MSDA journal : journal of the Maryland State Dental Association最新文献

The Maryland State Board of Dental Examiners (SBDE) has adopted the disease model in dealing with chemically dependent dentists. SBDE has found that a punitive attitude toward chemical dependence is not productive. The SBDE works closely with the Dentists' Well-Being Committee of the Maryland State Dental Association to help dentists regain productive lives while observing its responsibility to protect the public. The SBDE's concern for patient welfare is a top priority, but it does not lessen SBDE's compassion for dentists who may be suffering from this illness.

The following case example shows the difficulty dentists face when their alcohol or drug dependence causes them to violate laws or the Dental Practice Act. In this case, the dentist is charged with driving while intoxicated (DWI) and is in possession of inappropriately prescribed medications.

To identify chemically dependent patients, dentists should explore whether the patients have any history of, or are recovering from, chemical dependency. Occasionally, dental treatment plans must be modified for active or recovering chemically dependent patients. Dentists need to be alert for chemically dependent patients who are doctor-shopping and present themselves to dentists to secure narcotic analgesics. Dentists should be aware that chemical dependency is a disease, and the management of chemically dependent patients may require certain adjustments.

Many options are available to patients to maintain occlusal function. Dental implants provide yet another. This paper examines the author's experience with one type of dental implant technique. The findings are based on data contained within the data base the author maintains of approximately 3,000 individual implants. The maxilla is the more challenging of the two arches, and the subperiosteal allows us to choose between grafting procedures and endosseous implants or a combination of subperiosteal implant and root form implants. Each has its positives and negatives. The At Risk statistical computer analysis of the author's database validates the use of the subperiosteal as an alternative.

Discussions between two group leaders at the National Institute of Standards and Technology (NIST) led to the suggestion that a mercury-free, silver-based material could be used for dental direct-filling applications. This concept brought about a new approach that, nonetheless, is still based on powder technology such as amalgams. The resulting material also retains the tin and silver components of conventional amalgams. The condensation of a loose powder mixture into a cohesive solid relies, however, on cold-welding across atomically clean silver-silver interfaces after a mild acid treatment of the surfaces. The National Institute of Dental Research (NIDR) and American Dental Association Health Foundation (ADAHF) became involved in the research in 1992, and ADAHF scientists continue to collaborate with NIST metallurgists and electrochemists toward the further development of this promising new technology.

The Baltimore College of Dental Surgery, Dental School, University of Maryland at Baltimore offers an extensive curriculum for the study of substance abuse, alcoholism, and other chemical dependencies. This article outlines the curriculum course hours and topics of study for both dentists and dental hygienists. The goal of the curriculum is for students to understand the disease process, intervention methods, treatment options, and other aspects of chemical dependence.

Health care professionals are interested in practical definitions that provide solutions to problems. There are many advantages to defining chemical dependence as a disease. This paper gives a health care professional clear directions regarding identifying the problem of chemical dependence and specifying a specific treatment plan for patients. We review the issues of personal responsibility, the moral model of addictions, and the neuropharmacology of the disease process, and advocate for the disease model as an effective, practical method for treating alcoholism and drug dependence.

The Maryland Dental Hygienists' Association Rehabilitation Committee was formed in 1990 and is patterned after the Maryland State Dental Association (MSDA) Dentists' Well-Being Committee. The Rehabilitation Committee serves to assist dental hygienists who may be impaired by alcohol or drug abuse; chemical dependency; or other physical, emotional, or mental conditions.