Prostate MRI: access to and current practice of prostate MRI in the United States.

Purpose: MRI of the prostate has increasingly become more important in clinical medicine because of the risk of over-detection of low-grade, low-volume prostate cancer, as well as because of the poor sampling of transrectal ultrasound-guided prostate biopsy in high-risk patients. We sought to determine the access, imaging protocols, and indications for MRI imaging of the prostate in the United States.

Methods: A brief survey was sent through mailing lists to members of the Society of Abdominal Radiology and Texas Radiological Society.

The prevalence and risks of early childhood caries (ECC) in Toronto, Canada.

Aim: To determine the prevalence and risks of early childhood caries (ECC) among children less than 71 months of age in Toronto, Canada, and to evaluate the association between parental/caregiver depression and ECC.

Methods And Materials: A secondary analysis of data previously collected by the Toronto Public Health as part of the 2003 Toronto Perinatal and Child Health Survey was performed. The 90-item survey was conducted over the telephone to 1,000 families with children from zero years (birth) to six years of age.

A retrospective analysis of referral patterns for oral radiologic consultation over 3 years in Ontario, Canada.

Objectives: To determine the types of practitioners who most commonly refer and the film type and diagnostic entities that are most frequently submitted for oral radiologic consultation in Ontario, Canada.

Study Design: A total of 430 referral letters and responses from 2 Ontario oral radiologists from 2003 to 2005 were analyzed. Data collected included the specialty of the referring practitioner, the film type(s) submitted, the radiographic density of the entity of interest, and the interpretation by the radiologist.

A comparative study of the health care systems of Canada and Saudi Arabia: lessons and insights.

Introduction: Understanding the structure of a health care system is essential in improving public health policies and health outcomes.

Objectives: To describe and compare the health care systems of Canada and Saudi Arabia; to discuss possible lessons that could be learned from both for policy-making purposes.

Methods: A comprehensive method was used to describe the national health care systems of both countries.

Lack of oral care policies in Toronto daycares.

Objectives: Currently, there is a deficit of information on policies regarding oral hygiene practices in Toronto daycares. It is unknown if any tooth-brushing programs are in existence and if children are permitted to follow professional advice on oral hygiene. The main objectives of this investigation were to a) determine the prevalence of oral care policies in daycares and b) examine the availability of resources.

Severe dental caries, impacts and determinants among children 2-6 years of age in Inuvik Region, Northwest Territories, Canada.

In 2004-2005, 349 of 541 eligible, mostly preschool, children in the Inuvik Region in the Northwest Territories of Canada were examined clinically, and the parents or caregivers of 315 of these children were interviewed to measure their oral health status, and its impacts and determinants. Dental caries is a highly prevalent health problem among these preschool children in Inuvik Region: we found that 66% (230/349 children) had the disease and had, on average, 4.8 affected teeth, of which 2.

Introducing dental students to evidence-based decisions in dental care.

Practicing evidence-based dentistry is a process of lifelong and self-directed learning. Teaching evidence-based dentistry to dental students is the key to increasing the uptake of evidence-based treatments and practices in dentistry. This article describes the procedures undertaken to teach undergraduate dental students at the University of Toronto Faculty of Dentistry how to produce systematic reviews as a module in clinical epidemiology.

Structured or unstructured personnel interviews?

The challenge for health care managers is finding, hiring and retaining appropriately qualified and motivated employees. One useful method of gaining information about and insight into a candidate is interviewing, which can be classified as structured, unstructured or semi-structured. The disadvantages of unstructured interviews are reviewed; ways to enhance the psychometric properties of interviews by adding structure are reviewed and summarized; and the possible reasons for underutilization of structured interviews are explored.

Systematic review of the association between respiratory diseases and oral health.

Background: The purpose of this review was to investigate evidence for a possible etiological association between oral health and pneumonia or other respiratory diseases.

Methods: The following data sources were used: Ovid MEDLINE (In-Process & Other Non-Indexed Citations, Daily Update, and OLDMEDLINE); Cumulative Index to Nursing & Allied Health Literature; Evidence Based Medicine of Cochrane Central Register of Controlled Trials; Cochrane Database of Systematic Reviews; Database of Abstracts of Reviews of Effects; EMBASE; Health and Psychosocial Instruments; HealthSTAR; International Pharmaceutical Abstracts; PubMed; and Google Scholar from the earliest record until July 2005. Studies were selected from randomized controlled clinical trials and longitudinal, cohort, case-control, and epidemiological studies.

Is regular visiting associated with lower costs? Analyzing service utilization patterns in the first nations population in Canada.

Objectives: Using an administrative database of dental service records from the Non-Insured Health Benefits (NIHB) program of Health Canada for 1994-2001, the authors set out to test whether regular visitors had lower program expenditures.

Methods: The age-specific mean expenditures per client were compared among those with regular examinations in 8, 7 and fewer years. The study further examined the effect of regular visiting over the first 6 years on expenditures in the last 2 years.

Oral health care in Canada--a view from the trenches.

Purpose: Concern is increasing over the effect of lack of access to oral health care on the oral health, and hence general health, of disadvantaged groups. In preparation for a national symposium on this issue, key informants across Canada were canvassed for their perceptions of oral health services and their recommendations for improving oral health care delivery. This paper reports the results of that survey.

Why do we need an oral health care policy in Canada?

Although health care is a right of citizenship, severe inequities in oral health and access to care persist. This paper provides information on the financing, organization and delivery of oral health services in Canada. It concludes that dental care has largely fallen out of consideration as health care.

Prions in dentistry--what are they, should we be concerned, and what can we do?

Objective: To briefly review the characteristics of prions, the risk of transmission and implications for infection control in dentistry.

Methods: The literature on prion disease in the context of dentistry up to March 2005 was reviewed using the PubMed, MEDLINE, Cumulative Index to Nursing & Allied Health Literature, Google Scholar databases and the Web sites of the departments of health of countries affected by the disease.

Results: The sporadic form of Creutzfeldt-Jakob disease (CJD) is the most common human prion disease; the mean age of those affected to date is 68 years, the mortality rate is 85% within 1 year, and the average death rate is 1 per million persons.

The influence of dental insurance on institutionalized older adults in ranking their oral health status.

To assess whether dental insurance influences how institutionalized older adults ages 65 and older rank their oral health status, a census survey was designed for residents of Durham's (Canada) Municipal Homes for the Aged. The odds ratio (OR) and the Cochran & Mantel-Haenszel's OR were used to estimate the crude and adjusted effect of dental insurance on oral health status, respectively. Overall, 64 percent participated in the interview.

Comparison of remifentanil with fentanyl for deep sedation in oral surgery.

Purpose: The aim of this study was to compare recovery for oral surgery patients given a deep sedation regimen of midazolam, propofol, and remifentanil with a standard control of fentanyl in place of remifentanil.

Materials And Methods: This investigation was designed as a randomized, prospective, single-blinded controlled study. Group 1, the control, received midazolam 0.

Developing management information from an administrative database of dental services: identifying factors that influence costs.

Objective: We describe service patterns and compare changes in program expenditures with the Consumer Price Index over eight years in a dental program with a controlled-fee schedule offered to Canadian First Nations and Inuit people.

Methods: We obtained the computerized records of dental services for the period from 1994 to 2001. Each record identified the date and type of service, region and type of provider, age of the client and encrypted identifying information on clients, bands, and providers.

Access and care: reports from Canadian dental education and care agencies.

Representatives of faculties of dentistry and agencies working to improve the oral health of groups with restricted access to dental care were invited to address the access and care symposium held in Toronto in May 2004. They told of their clients" sometimes desperate needs in graphic terms. The agencies" response ranged from simple documentation of the need, to expression of frustration with current trends and the apparent indifference of policy makers, to the achievement of some success in arranging alternative models of care.

The use of administrative databases to assess oral health care.

Objective: We examined the potential for research using administrative databases containing dentists' claims to identify both the type of health services research questions addressed and the strength of the evidence that is achieved in such studies.

Methods: We searched Medline (1966 to March, 2003), retrieved additional reports from personal files, reviewed the literature cited in the relevant articles and conducted electronic searches on investigators' surnames. Information from relevant articles was abstracted into tables and the strength of the evidence for each was classified.

A macroeconomic review of dentistry in Canada in the 1990s.

Objectives: To document the trends in expenditures on dental health care services and the number of dental health care professionals in Canada from 1990 to 1999.

Methods: Information on dental and health expenditures, numbers of dentists, hygienists and dental therapists, and the population of Canada and the provinces were obtained from the Canadian Institute for Health Information; data on numbers of denturists were obtained from regional bodies and from Health Canada. Information on the costs of other disease categories was taken from studies by Health Canada (1993 and 1998).

Prevalence of dental caries among 7- and 13-year-old First Nations children, District of Manitoulin, Ontario.

Purpose: Dental caries is a disease that, although decreasing in the non-Aboriginal child population, remains high for Canadian Aboriginal and Native American children and adolescents. To address dental health issues in First Nations in the District of Manitoulin, Noojmowin Teg Health Centre initiated a multiphase collaborative research project with the department of community dentistry at the University of Toronto. The purpose of this paper was to identify the prevalence of dental caries in children 7 or 13 years of age and to compare these data with published data for the same age groups from other First Nations communities in Canada.

The effect of dental insurance on the ranking of dental treatment needs in older residents of Durham Region's homes for the aged.

The effect of dental insurance on the ranking of dental needs in older adults has not been reported previously. We examined this effect using data obtained from a cross-sectional survey of older adults living in homes for the aged in Durham Region, Ontario. History of dental insurance was obtained during interviews.

Investigating the potential for students to provide dental services in community settings.

Some dental educational institutions in North America have incorporated community-oriented programs into their curriculum. The purpose of this study was to investigate the potential for the clinical placement of Ontario's dental and dental hygiene students in community-based settings. Key informant interviews were used to collect data.

Diagnostic codes in dentistry--definition, utility and developments to date.

Diagnostic codes are computer-readable descriptors of patients' conditions contained in computerized patient records. The codes uniquely identify the diagnoses or conditions identified at initial or follow-up examinations that are otherwise written in English or French on the patient chart. Dental diagnostic codes would allow dentists to access information on the types and range of conditions they encounter in their practices, enhance patient communication, track clinical outcomes and monitor best practices.