Psychometric Analysis of the European Medical Risk-Related History Questionnaire within Indonesian-Speaking Population.

Objectives: Medical complications during dental treatment are increasingly anticipated because advances in medical treatment have prolonged life expectancy. Therefore, a thorough analysis of medical history data to assess the medical risks that may occur before, during, and after dental procedures is required. The European Medical Risk-Related History (EMRRH) questionnaire has been used in 10 European countries to detect medical problems and determine the risks of complications.

[Tuberculosis in the dental office. Epidemiology, clinical view and prevention].

The expectation that tuberculosis would be eliminated in the Netherlands by about 2030 has been negatively adjusted due to a variety of factors. The incidence of pulmonary and extrapulmonary tuberculosis has even increased. The risk for oral health care providers to be exposed to tuberculosis has also increased.

[An inventory of knowledge on tuberculosis among dentists in the Netherlands].

By the nature of his work, a dentist has a higher risk of tuberculosis infection than the average Dutch population. Thus, the question arises whether dentists do have sufficient knowledge on tuberculosis. In order to determine their knowledge, an inventory was conducted among a sample of dentists in the Netherlands.

[Miscommunication during the treatment of a medically compromised patient].

A 42-year-old patient with cardiac problems had periodontal disease. The required periodontal treatment was only carried out after a period of 6 months. During this time, the patient was at risk of endocarditis due to a bacteraemia, a problem which was not recognized by any of the oral healthcare providers.

A patient-administered Medical Risk Related History questionnaire (EMRRH) for use in 10 European countries (multicenter trial).

Objective: The objective of this study was to produce a standardized medical risk-related history (MRRH) in order to identify the medically compromised patient (MCP) attending the general dental practitioner for treatment, to develop such a history (EMRRH), and to validate it in dental practices in 10 European countries.

Study Design: The Dutch MRRH, adapted to allow for legal and cultural differences of the participating countries was introduced. After consensus and repeated testing, the questionnaire was validated.

[Antibiotic prophylaxis for patients with joint prostheses].

In The Netherlands only patients with reduced defence mechanism are considered for antibiotic prophylaxis, and only in case of a total hip replacement. The extend to which the American indications will be applied in Europe, is at this moment unknown. It becomes more and more clear that the risk from providing prophylaxis is greater than the risk of a joint infection.

[Medical accidents in the dental practice. Survey of 471 dentists in the Netherlands].

Objective: To determine frequency and nature of medical accidents in Dutch dental practice in relation to type and time of treatment, with and without the use of the MRRH; frequency and nature of the professional assistance.

Method: Dentists MRRH-users (n = 51) and control dentists (n = 420) recorded medical accidents by name, using a registration form, followed by an anonymous survey.

Results: 91 accidents were reported by name by 471 dentists.

[Local anesthesia and patients presenting with medical pathologies; the use of anamnesis in the prevention of medical complications in the dental office].

The treatment of medically compromised patients is becoming a frequent event in general dental practice as a consequence of the longer presence of natural teeth, an increase in life expectation and a shift towards more ambulatory medical treatment of patients with chronic diseases. Since the dentist is responsible for a correct approach of these patients, it is important that he has knowledge of interactions between medical conditions, compensating mechanisms and medical treatment and the impact of dental treatment on this. In this context, medical history taking is useful.

Acute medical complications in 277 general dental practices.

Background: Due to the aging of the population on one hand and both medical and dental innovations on the other, the number of medical complications which occur during dental treatment is expected to rise. In order to prevent such complications, dental practitioners have used a medical risk-related history which includes risk determination and preventive measures (together the MRRH system). In this study, the medical complications which occurred in their practice have been compared with those recorded by a control group.

Introductory notes regarding a European Medical Risk Related History questionnaire (EMMRH) designed for use in dental practice.

The Medical Risk Related History (MRRH) has been in use for several years in the Netherlands. Since 1994 the MRRH system has been subject to research in nine European countries. Legal and ethical demands in all participating countries have been listed, and a national epidemiological analysis of pathology interfering with dental treatment has been undertaken for every participant.

Stress in elective dental treatment: epinephrine, norepinephrine, the VAS, and CDAS in four different procedures.

This study focuses on progressive stress during defined, elective dental treatments, expressed in VAS, CDAS, and catecholamine excretion in urine. Fourteen male patients had avoided dental treatment for years; all were classified as ASA risk score I. The different dental sessions were: first visit after many years; check-up (nonpainful and nontraumatic); drilling and restoring under local anesthetics; drilling and restoring without local anesthesia; and extractions.

Characteristics of Prevotella intermedia-specific CD4+ T cell clones from peripheral blood of a chronic adult periodontitis patient.

Periodontitis is a chronic destructive inflammatory disease associated with periodontopathic bacteria. In addition, autoantigens such as collagen and heat shock proteins (hsp) have been suggested to play a role. Established periodontal lesions are characterized by dense infiltrations of immune cells such as cytokine-producing CD4+ and CD8+ T cells.

Detecting the medically compromised patient in dentistry by means of the medical risk-related history. A survey of 29,424 dental patients in The Netherlands.

Background: This study focuses on the detection of medically compromised dental patients in the Netherlands by means of a validated patient-administered medical risk-related history (MRRH). Due to social changes and scientific innovations in the past decade, more medically compromised patients will be needing special dental treatment.

Methods: The medical problems of 29,424 dental patients (age 18 years and over) from 50 dental practices in the Netherlands were registered by means of the MRRH.

Antigen-presenting properties of gingival fibroblasts in chronic adult periodontitis.

Chronic periodontitis is characterized by dense infiltrations of T lymphocytes in the connective tissue, which consists mainly of gingival fibroblasts. It is becoming increasingly clear that T lymphocytes and gingival fibroblasts are capable of influencing each other. For example, the T cell cytokine interferon-gamma (IFN-gamma) is able to induce MHC class II molecules on the surface of several cell types, including gingival fibroblasts.

Effect of a protein-rich meal on urinary and salivary free amino acid concentrations in human subjects.

The aim of the present study was to investigate whether in healthy volunteers acute changes in plasma free amino acid composition after a protein-rich test meal are reflected in the urinary and salivary concentrations of the corresponding amino acids. The ingestion of a protein-rich meal elicited a significant increase of plasma and urine amino acid concentrations. The postprandial salivary amino acid excretion showed only minor changes.

The validity of a medical risk-related history for dental patients in Belgium.

The aim of this study was to establish whether a patient-administered medical risk-related history (MRRH) for dental patients was valid. The MRRH, which was developed in the Netherlands, has now been tested in Belgium, where it was completed by total of 99 patients. Their answers were compared with the results of a verbal history, taken by a physician experienced in pre-assessment control.

Cardiovascular responses induced by dental treatment.

Changes in mean heart rate and mean systolic and diastolic blood pressure are induced in both the patient's anticipation of scheduled treatment and the actual dental treatment itself. Significant changes have been observed before application of a local anesthetic, during restorative treatment, during extractions, and when epinephrine-impregnated retraction cords were used. These cardiovascular responses may vary according to the local anesthetic used and the choice of vasoconstrictor.

[How much feedback is provided by the 'feedback post'? Four years of medical information provision to dental practitioners].

This article describes the 'Feedback Post AZIG', an institute to which dentists can turn for advice on medical questions. The frequency as well as the content of these questions, posed between 1991 and 1994, are considered. Dentist clearly have a need for medical feedback and this need increases every year.

[The significance of endocrine factors and microorganisms in the development of gingivitis in pregnant women].

40-100% of pregnant women suffer from the co-called pregnancy gingivitis. The cause of pregnancy gingivitis is possible multicausal: increased plasma female sex-hormones, alteration in dental plague and perhaps Prevotella intermedia in the subgingival plague, together with alteration of immunoresponse. Increasing levels of progesterone in the gingiva as well as estrogens due to specific receptors affect vascular permeability and exudation, provoke stasis of microcirculation, increase prostaglandine E2 formation in human gingiva.

Type-1 and type-2 CD8+ T-cell subsets isolated from chronic adult periodontitis tissue differ in surface phenotype and biological functions.

Cloning of CD8+ T cells expressing the alpha beta T-cell receptor from inflamed human gingiva revealed that at least two different subsets were found within the tissue and that these subsets were able to interact with each other. One subset produced high levels of interferon-gamma (IFN-gamma) and no interleukin-4 (IL-4) or IL-5, exhibited phytohaemagglutinin (PHA)- or anti-CD3-mediated cytolytic activity, and were CD28+. The other subset produced high levels of IL-4 in combination with IL-5, displayed no cytotoxicity and were CD28-.