many unique challenges. Other cultural beliefs can represent years of ideas passed on from one generation to another and need to be respected. Education is an excellent way of changing harmful cultural habits.
PMID: 22988662 [PubMed - indexed for MEDLINE]
Reaching the Texas dental goals of healthy people 2010.
Tex Dent J. 2011 Dec;128(12):1255-9
Authors: Devine B
BACKGROUND: The U.S. Department of Health and Human Services has promoted Healthy People 2010, which is a set of national health objectives for the nation to achieve over the first decade of the new century (1). Texas has not yet met its target of 50 percent of 8-year-old children with dental sealants having been placed on their 6-year molars, which is one of the Healthy People 2010 goals. An assessment of the dental needs of children in Tarrant County, Texas, was initiated by the JPS Health Network (named after John Peter Smith). The JPS Health Network established the Healthy Smiles program to address the dental needs of the students in this county because a school based dental sealant program would be effective in reducing dental decay.
METHODS: Approved Title One elementary schools in Tarrant County were scheduled for dental screenings, education, and fluoride and dental sealant applications. Students were given visual dental screenings and classified as to future dental needs. First grade students received fluoride varnish and second and third grade students received fluoride and dental sealants.
RESULTS: For the 2010-2011 school year: A total of 28,322 students were seen by dental professionals from the JPS Health Network; 8,348 dental sealants were placed; and 11,825 fluoride applications were given by dental staff.
CONCLUSIONS: The JPS Health Network Healthy Smiles Program proved to be an effective way to deliver oral preventive care and dental education to a large number of low-income students.
CLINICAL IMPLICATIONS: Dental caries prevention programs such as Healthy Smiles could help Texas reach its goals for improved oral health for the children of Texas.
PMID: 22375443 [PubMed - indexed for MEDLINE]