Tobacco cessation is not a routine part of dental practice. Knowledge, time spent counseling patients, and specific strategies for quitting were associated with dentists' perceptions of success.

Tobacco cessation knowledge, attitudes, and behaviors of dentists participating in a large national managed care dental plan were assessed using a mailed survey. The survey was administered to dentists recruited to participate in an evaluation of a CD-ROM and supportive electronic detailing to promote increased tobacco cessation activities. General dentists who met specific technological criteria, had an active E-mail account, and at least 200 adult patients were eligible to participate in this study. A total of 184 dentists, located in 29 states, agreed to participate. The survey instrument included questions that addressed (a) Ask, Advise, Assess, Assist, and Arrange behaviors, (b) self-efficacy including knowledge, confidence, and success regarding tobacco cessation, (c) success of various tobacco cessation strategies, (d) barriers to tobacco cessation, and (e) demographics including year of graduation, gender, and race/ethnicity. Self-reported baseline tobacco intervention-related behaviors were low, with 28% of dentists reporting that they asked their patients about tobacco or recorded tobacco use in their patients' charts at least 41% of the time. For Advise behavior, approximately half of the dentists advised tobacco-using patients to quit at least 41% of the time. Although self-reported lack of knowledge was high, 71% of respondents indicated that their lack of knowledge was either not a barrier or a slight barrier to incorporating tobacco cessation into their practices. The survey revealed that dentists do not routinely incorporate tobacco cessation into their practices. Newer information-transfer technologies may serve as vehicles for increased smoking cessation activities by dentists.

“Diabetes and Oral Disease: Implications for Health Professionals” was a one-day conference convened by the Columbia University College of Dental Medicine, the Columbia University College of Physicians and Surgeons, and the New York Academy of Sciences on May 4, 2011in New York City. The program included an examination of the bidirectional relationship between oral disease and diabetes and the inter-professional working relationships for the care of people who have diabetes. The overall goal of the conference was to promote discussion among the healthcare professions who treat people with diabetes, encourage improved communication and collaboration among them and ultimately, improve patient management of the oral and overall effects of diabetes. Attracting over 150 members of the medical and dental professions from eight different countries, the conference included speakers from academia and government and was divided into four sessions. This report summarizes the scientific presentations of the event.

SummarySome controversial aspects of rheumatic heart disease are discussed in the light of personal experience in Edinburgh. Symptoms are not always a reliable guide to severity, and the correct time for surgical treatment should be based on an objective assessment. Dangers of delay include progressive damage to the pulmonary circulation, lungs, right ventricle, and liver, and the risks of systemic embolism, pulmonary oedema, and pulmonary infarction.The New York Heart Association classification of disability is unreliable and a potentially dangerous guide.The concepts of the pliant valve, critical stenosis, areas of auscultation, and the ejection murmur are criticized.No relation has been found between the size of the left auricle or atrium and the incidence of embolism. There is reason to doubt the value of anticoagulants.In relation to mitral valvotomy factors influencing operative mortality, complications, traumatic mitral incompetence, systemic embolism, and restenosis are discussed, and also the influence of calcification and of associated aortic valvular disease.Reference is also made to the place of open heart surgery. Two hundred and six women attending the antenatal clinic at St. Mary's Hospital took part in the study. All were less than 16 weeks pregnant at the first attendance, and in order to eliminate iron deficiency all received 1 g. of intravenous iron dextran as four 250-mg. doses at weekly intervals. At the 20th week they were allotted to one of two groups, receiving tablets dispensed in a bottle with a grey or a red label. These were to be taken once daily, and contained either ferrous fumarate 260 mg. or ferrous fumarate 260 mg. and 100 jug. of folic acid, the survey being conducted as a blind trial.On the first attendance (average 15 weeks) blood was taken for a blood count, serum iron estimation, and folate determination of both serum and red cells. This was repeated at the 30th and 38th weeks of pregnancy and a sternal marrow aspiration was performed in the 37th-38th week. All the marrows were assessed at the end of the survey without any knowledge of the colour of tablet taken or of any of the assay results obtained.Haematological methods were those set out by Dacie and Lewis (1963). Neutrophil polymorphs having five or more distinct nuclear segments were termed hypersegmented, the normal frequency of such cells being 0 to 3 %. Marrows were regarded as showing megaloblastic haemopoiesis when megaloblastic change was present in erythroblasts. Giant metamyelocytes were usually present as well. Iron status was assessed by both serum iron estimation and staining of marrow spreads for iron by Perls's Prussian-blue method.Red cell and serum folates were determined by microbiological assay with the method of Toepfer et al. (1951) and Lactobacillus casei as the test organism. One gramme of ascorbate was added to each 500 ml. of medium. For red cell folate assay the blood was diluted tenfold in a 0.1 M phosphate-ascorbate buffer pH 6 (Hansen, 1964). In our hands this method gave red cell folate r...

Background: Chronic medical conditions have been associated with periodontal disease. This study examined if periodontal treatment can contribute to changes in overall risk and medical expenditures for three chronic conditions [Diabetes Mellitus (DM), Coronary Artery Disease (CAD), and Cerebrovascular Disease (CVD)].