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Survey of Needs for Dental Care, 1965. I. Methodology and Composition of Sample
S u rv e y I.
o f needs
M e th o d o lo g y
fo r and
d e n ta l c a re , 1 9 6 5 c o m p o s itio n
Bureau of Economic Research and Statistics
Dental needs, especially of school children, have often been measured in local settings. When these studies are compared, the .prevalence of dental needs is seen to vary considerably from place to place and from age to age. In some instances, such variances are the result of differences in study methodology. To obtain internally comparable data on dental needs for the entire nation and for groups based on age, education, region, income, and length of time since the last visit to a dentist, this Survey of Needs for Dental Care, 1965 was begun in December, 1965. Cooperating dentists from every state devoted considerable time and effort to com pleting the questionnaires. Without such profes sion-wide cooperation, this new body of informa tion could not have been assembled. Approximately 20,000 dentists, including non members as well as members of the Association, were sent postcard-size questionnaires with in structions as to how to complete both sides. More than 1,500 of the profession responded. Each dentist was asked to record the dental needs of eight consecutive patients beginning in the morn ing of the Tuesday after receipt of the question naires. Only patients visiting for the first time in the present visit series were to be reported on. There were undoubtedly some inclusions of pa tients visiting within a series, but this is unlikely to have significantly affected the overall results. These definite instructions were given so that the dentists would not consciously or unconsciously select or exclude any particular type of patient. The total number of usable questionnaires re turned was 11,852. 1128
o f s a m p le
This survey is similar in purpose and method to one conducted by the Association in 1952, except that the present survey includes only firstvisit patients, whereas the former one was com prised of consecutive dental patients, without re gard to such first-visit status. The two surveys provide complementary data and comparable data for most groupings of patients according to length of time since last visit to a dentist. One limitation of this survey must be remem bered in studying or using the results meaning fully: This is a survey of dental patients and does not include persons who never go to a dentist. People seeing a dentist infrequently are under represented as compared with those seeing a dentist more frequently. Therefore, the statistics derived from the study do not strictly describe the general population. Tables will be presented, however, which tend to overcome this limitation. For instance, dental needs will be analyzed according to length of time since the patient last saw a dentist. Needs will also be broken down according to age, sex, in come, region, city size, and other factors. Thus, it will be possible to compare the sample with the population with respect to factors related to pre valence of dental needs. The mailing of questionnaires was made on the basis of population of the state rather than on the number of dentists in the state. Thus, in the group of states with higher dentist-population ratios, the mailing was made to a smaller proportion of dentists than in those states with a lower ratio. By such selective sampling technics, it was possi ble to obtain a close geographic representation of the general population in the survey sample, as shown in Table 1 and Figure 1. The distribution of dental patients according to size of city or town is shown in Table 2. Unfortunately, there is no closely comparable data available for the general population. The Bureau of the Census, in its presentations of this type,
does not classify all places by size (Table 3). Almost 30 percent of the population lives in places not classified as to size. Tables 2 and 3,
Table 1 ■ Percentage distribution of population, ] 965, and of white patients in Survey of Needs for Dental Care, 1965, by region and by state
Region and State New England Connecticut Maine Massachusetts New Hampshire Rhode Island Vermont
Percentage of population* 5.7 1.5 0.5 2.7 O.S 0.5 0 .2
Patients No.
%
669 194 42 319 31 50 33
5.7 0.4 2.7 0.3 0.4 0.3
2,054 377 1,035 642
17.6 3.2 8.9 5.5
1,760 53
15.1 0.5
1 .6
Middle A tlantic New Jersey New York Pennsylvania
18.8 3.5 9.3
South A tlantic Delaware District of Columbia Florida Georgia Maryland North Carolina South Carolina Virginia W est Virginia
14.8 0.3 0.4 3.0 2.3
East North Central Illinois Indiana Michigan Ohio Wisconsin
19.7 5.5 2.5 4.3 5.3
East South Central Alabam a Kentucky Mississippi Tennessee
6 .6
1.2
66
0 .6
2 .0
104
0.9
W est North Central Iowa Kansas Minnesota Missouri Nebraska North Dakota South Dakota
8 .2
1,346 219 184 398 296
11.5 1.9
6 .0
10
391 127 251 343 105 364 116
1.8
2.5 1.3 2.3 0.9
2.1
1 .8 1 .6
1.4 1 .2 1.8
2.3
'
0.1
3.4 1.1 2.1
2.9 0.9 3.1 1.0
2,491 596 252 490 778 375
21.4 5.1
524 155 199
4.5 1.3 1.7
1.6
3.4 2.5 0.9 0.5 0.7
0 .8
112
61 76
West South Central Arkansas LouisianaOklahoma Texas
9.6
8.1
1.3 5.5
945 106 139 127 573
Mountain Arizona Colorado Idaho Montana Nevada New Mexico Utah Wyoming
4.0
612
5.2 0.7 1.5 0.7 0.5 0.4 0.3
Pacific Alaska California Hawaii Oregon Washington Total
1.8
0 .8
86
1.0
0 .2
177 78 62 46 35 98 30
12.6
1,270
0.4 0.4 0 .2
0.5 0.5
0.1
8
1 .2 1.1
of patients
1 ,0 0 0 , 0 0 0
or more -1 ,0 0 0 , 0 0 0 25,000- 1 0 0 , 0 0 0 2,50025,000 Under 2,500 Farm
10.9 24.5 24.6 28.1 6.9 5.0
1 0 0 ,0 0 0
Total
100.0
Table 3 ■ Percentage distribution of population by size of place, I9 6 0 *
Size of place
Percentage of population
4.9
0 .8
0.3 10.9 0.1
931
8 .0
0
0 .0
1.0
182 149
1.5 1.3
11,671
100.0
100.0
Percentage Size of place
0.9
9.6 0.4 1.5
Table 2 ■ Percentage distribution of white patients by size of city or town
2 .2
4.2 6.7 3.2
0.3 0.4 1 .0
however, are comparable in the largest two sizeof-city categories, because no unincorporated places or rural areas are involved therein. Such comparison reveals a slight overrepresentation of dental patients in places of more than 100,000 population. This overrepresentation is to be ex pected because the dentist-population ratio is higher in larger places, generally. Also, it is likely that some dentists may have inadvertently re corded their own city’s size rather than that of their patients. Table 4 and Figure 2 show, by age and sex, the survey sample as a percentage of the total population. These percentages have considerable significance in comparing age groups and sexes with respect to dental visits. Males represented 47.1 percent of the sample; females, 52.9 percent. The percentage of the male population in the 20to-24-year-old group represented in the sample is somewhat lower than might be expected from a comparison with the number of females. The same phenomenon, although considerably more pro nounced, was noted in the 1952 survey. It is
^Source: U.S. Bureau of the Census. Statistical abstract of the United States: 1965, ed. 8 6 . Washington, D.C., Government Printing Office, 1965, p. 11.
Urban territory Places of 1,000,000 or more Places of 500,000 to 1,000,000 Places of 250,000 to 500,000 Places of 100,000 to 250,000 Places of 50,000 to 100,000 Places of 25,000 to 50,000 Places of 10,000 to 25,000 Places of 5,000 to 10,000 Places of 2,500 to 5,000 Places under 2,500 Unincorporated parts of urbanized areas Rural territory Places of 1,000 to 2,500 Places under 1,000 Other rural territory Total
69.9 9.8 6 .2 6 .0
6.5 7.7 8.3 9.8 5.5 4.2 0.4 5.5 30.1 3.6 2 .2
24.3 100.0
^Source: U.S. Bureau of the Census. Statistical abstract of the United States: 1965, ed. 8 6 . Washington, D.C., Government Printing Office, 1965, p. 15.
REPO RTS OF C O U N C IL S A N D B U R E A U S
■ 1129
New England
Middle ■Atlantic
South Atlantic
Fig. 1 ■ Comparison of regional Needs for Dental Care, 1965
East North Central
distribution of
East South Central 1965
West North Central
West South Central
Mountain
Pacific
population with distribution of patients included in Survey of
p ro b a b le t h a t th e la r g e n u m b e r o f y o u n g m e n in
g e n e ra l is a ls o p r e s e n te d in T a b le 5 . T h e p r o
th e A r m e d F o rc e s , w h o w e re in c lu d e d in th e p o p
n o u n c e d d iffe re n c e in d is trib u tio n o f in c o m e b e tw e e n th e p o p u la tio n a n d d e n ta l p a tie n ts is a
u la tio n ag e d is trib u tio n b u t n o t in th e s u rv e y , a c c o u n ts f o r th e d e v ia tio n s o f th is a g e g ro u p .
fu n c tio n o f th e te n d e n c y f o r h ig h e r-in c o m e g ro u p s to v is it th e d e n tis t m o r e o fte n . I t is tr u e th a t so m e
T a b le 5 sh o w s h o w all p a tie n ts w e re d is trib u te d a c c o rd in g to in c o m e as e s tim a te d b y th e d e n tis ts
o f th e d iffe re n c e is o n ly a p p a r e n t, b e c a u s e o f th e c o n tin u in g ris e in in c o m e s a s a w h o le o v e r th e 2 - y e a r s p a n b e tw e e n th e d a te s o f th e re la tiv e
re s p o n d in g . T h e r e a re v a rio u s b a s e s o n w h ic h a d e n tis t m a y e s tim a te in c o m e , as th e r e s p o n d e n ts w e re a s k e d to d o , a lth o u g h so m e o f th e s e in d ic a to r s c a n b e m isle a d in g . T h e 1 9 6 3 in c o m e o f th e w h ite p o p u la tio n in
Male patients
Total patients
Female patients
No. 158 599 767 794 694 786 877 694 424 255
0.0015 0.0060 0.0083 0.0095
6,048
0.0061
Age group
No.
- 4 5- 9 10-14 15-19 20-24 25-34 35-44 45-54 55-64 65-
297 1,230 1,484 1,507 1,178 1,4.67 1,650 1,332 807 475
0.0014 0.0060 0.0079 0.0089 0.0087 0.0066 0.0067 0.0060 0.0048 0.0026
139 631 717 713 484 681 773 638 383 220
0.0013 0.0061 0.0075 0.0083 0 0071 0.0061 0.0065 0.0059 0.0047 0.0028
11,427
0.0059
5,379
0.0056
Total
T h e d is trib u tio n o f p a tie n ts a c c o rd in g to le n g th o f tim e sin c e la s t v is it to a d e n tis t is s h o w n in
Percentage of 1965 population
Percentage of 1965 population
No.
d a ta in T a b le 5.
Percentage of 1965 population
0 .0 1 0 2
0.0070 0.0070 0.0061 0 0048 0.0025
^Source: Statistical abstract of the United States, 1966. Washington, D. C., Government Printing Office, 1966, p. 6 , 7.
1130 ■ JAD A, Vol. 73, Nov. 1966
Table 4 ■ Distribution of white patients, and number of white pa tients as percentage of 1965 population by age and by sex
Fig. 2 ■ Percentage of
1965 population included in Survey of Needs for Dental Care, 1965, by age and sex 1131
45 Table 5 ■ Percentage distribution of white patients by estimated income* and of white population by income Percentage of patients
Income Under $2,000 $ 2,000-$3,999 $ 4,000-$5,999 $ 6,000-$9,999 $10,000 and up Total Median
Percentage of populationf
1.8 6.3 21.4 44.6 25.9
% of survey sample % of 1965 population
9.0 15.1 20.1 34.3 21.5
100.0
100.0
$7,840
$6,700
* l f patient was a dependent, income of fam ily head was recorded. fSource: U.S. Bureau of the Census. Statistical abstract of the United States: 1965, ed. 86. Washington, D.C., Government Printing Office, 1965, p. 342.
Table 6 ■ Percentage distribution of white patients by length of time since last visit to a dentist and by sex Length of time since last visit. to dentist
Males
Less than 6 months 6 to 11 months 1 year 1.5 years 2 years 3 years More than 3 years Never been to dentist before
14.7 36.0 14.8 7.2 8.8 4.6 9.3 4.6
16.9 37.9 15.3 .6.9 8.8 4.0 6.2 4.0
15.9 37.0 15.1 7.0 8.8 4.3 7.6 4.3
100.0
100.0
100.0
Total
Females
Total
T a b le 6. I n a c c o r d a n c e w ith th e fa c t t h a t m o re w o m e n th a n m e n a re f o u n d in a r a n d o m g r o u p o f d e n ta l p a tie n ts , th is ta b le sh o w s t h a t th e a v e ra g e w o m a n la s t sa w h e r d e n tis t a t a m o r e r e c e n t d a te th a n th e a v e ra g e m a n . T h e 1 9 6 0 c e n s u s in d ic a te s t h a t N e g ro e s c o m p ris e d 1 0 .5 p e r c e n t o f th e to ta l p o p u la tio n . O f th e p a tie n ts in c lu d e d in th e s u rv e y , le ss th a n 2 p e r c e n t w e re N e g ro . B e c a u s e o f th is p r o n o u n c e d u n d e r r e p r e s e n ta tio n , a n d b e c a u s e o f e s ta b lis h e d r a c ia l d iife re n c e s in p re v a le n c e o f d e n ta l d is e a se , a lm o s t a ll ta b le s p re s e n te d w ill b e fo r w h ite p a tie n ts o n ly . A
s u m m a ry ta b le o f s o m e o f th e d e n ta l
n e e d s o f N e g ro e s w ill b e p re s e n te d , h o w e v e r. T h e “ o th e r ” ra c ia l c a te g o ry w a s re a s o n a b ly r e p r e s e n ta tiv e as to n u m b e r , b u t s p e c ific a tio n s g iv e n a lo n g w ith th is re s p o n s e in d ic a te a w id e v a ria n c e in c la s sific a tio n , re n d e r in g th e d a ta u n r e lia b le . T h e re fo r e , n o d a ta a re p r e s e n te d f o r th is
-$2,000
$2,000$4,000$10,000+ $3,999 $5,999 $9,999 Fig. 3 ■ Comparison of income-group distribution of 1963 population with distribution of patients included in Survey of Needs for Dental Care, 1965
g r o u p o f p a tie n ts . a n a ly s e s o f th e n e e d s as in d ic a te d b y th is su rv e y
b e fo r e b e e n to a d e n tis t, th e r e a re tw o so m e w h a t c o u n te r b a la n c in g b ia s e s : a te n d e n c y to sh o w h ig h
in c lu d e a te n d e n c y f o r g r e a te r n e e d s b e c a u s e o f th e s a m p le ’s c o n s is tin g o f p e o p le v is itin g a d e n tis t
n e e d s b e c a u s e o f le s s p re v io u s c a re a n d a te n d e n c y to sh o w lo w n e e d s b e c a u s e o f th e e v id e n t la c k o f
a n d a te n d e n c y f o r lo w e r n e e d s b e c a u s e o f p a tie n ts w h o g e n e ra lly re c e iv e m o re c a r e b e in g m o r e lik e ly
n e e d f o r d e n ta l c a r e th a t w o u ld o f te n b e tr u e f o r th o s e w h o n e v e r b e fo r e h a v e v is ite d a d e n tist.
I n g e n e ra l, b ia s in g fa c to rs to b e c o n s id e re d in
to b e d r a w n in to th e s a m p le . In th e c a s e o f p a tie n ts w h o a re in th e c a te g o ry o f th o s e w h o h a d n e v e r 1132 ■ JA D A , Vol. 73, Nov. 1966
T h e n e x t a rtic le in th is se rie s w ill p re s e n t d e n ta l n e e d s a c c o rd in g to a g e a n d se x o f th e p a tie n t.
B O O K S E C T IO N
Book R eview s Titles preceded by an asterisk are available on loan from the Association's Bureau of Library and Indexing Service at no charge. Books may be purchased through the Bureau at list price. Illi nois residents should add 4 percent Re tailers Use Tax to the purchase price of books.
*The Parathyroid Glands Pieter J. Gaillard, Roy V. Talmage, and Ann M . Budy. 353 pages with illustrations. Index. $15. Chicago, University of Chicago Press, 1965.
This volume is a collection of papers presented at the second symposium on the parathyroid glands held at Noordwijkaan Zee, The Netherlands, on August 25-29, 1964. The theme of the conference was the examina tion of the present state of knowl edge on the mechanisms involved in the regulation of bone resorption. The fine structure of -both the human and rat parathyroids is ex plored by J. D. Lever. Electron mi crographs illustrate the author’s the sis that the relationship of the 35150/x vesicular bodies to the Golgi and endoplasmic reticular mem branes indicates that these bodies represent intermediate or final secre tory products of the parathyroid. Ex ploring the same subject in the frog and toad, R. Lange and H. V. Brehm point out, “the existence of the secre tory granules and their connection
with the storage of the parathyroid hormone is no longer seriously ques tioned.” They relate the origin of these granules to the Golgi appara tus. The enzyme systems of the mam malian parathyroid and thyroid are discussed by A. G. Everson Pearse. Histological staining technics are used to locate leucine aminopeptidase, the dehydrogenases, and phos phatases. He draws the conclusion that the mitochondrian-rich intrafollicular and parafollicular cells of the thyroid are the probaible source of calcitonin. Isolation and purification of a highly active parathyroid hormone (PTH) preparation is described by J. T. Potts and G. D. Aurbach. These studies suggest a polypeptide com prising 52 amino acid residues. A tentative, incomplete structure is pro posed for the polypeptide. The controversy over the origin of calcitonin is discussed by D. H. Copp and I. MacIntyre and others. The former marshals the evidence for a parathyroid origin of a serum calcium lowering substance. The lat ter concludes, from the perfusion ex periments, that calcitonin is exclu sively of thyroid origin. Both authors agree that a calcitonin exists in the thyroids. L. G. Raisz and others report on tissue culture experiments that dem onstrate that the calcium concentra tion of the medium regulates amino acid uptake and protein and nucleic acid synthesis. They suggest that this negative feedback control of parathy roid function is caused fey the effect of calcium on transport of amino
acids acrosss cell membranes. R. V. Talmage and others agree with Raisz that regulation of parathyroid secre tion is controlled by calcium ion con centration in circulating fluids. Al though confirming the increase in os teoclastic population with increased parathyroid activity, they submit evi dence that indicates that the rate of calcium removal from bone is not dependent on the size of the osteo clast population. They also claim inability to demonstrate endogenous hormone effects on osteoblasts and bone matrix formation. In contrast to these studies, L. F. Belanger im plicates the large mature osteocyte specifically in bone dissolution. He defines osteolysis as bone matrix modification with a loss of bone salt, which takes place within the inti macy under the influence of the ma ture osteocyte. P. Goldhaber points out that oxy gen, parathyroid extract (PTE), vita min A alcohol, vitamins D2 and D3, dihydrotachysterol, and heparin may each act as a bone resorption factor. This author also demonstrates an un known bone resorption factor in rat serum, not derived from the parathy roid gland. That the effect of PTH on phos phate is to increase the rate of its entry into various tissue cells such as bone, intestine, and kidney is demonstrated by W. F. Neuman. Us ing the mitochondrial system, H. F. Deluca and J. D. Sallis proposed a function for vitamin D in the move ment of calcium from the mitochon dria under, the influence of PTH. This action is linked to the oxidative phosphorylation chain. Studying this ion transport problem, G. D. Aur bach comes to the conclusion that PTH seems to stimulate the use of a high energy intermediate for this purpose since PTH stimulates C 02 production from succinate. This ef fect seems to be secondary to an accelerated oxidation of nicotina mide adenine dinucleotide (NADH). He suggests this phenomenon as a method for bioassay of PTH. B. E. C. Nordin suggests that the constancy of plasma calcium levels is maintained partly by a pH gradi 1133
ent that exists between tissue fluid and effective mineral surface, which in turn is regulated by PTH and oth er substances. The observations of Aurbaoh and Nordin should be compared with the reports of R. Van Reen and I. W. Hekkelman who studied the effect of PTE on isocitric dehydrogenase (ICD). Van Reen notes that the con centration of nicotinamide ade nine diïiucleotide phosphate, reduced form, (NADPH), determines the amount of ICD that dissolves. PTE does not increase ICD levels but in creases nicotinamide ’adenine dinu cleotide phosphate, oxidized form (NADP), levels. Hekkelman demon strates a binding of ICD with NADPH, which explains Van Reen’s ob servation. Under the influence of PTE, less NADPH is available and citrate accumulates in the bone. Thus PTE causes citrate chelation of calcijim and dissolution of bone. D. V. Cohen in studying this problem, demonstrates decreased metabolism of citrate under the influence of PTE as measured by CO.* production. His data also show that incorporation of citrate into the cellular fraction of bone was reduced by PTE. He suggests that this reduction could be caused by decreased cellular mito chondrial permeability or transport, under the influence of the hormone. Studies of the effect of the para thyroid hormone on explanted mouse limb bone by P. J. Gaillard, indicate that PTE impairs the synthesis of collagen by the osteoblasts. From work with actinomycin D, this au thor suggests that the reaction of radius explants to added PTE de pends on the synthesis of certain en zymes contingent on nuclear messen ger RNA production. Nichols and others conclude that inhibition of collagen synthesis and stimulation of cell constituent syn thesis are the primary action of PTE. The evidence to support this con cept is the fact that PTE inhibits glycine uptake and protein synthesis and that there is an increase in collagenase shortly after PTE adminis tration. The sequence of events in bone matrix resorption is decalcifica 1134 ■ JA D A , Vol. 73, Nov. 1966
tion by lactic and other acids, fol lowed by collagenolytic breakdown of denuded fibers. The PTE effect is on the actual assembly of the colla gen molecules on the ribosomes. Da ta to support these concepts are also supplied by G. R. Martin and others. PTE inhibits cysteine incorporation into collagen and other1proteins and accumulation of citrate and resorp tion of bone in tissue cultures. DNA synthesis is increased With PTE and studies with inhibitors' indicate that the nucleic acid' effect is required to produce bone resorption (compare with GaiUard’s work). W. A. DeVoogd Van Der Straaten demon strates that PTE interferes with in tracellular fixation of nicotinic acid, before its use in the biosynthesis of the nucleotides. He also confirms Hekkelman’s concept of the effect of PTE on the binding of NADPH. The occurrence of cataracts in rats with hypoparathyroidism induced A. D. Kenny and others and H. D. Firschein and A. Kemrer to study the effect of PTE on the rat lens. The former demonstrates that there is no change in calcium and phosphate levels after parathyroidectomy. The latter suggest that, in hypoparathy roidism, a decrease in calcium levels in the aqueous humor results in movement of small ions and water into the lens causing vacuole forma tion. Comparison of this volume with the results of the first symposium held in 1960 amply supports Mc Lean’s statement that in the last few years there has been an “explosion in parathyroid research.” The con tributors have made giant strides in the understanding of the mechanism of parathyroid hormone action. These are digested by the discussion in the text that evaluates each group of papers. The articles are well written and profusely illustrated with numer ous halftones and charts. Twentyone pages of bibliography testify to the fact that the book covers thor oughly the research that is going on in this field. ‘ This volume' is an important source for information and ideas for the research worker in mineral me
tabolism. It is of value also to the biochemists in general, who are in terested in the mechanisms of inter mediate metabolism. The book also belongs in the library of physicians who are engaged in the study and treatment of diseases of the parathy roids and of bones and teeth. The editors should be congratulat ed for a difficult task well executed in every detail. Samuel Natelson
* M edical Illustrations Manuscripts
in
Medieval
Loren MacKinney. 263 pages with 106 illustrations. Bib liography. Index. $15. Berkeley and Los Angeles, University of California Press, 1965.
Medievalists, medical historians, or simply anyone who loves beauty will covet this volume. Both the text and the illustrations are exquisite. The structure of the book is two part: general text and a checklist of medical miniatures in extant manu scripts, most of which were examin ed firsthand by the author or his wife. The latter part was prepared with the assistance of Thomas Hern don. Although it is an uncompromising work of scholarship, the book suffers no pedantries to put off the general reader. In Part 1, a most readable discourse on illumination of medical manuscripts has been organized ac cording to topic: hospitals and clin ics, diagnosis and prognosis, materia medica, dentistry, surgery, and so on. Throughout, the author makes reference to the 106 illustrations, a fifth of them in color, collected at the end of the book. Those whose enthusiasms are fired by this lovely book will welcome the 5-page se lected bibliography. The author has given has reader a collection of art treasures, a host of intellectual surprises, and a pleasant introduction to a little-known sub ject. L ouanna F urbee
ATLAS
O F
DEVELOPMENTAL ANATOMY OF THE FACE With special reference to normal and cleft lip and palate
BERTRAM S. KRAUS • HIRONORI KITAMURA • RALPH A. LATHAM
m iscellan eo u s findings, su ch as e n a m el p earls, an d d e n tal an o m alies as so ciated w ith cle ft p a la te . T h e b o o k p resen ts a w ealth o f h isto lo g ic m a terial o f th e n o rm a l a n d c le ft lip and p a la te sp ecim ens d u rin g th e p re n a ta l p eriod. T h e au th o rs h av e effectively d e m o n stra te d ch ang es w ith age and v ariatio n s in m o rp h o lo g y o f b o th n o rm a l a n d a b n o rm a l specim ens. It is p e rh a p s u n fo rtu n a te th a t th e au th o rs h a v e avo id ed ex p lan a tio n s o f th e p h o to m ic ro g ra p h s o r discussion o f th e m a te ria l p resen te d , b u t th ey did this p u rp o se ly in th a t th e y state th a t th e fu n c tio n o f th e tex t is to illu strate a n d n o t to co n v ert. A m o st v alu ab le re fe re n c e tex t fo r p re n a ta l facial d ev elo p m en t, this b o o k w ill p ro b a b ly b e o f g reatest v alu e to th e k n o w led g eab le inv esti g a to r in th e field o f o ra l d ev elo p m en t a n d m ald ev elo p m en t. J a m es K . A v e r y
D e v e lo p in g t h e S u p e r v is o ry S k ills o f t h e N u r s e : A B e h a v io r a l S c ie n c e A p p r o a c h
Adelma E. Mooth and M iriam M. Ritvo. 107 pages. $3.50. New York, M a c M il lan Company, 1966.
" A tla s o f th e F a c e
D e v e lo p m e n ta l
A n a to m y
of
Bertram S. Kraus, Hironori Kitamura, and Ralph Latham. 378 pages with 1,224 illustrations. $20. New York, Hoeber Medical Division, Harper & Row, 1966.
In p re p a rin g this b o o k , th e au th o rs have u sed 1,200 gross an d m ic ro p h o to g rap h s o f 35 cleft an d 47 n o rm alap p earin g sp ecim en s selected fro m a collection o f 2 5 ,0 0 0 h u m a n em b ryos an d fetuses. T h e m ate ria l is p resen ted m ain ly in th e fo rm o f his tologic sections w ith ap p ro p ria te d ia gram s and ex p lan a tio n s o f lo catio n o f each o f the sections. T h e speci m ens a re cata lo g u e d fo r easy re f
ere n ce an d coded fo r a n a to m ic la n d m ark s. T h e m a te ria l h as 'been d ivided in to fo u r m a jo r sections, th e first o f w h ich is a series o f n o rm a l em b ry o s ra n g in g in ages fro m 35 days to b irth . T h e second m a jo r division, u s ing fro n ta l sectio n s sim ilar to th e n o rm a l series, consists o f cleft lip a n d p a late em b ry o s fro m 41 days to b irth . T h e te ch n ical p re p a ra tio n an d p re se n ta tio n o f these tw o series is ex cellent. D ivisio n th re e co n sists o f a n in tere stin g a rra y o f associated m a lfo rm a tio n s th a t o c c u rre d in th e c left sp ecim en s illu strated in division tw o. T h e fo u rth a n d final division, e n title d “S pecial to p ic s,” p resen ts
A co g en t and u p -to -th e -m in u te dis cussion o f th e n a tu re o f th e su p e r visory p ro cess a n d a d e tailed p res e n ta tio n o f th e case m e th o d o f in stru c tio n e x ten d this b o o k ’s a p p li cability b ey o n d the n u rsin g situ ation. Its c o n te n t should be o f p a rtic u la r in te re st fo r those te a c h in g p ro fe s sional stu d en ts, n o t o n ly b ecau se th e case m e th o d is an effective w ay o f teac h in g , b u t also b ecau se th e p ro fe s sional p ra c titio n e r w ill so o ften be in a p o sitio n w h ere su p e rv iso ry skills a re n eeded. S u pervision is d escrib ed as a dy n am ic p ro cess b ased o n an u n d e r sta n d in g of hum an in te ra c tio n , w herein th e su p e rv iso r “ en co u ra g es a n d p a rtic ip a te s in th e d ev elo p m en t o f (h is) su b o rd in a te s.” R eq u isite k n o w led g e a n d sen sitiv ity can be g a in ed th ro u g h sem in ars w h e re a “c a se ” is analyzed. In m a n y w ays, th e ty p e o f sem in ar sug g ested fo l low s th e tra d itio n a l m ed ical m o d el o f case p re se n ta tio n an d b rain -sto rm in g BOOKS " 1 1 3 5
for a solution or an understanding of why there was a failure. The em phasis here is psychological however: “one collects the facts and analyzes how people behaved, what their needs were, what happened, what seemed to precipitate the incident, and what were the positive learnings from this incident that can prevent a recurrence.” The case method thus takes a problem-solving approach, attempting through fact-finding and discussion to build up a body of knowledge for the group and to in crease the understanding of each in dividual member. When successful, the experience for the individual could best be described as sensitivity training. Particular attention is paid to the role of the seminar leader. The ma jor technic suggested is a judicious asking of questions, which makes it necessary for participants to examine the foundations on which many of their attitudes and response tenden cies are based. Some “do’s” and “dont’s” are also offered the group leader and an attempt made to use one case as a demonstration. At that point, the authors relinquish their expository task and merely present a series of cases to be used as the content of the supervisory training seminars. The major failing of the book is that these materials are not used to demonstrate the learning process. Presenting case content for future seminars is not a particularly valuable contribution, since the most worthwhile discussions center about situations in which the participants have first-hand experience. A trans cription of an entire seminar session, including the case material, leader’s questions and comments, and mem bers’ reactions, would have made the whole process of learning by the case method much clearer. In spite of this shortcoming, De veloping the Supervisory Skills of the Nurse provides a good introduc tion to a method of teaching that is rapidly coming into widespread use. Both authors, faculty members at Boston University, were well qualified for the undertaking. Jane Moosbruker 1136 ■ JA D A , Vol. 73, Nov. 1966
Drugs of Choice: 1966-1967 W a lte r Model I, editor. Fifth edition. 969 pages. Index. $16.75. St. Louis, The C. V. Mosby Co., 1966.
An excellent reference book for the health-oriented individual, this current edition, although not dras tically different, has been revised and updated in several areas. Without being unduly cautious, the various contributors have continued to cen ter their discussions around the proved drugs of therapy but do not fail, in most instances, to mention the new but as yet incompletely test ed agents. The book is written for the phy sician and is heavily oriented to the regimen of drug therapy as these drugs apply to the medical patient. There is no section on dentistry as such. Many chapters, however, have information of great value to the dentil clincian. Such sections as the principles of drug choice, adverse drug reactions, local antiseptics, anti bacterial agents, sedatives, and so on are of importance and interest to all health practitioners. Those areas where the mechanics of therapy of cardiovascular disease and other medical problems are discussed give insight into the problems of the pa tient and how these problems can relate to the dental treatment. As a result, although the book is not di rected to dentistry, the dentist will find it an excellent reference addition to his library. James W. Smudski
M aking the Most of Radio-TV Roy E. Johnson. 56 pages. Appendix. $2. New York, National Public Relations Council on Health and W elfare Services, Inc., 1966.
Although a “how to” publication, this book sets no rigid guidelines for the novice or professional public relations practitioner. Rather, the book clearly defines the method in whioh radio and television can be
used effectively to convey a health agency’s public information program to the public. The author has had muoh experi ence in health agency public rela tions; he recently retired after 27 years as an official of the Amerioan Red Cross. During that time, he served as director of its office of public information and as head of its radio and television department. Mr. Johnson is also a member of the board of directors of the National Public Relations Council of Health and Welfare Services, Inc. Throughout his career, Mr. John son was aware that the success of a health agency’s national public in formation program depends on the efforts of the novice public relations chairman charged with coordinating the program at the local level. Mr. Johnson realized that, though the novice may never become as adept as the professional, there are certain steps that could make his job easier, especially in using radio-television stations for public service purposes. Mr. Johnson provides readers with information about preparing such items as news releases, radio-TV spot announcements, interviews, and other scripts. He also discusses the proper methods of contacting stations to ob tain public service time and inter views. The author presents methods of evaluating local radio and televi sion to determine if they are the proper mediums for use in convey ing one’s message. The book will present no solutions for public relations problems that plague all organizations. It will, however, give the professional an interesting refresher course on how radio and television oan best serve the public information program. It will also aid the novice faced for the first time with the responsibility of using radio and television to com municate effectively with the public. Making the Most of Radio-TV is a good primer for the fledgling pub lic relations chairman of dental component and constituent societies and their women’s auxiliary organi zations. Dean D ranias
Additions to the Library The books listed here have been added recently to the Bureau collection. Re quests for this material, available on loan to all members of the Association, should be addressed to the Bureau of Library and Indexing Service. There is no charge for borrowing books, but there is a minimal charge of one dollar ($1.00) for each package library. Illi nois residents should add 4 per cent Retailers Use Tax to the purchase price of books and to the rental fee for a package library. Book prices are subject to change without notice in accordance with changes in publishers' prices. Practically all the dental journals pub lished in the world at present are av ail able to members on loan. Lists of books, package libraries, and journals are available on request.
Books American A ssociation of Orthodontists. Council on Orthodontic Education. Orthodontics: principles and policies, educational requirements, organizational structure. St. Louis [1966] 20 p. American D ental Associaton. Bureau of D ental H ealth Education & Amer ican Association of P ublic H ealth D entists. National conference on pa tient education, Las Vegas, November 6, 1965. Chicago, 1966. 32 p. American D ental Society of E urope. Transactions, 1965. London, 1965. 55 p. Mimeo. Ârruda, J. V. Uma técnica cirürgica para aprofundamento dos sulcos vestibulares e linguais nos desdentados totais.
ances. London, Pitman Medical Publish ing Co., 1965. 133 p. $2.40. The E conomics of H ealth and M edical Care; proceedings of the conference, May 10-12, 1962. Sponsored by Bureau of Public Health Economics and Depart ment of Economics University of Mich igan. Ann Arbor, 1964. 321 p. European Organization for R esearch on F luorine and D ental Caries Preven tion . Advances in fluorine research and dental caries prevention; proceedings of the 12th congress, Utrecht, the Nether lands, 9th-llth June 1965. Edited by P. M. C. James [et al] Oxford, New York, Pergamon Press, 1966. 246 p. $18.50. International Academy of Oral Pathol ogy. Second proceedings; a conference held at Melbourne University, Australia, September 1-4, 1965. New York [1966] 147 p. $5. International A nesthesiology C linics, August 1965. European trends in anes thesiology. Boston, Little, Brown [1966]. J archo, Saul, ed. Human paleopathology; proceedings of a symposium on human paleopathology held in Washington, D. C., January 14, 1965, under the auspices of the Subcommittee on Geo graphic Pathology, National Academy of Sciences—National Research Council. New Haven, Yale University Press, 1966. 182 p. $7.50. Jensen, J. R. Pulpal problems and their detection. (Practical dental monographs, May-June 1966.) Chicago, Year Book Medical Publishers, 1966. 28 p. K reshover, S. J., & M cClure, F. J., ed. Environmental variables in oral disease; a symposium presented at the Montreal meeting of the American Association for the Advancement of Science, Decem ber 1964. Washington, American Asso ciation for the Advancement of Science, 1966. 312 p. $8.75. • K unzel, Walter, & T oman, J aroslav, ed. Kinderzahnheilkunde und ihre Grenzgebiete. Berlin, Volk und Gesundheit, 1965. 544 p. . K umar, V inod. Configuration of periodon tal pockets in relation to age, sex and location. (M. S. thesis—New York Uni versity.) New York, 1966. 74 p. Mimeo. BCuriakose, V. K. The incidence of torus palatinus in American population. (M. S. thesis—University of New York.) New York, 1965. 42 p. Typewritten. Lammie, G. A. Dental orthopaedics. Ox ford, Alden Press, 1966. 301 p. $10.10. M anson, J. D. Periodontics for the gen eral practitioner; a manual of practical periodontics. Chicago, Year Book Med ical Publishers, 1966. 220 p. $12.50. M arsh all, J. D., ed. Approaches to li brary history; proceedings of the second library history seminar, Florida State University Library School, Tallahassee, March 4, 5, and 6, 1965. Tallahassee, Journal of Library History, 1966. 183 p.
$8.
Merck Manual of D iagnosis and T her apy. 11th ed. Rahway, N. J., Merck Sharp & Dohme Research Laboratories, 1966. 1,850 p. $7.50. Metse, P. I. Estologiki metabolai ton polphoi othonton kliythn ex epitthrasethe phsiko-chmikthn tinthn aitithn epi tes apokekalgmmenes odontines. Athens, 1965. 96 p. English summary. M itchell, G. E., & Others. Selected local dental health programs; Contra Costa County, California, Hartford, Connecti cut, Jefferson County, Alabama. (U. S. Public Health Service Publication No. 1402.) Washington, U. S. Division of Dental Health, 1965. 26 p. M ollin, A. D. Universal light arch tech nique for treatment of malocclusion. Brooklyn, N. Y., Bruder, 1966. 200 p.
$20. M ontgomery, G. L. Pathology for stu dents of dentistry. 3d ed. Edinburgh, Livingstone, 1966. 399 p. $8. M oraes, P. A. Occorrencia de dermatófitos em solos do municipio de Piraci caba. (Docente livre thesis—Faculdade de Farmácia e Odontologia de Piraci caba.) Piracicaba, 1965. 48 p. N ascimento, Aparecido. Estudo macro scópico do periodonto de sustentado de peixes do genero leporinus (piavas). (D. C. thesis—Faculdade de Farmácia e Odontologia de Piracicaba.) Piracicaba, 1965. 81 p. Mimeo. R enci, J ose. Prevalencia de maloclusoes em escolares de Piracicaba, de 7 a 12 anos de idade, segundo os indices de Draker e da OMS. (D. C. thesis—Facul dade de Farmácia e Odontologia de Piracicaba.) Piracicaba, 1965. 87 p. Mimeo. San D iego C ounty D ental Society. The roster, 1966. San Diego, Calif., 1966. 84 p. Schwarz, A. M., & G ratzinger, Max. Re movable orthodontic appliances. Phila delphia, Saunders, 1966. 355 p. $18. Smith , M aurice. A short history of den tistry. Translated into Korean by Choe Jin-hwan. Seoul, Korean Academy of the History of Dentistry, 1966. 215 p. T okvam, Otto. Maxillo-facial injuries; eti ology, clinical features and treatment. Bombay, Popular Prakashan, 1965. 193 p. $14. U. S. N ational C enter for H ealth Sta tistics. Volume of dental visits, United States, July 1963-June 1964; statistics on volume of dental visits by type of dental service, age, sex, residence, geo graphic region, family income, color, education of head of family, usual activ ity status, and marital status. (U. S. Public Health Service publication No. 1000—Series 10—No. 23.) Washington, Govt. Print. Off., 1965. 55 p. $0.45. Walther, D. P., ed. Current orthodontics. Bristol, Wright, 1966. 546 p. $21.75. Woodruff, M. F. A. Surgery for dental students. 2d ed. Oxford, Blackwell, 1966. 326 p. $8.
1137
o f needs
M e th o d o lo g y
fo r and
d e n ta l c a re , 1 9 6 5 c o m p o s itio n
Bureau of Economic Research and Statistics
Dental needs, especially of school children, have often been measured in local settings. When these studies are compared, the .prevalence of dental needs is seen to vary considerably from place to place and from age to age. In some instances, such variances are the result of differences in study methodology. To obtain internally comparable data on dental needs for the entire nation and for groups based on age, education, region, income, and length of time since the last visit to a dentist, this Survey of Needs for Dental Care, 1965 was begun in December, 1965. Cooperating dentists from every state devoted considerable time and effort to com pleting the questionnaires. Without such profes sion-wide cooperation, this new body of informa tion could not have been assembled. Approximately 20,000 dentists, including non members as well as members of the Association, were sent postcard-size questionnaires with in structions as to how to complete both sides. More than 1,500 of the profession responded. Each dentist was asked to record the dental needs of eight consecutive patients beginning in the morn ing of the Tuesday after receipt of the question naires. Only patients visiting for the first time in the present visit series were to be reported on. There were undoubtedly some inclusions of pa tients visiting within a series, but this is unlikely to have significantly affected the overall results. These definite instructions were given so that the dentists would not consciously or unconsciously select or exclude any particular type of patient. The total number of usable questionnaires re turned was 11,852. 1128
o f s a m p le
This survey is similar in purpose and method to one conducted by the Association in 1952, except that the present survey includes only firstvisit patients, whereas the former one was com prised of consecutive dental patients, without re gard to such first-visit status. The two surveys provide complementary data and comparable data for most groupings of patients according to length of time since last visit to a dentist. One limitation of this survey must be remem bered in studying or using the results meaning fully: This is a survey of dental patients and does not include persons who never go to a dentist. People seeing a dentist infrequently are under represented as compared with those seeing a dentist more frequently. Therefore, the statistics derived from the study do not strictly describe the general population. Tables will be presented, however, which tend to overcome this limitation. For instance, dental needs will be analyzed according to length of time since the patient last saw a dentist. Needs will also be broken down according to age, sex, in come, region, city size, and other factors. Thus, it will be possible to compare the sample with the population with respect to factors related to pre valence of dental needs. The mailing of questionnaires was made on the basis of population of the state rather than on the number of dentists in the state. Thus, in the group of states with higher dentist-population ratios, the mailing was made to a smaller proportion of dentists than in those states with a lower ratio. By such selective sampling technics, it was possi ble to obtain a close geographic representation of the general population in the survey sample, as shown in Table 1 and Figure 1. The distribution of dental patients according to size of city or town is shown in Table 2. Unfortunately, there is no closely comparable data available for the general population. The Bureau of the Census, in its presentations of this type,
does not classify all places by size (Table 3). Almost 30 percent of the population lives in places not classified as to size. Tables 2 and 3,
Table 1 ■ Percentage distribution of population, ] 965, and of white patients in Survey of Needs for Dental Care, 1965, by region and by state
Region and State New England Connecticut Maine Massachusetts New Hampshire Rhode Island Vermont
Percentage of population* 5.7 1.5 0.5 2.7 O.S 0.5 0 .2
Patients No.
%
669 194 42 319 31 50 33
5.7 0.4 2.7 0.3 0.4 0.3
2,054 377 1,035 642
17.6 3.2 8.9 5.5
1,760 53
15.1 0.5
1 .6
Middle A tlantic New Jersey New York Pennsylvania
18.8 3.5 9.3
South A tlantic Delaware District of Columbia Florida Georgia Maryland North Carolina South Carolina Virginia W est Virginia
14.8 0.3 0.4 3.0 2.3
East North Central Illinois Indiana Michigan Ohio Wisconsin
19.7 5.5 2.5 4.3 5.3
East South Central Alabam a Kentucky Mississippi Tennessee
6 .6
1.2
66
0 .6
2 .0
104
0.9
W est North Central Iowa Kansas Minnesota Missouri Nebraska North Dakota South Dakota
8 .2
1,346 219 184 398 296
11.5 1.9
6 .0
10
391 127 251 343 105 364 116
1.8
2.5 1.3 2.3 0.9
2.1
1 .8 1 .6
1.4 1 .2 1.8
2.3
'
0.1
3.4 1.1 2.1
2.9 0.9 3.1 1.0
2,491 596 252 490 778 375
21.4 5.1
524 155 199
4.5 1.3 1.7
1.6
3.4 2.5 0.9 0.5 0.7
0 .8
112
61 76
West South Central Arkansas LouisianaOklahoma Texas
9.6
8.1
1.3 5.5
945 106 139 127 573
Mountain Arizona Colorado Idaho Montana Nevada New Mexico Utah Wyoming
4.0
612
5.2 0.7 1.5 0.7 0.5 0.4 0.3
Pacific Alaska California Hawaii Oregon Washington Total
1.8
0 .8
86
1.0
0 .2
177 78 62 46 35 98 30
12.6
1,270
0.4 0.4 0 .2
0.5 0.5
0.1
8
1 .2 1.1
of patients
1 ,0 0 0 , 0 0 0
or more -1 ,0 0 0 , 0 0 0 25,000- 1 0 0 , 0 0 0 2,50025,000 Under 2,500 Farm
10.9 24.5 24.6 28.1 6.9 5.0
1 0 0 ,0 0 0
Total
100.0
Table 3 ■ Percentage distribution of population by size of place, I9 6 0 *
Size of place
Percentage of population
4.9
0 .8
0.3 10.9 0.1
931
8 .0
0
0 .0
1.0
182 149
1.5 1.3
11,671
100.0
100.0
Percentage Size of place
0.9
9.6 0.4 1.5
Table 2 ■ Percentage distribution of white patients by size of city or town
2 .2
4.2 6.7 3.2
0.3 0.4 1 .0
however, are comparable in the largest two sizeof-city categories, because no unincorporated places or rural areas are involved therein. Such comparison reveals a slight overrepresentation of dental patients in places of more than 100,000 population. This overrepresentation is to be ex pected because the dentist-population ratio is higher in larger places, generally. Also, it is likely that some dentists may have inadvertently re corded their own city’s size rather than that of their patients. Table 4 and Figure 2 show, by age and sex, the survey sample as a percentage of the total population. These percentages have considerable significance in comparing age groups and sexes with respect to dental visits. Males represented 47.1 percent of the sample; females, 52.9 percent. The percentage of the male population in the 20to-24-year-old group represented in the sample is somewhat lower than might be expected from a comparison with the number of females. The same phenomenon, although considerably more pro nounced, was noted in the 1952 survey. It is
^Source: U.S. Bureau of the Census. Statistical abstract of the United States: 1965, ed. 8 6 . Washington, D.C., Government Printing Office, 1965, p. 11.
Urban territory Places of 1,000,000 or more Places of 500,000 to 1,000,000 Places of 250,000 to 500,000 Places of 100,000 to 250,000 Places of 50,000 to 100,000 Places of 25,000 to 50,000 Places of 10,000 to 25,000 Places of 5,000 to 10,000 Places of 2,500 to 5,000 Places under 2,500 Unincorporated parts of urbanized areas Rural territory Places of 1,000 to 2,500 Places under 1,000 Other rural territory Total
69.9 9.8 6 .2 6 .0
6.5 7.7 8.3 9.8 5.5 4.2 0.4 5.5 30.1 3.6 2 .2
24.3 100.0
^Source: U.S. Bureau of the Census. Statistical abstract of the United States: 1965, ed. 8 6 . Washington, D.C., Government Printing Office, 1965, p. 15.
REPO RTS OF C O U N C IL S A N D B U R E A U S
■ 1129
New England
Middle ■Atlantic
South Atlantic
Fig. 1 ■ Comparison of regional Needs for Dental Care, 1965
East North Central
distribution of
East South Central 1965
West North Central
West South Central
Mountain
Pacific
population with distribution of patients included in Survey of
p ro b a b le t h a t th e la r g e n u m b e r o f y o u n g m e n in
g e n e ra l is a ls o p r e s e n te d in T a b le 5 . T h e p r o
th e A r m e d F o rc e s , w h o w e re in c lu d e d in th e p o p
n o u n c e d d iffe re n c e in d is trib u tio n o f in c o m e b e tw e e n th e p o p u la tio n a n d d e n ta l p a tie n ts is a
u la tio n ag e d is trib u tio n b u t n o t in th e s u rv e y , a c c o u n ts f o r th e d e v ia tio n s o f th is a g e g ro u p .
fu n c tio n o f th e te n d e n c y f o r h ig h e r-in c o m e g ro u p s to v is it th e d e n tis t m o r e o fte n . I t is tr u e th a t so m e
T a b le 5 sh o w s h o w all p a tie n ts w e re d is trib u te d a c c o rd in g to in c o m e as e s tim a te d b y th e d e n tis ts
o f th e d iffe re n c e is o n ly a p p a r e n t, b e c a u s e o f th e c o n tin u in g ris e in in c o m e s a s a w h o le o v e r th e 2 - y e a r s p a n b e tw e e n th e d a te s o f th e re la tiv e
re s p o n d in g . T h e r e a re v a rio u s b a s e s o n w h ic h a d e n tis t m a y e s tim a te in c o m e , as th e r e s p o n d e n ts w e re a s k e d to d o , a lth o u g h so m e o f th e s e in d ic a to r s c a n b e m isle a d in g . T h e 1 9 6 3 in c o m e o f th e w h ite p o p u la tio n in
Male patients
Total patients
Female patients
No. 158 599 767 794 694 786 877 694 424 255
0.0015 0.0060 0.0083 0.0095
6,048
0.0061
Age group
No.
- 4 5- 9 10-14 15-19 20-24 25-34 35-44 45-54 55-64 65-
297 1,230 1,484 1,507 1,178 1,4.67 1,650 1,332 807 475
0.0014 0.0060 0.0079 0.0089 0.0087 0.0066 0.0067 0.0060 0.0048 0.0026
139 631 717 713 484 681 773 638 383 220
0.0013 0.0061 0.0075 0.0083 0 0071 0.0061 0.0065 0.0059 0.0047 0.0028
11,427
0.0059
5,379
0.0056
Total
T h e d is trib u tio n o f p a tie n ts a c c o rd in g to le n g th o f tim e sin c e la s t v is it to a d e n tis t is s h o w n in
Percentage of 1965 population
Percentage of 1965 population
No.
d a ta in T a b le 5.
Percentage of 1965 population
0 .0 1 0 2
0.0070 0.0070 0.0061 0 0048 0.0025
^Source: Statistical abstract of the United States, 1966. Washington, D. C., Government Printing Office, 1966, p. 6 , 7.
1130 ■ JAD A, Vol. 73, Nov. 1966
Table 4 ■ Distribution of white patients, and number of white pa tients as percentage of 1965 population by age and by sex
Fig. 2 ■ Percentage of
1965 population included in Survey of Needs for Dental Care, 1965, by age and sex 1131
45 Table 5 ■ Percentage distribution of white patients by estimated income* and of white population by income Percentage of patients
Income Under $2,000 $ 2,000-$3,999 $ 4,000-$5,999 $ 6,000-$9,999 $10,000 and up Total Median
Percentage of populationf
1.8 6.3 21.4 44.6 25.9
% of survey sample % of 1965 population
9.0 15.1 20.1 34.3 21.5
100.0
100.0
$7,840
$6,700
* l f patient was a dependent, income of fam ily head was recorded. fSource: U.S. Bureau of the Census. Statistical abstract of the United States: 1965, ed. 86. Washington, D.C., Government Printing Office, 1965, p. 342.
Table 6 ■ Percentage distribution of white patients by length of time since last visit to a dentist and by sex Length of time since last visit. to dentist
Males
Less than 6 months 6 to 11 months 1 year 1.5 years 2 years 3 years More than 3 years Never been to dentist before
14.7 36.0 14.8 7.2 8.8 4.6 9.3 4.6
16.9 37.9 15.3 .6.9 8.8 4.0 6.2 4.0
15.9 37.0 15.1 7.0 8.8 4.3 7.6 4.3
100.0
100.0
100.0
Total
Females
Total
T a b le 6. I n a c c o r d a n c e w ith th e fa c t t h a t m o re w o m e n th a n m e n a re f o u n d in a r a n d o m g r o u p o f d e n ta l p a tie n ts , th is ta b le sh o w s t h a t th e a v e ra g e w o m a n la s t sa w h e r d e n tis t a t a m o r e r e c e n t d a te th a n th e a v e ra g e m a n . T h e 1 9 6 0 c e n s u s in d ic a te s t h a t N e g ro e s c o m p ris e d 1 0 .5 p e r c e n t o f th e to ta l p o p u la tio n . O f th e p a tie n ts in c lu d e d in th e s u rv e y , le ss th a n 2 p e r c e n t w e re N e g ro . B e c a u s e o f th is p r o n o u n c e d u n d e r r e p r e s e n ta tio n , a n d b e c a u s e o f e s ta b lis h e d r a c ia l d iife re n c e s in p re v a le n c e o f d e n ta l d is e a se , a lm o s t a ll ta b le s p re s e n te d w ill b e fo r w h ite p a tie n ts o n ly . A
s u m m a ry ta b le o f s o m e o f th e d e n ta l
n e e d s o f N e g ro e s w ill b e p re s e n te d , h o w e v e r. T h e “ o th e r ” ra c ia l c a te g o ry w a s re a s o n a b ly r e p r e s e n ta tiv e as to n u m b e r , b u t s p e c ific a tio n s g iv e n a lo n g w ith th is re s p o n s e in d ic a te a w id e v a ria n c e in c la s sific a tio n , re n d e r in g th e d a ta u n r e lia b le . T h e re fo r e , n o d a ta a re p r e s e n te d f o r th is
-$2,000
$2,000$4,000$10,000+ $3,999 $5,999 $9,999 Fig. 3 ■ Comparison of income-group distribution of 1963 population with distribution of patients included in Survey of Needs for Dental Care, 1965
g r o u p o f p a tie n ts . a n a ly s e s o f th e n e e d s as in d ic a te d b y th is su rv e y
b e fo r e b e e n to a d e n tis t, th e r e a re tw o so m e w h a t c o u n te r b a la n c in g b ia s e s : a te n d e n c y to sh o w h ig h
in c lu d e a te n d e n c y f o r g r e a te r n e e d s b e c a u s e o f th e s a m p le ’s c o n s is tin g o f p e o p le v is itin g a d e n tis t
n e e d s b e c a u s e o f le s s p re v io u s c a re a n d a te n d e n c y to sh o w lo w n e e d s b e c a u s e o f th e e v id e n t la c k o f
a n d a te n d e n c y f o r lo w e r n e e d s b e c a u s e o f p a tie n ts w h o g e n e ra lly re c e iv e m o re c a r e b e in g m o r e lik e ly
n e e d f o r d e n ta l c a r e th a t w o u ld o f te n b e tr u e f o r th o s e w h o n e v e r b e fo r e h a v e v is ite d a d e n tist.
I n g e n e ra l, b ia s in g fa c to rs to b e c o n s id e re d in
to b e d r a w n in to th e s a m p le . In th e c a s e o f p a tie n ts w h o a re in th e c a te g o ry o f th o s e w h o h a d n e v e r 1132 ■ JA D A , Vol. 73, Nov. 1966
T h e n e x t a rtic le in th is se rie s w ill p re s e n t d e n ta l n e e d s a c c o rd in g to a g e a n d se x o f th e p a tie n t.
B O O K S E C T IO N
Book R eview s Titles preceded by an asterisk are available on loan from the Association's Bureau of Library and Indexing Service at no charge. Books may be purchased through the Bureau at list price. Illi nois residents should add 4 percent Re tailers Use Tax to the purchase price of books.
*The Parathyroid Glands Pieter J. Gaillard, Roy V. Talmage, and Ann M . Budy. 353 pages with illustrations. Index. $15. Chicago, University of Chicago Press, 1965.
This volume is a collection of papers presented at the second symposium on the parathyroid glands held at Noordwijkaan Zee, The Netherlands, on August 25-29, 1964. The theme of the conference was the examina tion of the present state of knowl edge on the mechanisms involved in the regulation of bone resorption. The fine structure of -both the human and rat parathyroids is ex plored by J. D. Lever. Electron mi crographs illustrate the author’s the sis that the relationship of the 35150/x vesicular bodies to the Golgi and endoplasmic reticular mem branes indicates that these bodies represent intermediate or final secre tory products of the parathyroid. Ex ploring the same subject in the frog and toad, R. Lange and H. V. Brehm point out, “the existence of the secre tory granules and their connection
with the storage of the parathyroid hormone is no longer seriously ques tioned.” They relate the origin of these granules to the Golgi appara tus. The enzyme systems of the mam malian parathyroid and thyroid are discussed by A. G. Everson Pearse. Histological staining technics are used to locate leucine aminopeptidase, the dehydrogenases, and phos phatases. He draws the conclusion that the mitochondrian-rich intrafollicular and parafollicular cells of the thyroid are the probaible source of calcitonin. Isolation and purification of a highly active parathyroid hormone (PTH) preparation is described by J. T. Potts and G. D. Aurbach. These studies suggest a polypeptide com prising 52 amino acid residues. A tentative, incomplete structure is pro posed for the polypeptide. The controversy over the origin of calcitonin is discussed by D. H. Copp and I. MacIntyre and others. The former marshals the evidence for a parathyroid origin of a serum calcium lowering substance. The lat ter concludes, from the perfusion ex periments, that calcitonin is exclu sively of thyroid origin. Both authors agree that a calcitonin exists in the thyroids. L. G. Raisz and others report on tissue culture experiments that dem onstrate that the calcium concentra tion of the medium regulates amino acid uptake and protein and nucleic acid synthesis. They suggest that this negative feedback control of parathy roid function is caused fey the effect of calcium on transport of amino
acids acrosss cell membranes. R. V. Talmage and others agree with Raisz that regulation of parathyroid secre tion is controlled by calcium ion con centration in circulating fluids. Al though confirming the increase in os teoclastic population with increased parathyroid activity, they submit evi dence that indicates that the rate of calcium removal from bone is not dependent on the size of the osteo clast population. They also claim inability to demonstrate endogenous hormone effects on osteoblasts and bone matrix formation. In contrast to these studies, L. F. Belanger im plicates the large mature osteocyte specifically in bone dissolution. He defines osteolysis as bone matrix modification with a loss of bone salt, which takes place within the inti macy under the influence of the ma ture osteocyte. P. Goldhaber points out that oxy gen, parathyroid extract (PTE), vita min A alcohol, vitamins D2 and D3, dihydrotachysterol, and heparin may each act as a bone resorption factor. This author also demonstrates an un known bone resorption factor in rat serum, not derived from the parathy roid gland. That the effect of PTH on phos phate is to increase the rate of its entry into various tissue cells such as bone, intestine, and kidney is demonstrated by W. F. Neuman. Us ing the mitochondrial system, H. F. Deluca and J. D. Sallis proposed a function for vitamin D in the move ment of calcium from the mitochon dria under, the influence of PTH. This action is linked to the oxidative phosphorylation chain. Studying this ion transport problem, G. D. Aur bach comes to the conclusion that PTH seems to stimulate the use of a high energy intermediate for this purpose since PTH stimulates C 02 production from succinate. This ef fect seems to be secondary to an accelerated oxidation of nicotina mide adenine dinucleotide (NADH). He suggests this phenomenon as a method for bioassay of PTH. B. E. C. Nordin suggests that the constancy of plasma calcium levels is maintained partly by a pH gradi 1133
ent that exists between tissue fluid and effective mineral surface, which in turn is regulated by PTH and oth er substances. The observations of Aurbaoh and Nordin should be compared with the reports of R. Van Reen and I. W. Hekkelman who studied the effect of PTE on isocitric dehydrogenase (ICD). Van Reen notes that the con centration of nicotinamide ade nine diïiucleotide phosphate, reduced form, (NADPH), determines the amount of ICD that dissolves. PTE does not increase ICD levels but in creases nicotinamide ’adenine dinu cleotide phosphate, oxidized form (NADP), levels. Hekkelman demon strates a binding of ICD with NADPH, which explains Van Reen’s ob servation. Under the influence of PTE, less NADPH is available and citrate accumulates in the bone. Thus PTE causes citrate chelation of calcijim and dissolution of bone. D. V. Cohen in studying this problem, demonstrates decreased metabolism of citrate under the influence of PTE as measured by CO.* production. His data also show that incorporation of citrate into the cellular fraction of bone was reduced by PTE. He suggests that this reduction could be caused by decreased cellular mito chondrial permeability or transport, under the influence of the hormone. Studies of the effect of the para thyroid hormone on explanted mouse limb bone by P. J. Gaillard, indicate that PTE impairs the synthesis of collagen by the osteoblasts. From work with actinomycin D, this au thor suggests that the reaction of radius explants to added PTE de pends on the synthesis of certain en zymes contingent on nuclear messen ger RNA production. Nichols and others conclude that inhibition of collagen synthesis and stimulation of cell constituent syn thesis are the primary action of PTE. The evidence to support this con cept is the fact that PTE inhibits glycine uptake and protein synthesis and that there is an increase in collagenase shortly after PTE adminis tration. The sequence of events in bone matrix resorption is decalcifica 1134 ■ JA D A , Vol. 73, Nov. 1966
tion by lactic and other acids, fol lowed by collagenolytic breakdown of denuded fibers. The PTE effect is on the actual assembly of the colla gen molecules on the ribosomes. Da ta to support these concepts are also supplied by G. R. Martin and others. PTE inhibits cysteine incorporation into collagen and other1proteins and accumulation of citrate and resorp tion of bone in tissue cultures. DNA synthesis is increased With PTE and studies with inhibitors' indicate that the nucleic acid' effect is required to produce bone resorption (compare with GaiUard’s work). W. A. DeVoogd Van Der Straaten demon strates that PTE interferes with in tracellular fixation of nicotinic acid, before its use in the biosynthesis of the nucleotides. He also confirms Hekkelman’s concept of the effect of PTE on the binding of NADPH. The occurrence of cataracts in rats with hypoparathyroidism induced A. D. Kenny and others and H. D. Firschein and A. Kemrer to study the effect of PTE on the rat lens. The former demonstrates that there is no change in calcium and phosphate levels after parathyroidectomy. The latter suggest that, in hypoparathy roidism, a decrease in calcium levels in the aqueous humor results in movement of small ions and water into the lens causing vacuole forma tion. Comparison of this volume with the results of the first symposium held in 1960 amply supports Mc Lean’s statement that in the last few years there has been an “explosion in parathyroid research.” The con tributors have made giant strides in the understanding of the mechanism of parathyroid hormone action. These are digested by the discussion in the text that evaluates each group of papers. The articles are well written and profusely illustrated with numer ous halftones and charts. Twentyone pages of bibliography testify to the fact that the book covers thor oughly the research that is going on in this field. ‘ This volume' is an important source for information and ideas for the research worker in mineral me
tabolism. It is of value also to the biochemists in general, who are in terested in the mechanisms of inter mediate metabolism. The book also belongs in the library of physicians who are engaged in the study and treatment of diseases of the parathy roids and of bones and teeth. The editors should be congratulat ed for a difficult task well executed in every detail. Samuel Natelson
* M edical Illustrations Manuscripts
in
Medieval
Loren MacKinney. 263 pages with 106 illustrations. Bib liography. Index. $15. Berkeley and Los Angeles, University of California Press, 1965.
Medievalists, medical historians, or simply anyone who loves beauty will covet this volume. Both the text and the illustrations are exquisite. The structure of the book is two part: general text and a checklist of medical miniatures in extant manu scripts, most of which were examin ed firsthand by the author or his wife. The latter part was prepared with the assistance of Thomas Hern don. Although it is an uncompromising work of scholarship, the book suffers no pedantries to put off the general reader. In Part 1, a most readable discourse on illumination of medical manuscripts has been organized ac cording to topic: hospitals and clin ics, diagnosis and prognosis, materia medica, dentistry, surgery, and so on. Throughout, the author makes reference to the 106 illustrations, a fifth of them in color, collected at the end of the book. Those whose enthusiasms are fired by this lovely book will welcome the 5-page se lected bibliography. The author has given has reader a collection of art treasures, a host of intellectual surprises, and a pleasant introduction to a little-known sub ject. L ouanna F urbee
ATLAS
O F
DEVELOPMENTAL ANATOMY OF THE FACE With special reference to normal and cleft lip and palate
BERTRAM S. KRAUS • HIRONORI KITAMURA • RALPH A. LATHAM
m iscellan eo u s findings, su ch as e n a m el p earls, an d d e n tal an o m alies as so ciated w ith cle ft p a la te . T h e b o o k p resen ts a w ealth o f h isto lo g ic m a terial o f th e n o rm a l a n d c le ft lip and p a la te sp ecim ens d u rin g th e p re n a ta l p eriod. T h e au th o rs h av e effectively d e m o n stra te d ch ang es w ith age and v ariatio n s in m o rp h o lo g y o f b o th n o rm a l a n d a b n o rm a l specim ens. It is p e rh a p s u n fo rtu n a te th a t th e au th o rs h a v e avo id ed ex p lan a tio n s o f th e p h o to m ic ro g ra p h s o r discussion o f th e m a te ria l p resen te d , b u t th ey did this p u rp o se ly in th a t th e y state th a t th e fu n c tio n o f th e tex t is to illu strate a n d n o t to co n v ert. A m o st v alu ab le re fe re n c e tex t fo r p re n a ta l facial d ev elo p m en t, this b o o k w ill p ro b a b ly b e o f g reatest v alu e to th e k n o w led g eab le inv esti g a to r in th e field o f o ra l d ev elo p m en t a n d m ald ev elo p m en t. J a m es K . A v e r y
D e v e lo p in g t h e S u p e r v is o ry S k ills o f t h e N u r s e : A B e h a v io r a l S c ie n c e A p p r o a c h
Adelma E. Mooth and M iriam M. Ritvo. 107 pages. $3.50. New York, M a c M il lan Company, 1966.
" A tla s o f th e F a c e
D e v e lo p m e n ta l
A n a to m y
of
Bertram S. Kraus, Hironori Kitamura, and Ralph Latham. 378 pages with 1,224 illustrations. $20. New York, Hoeber Medical Division, Harper & Row, 1966.
In p re p a rin g this b o o k , th e au th o rs have u sed 1,200 gross an d m ic ro p h o to g rap h s o f 35 cleft an d 47 n o rm alap p earin g sp ecim en s selected fro m a collection o f 2 5 ,0 0 0 h u m a n em b ryos an d fetuses. T h e m ate ria l is p resen ted m ain ly in th e fo rm o f his tologic sections w ith ap p ro p ria te d ia gram s and ex p lan a tio n s o f lo catio n o f each o f the sections. T h e speci m ens a re cata lo g u e d fo r easy re f
ere n ce an d coded fo r a n a to m ic la n d m ark s. T h e m a te ria l h as 'been d ivided in to fo u r m a jo r sections, th e first o f w h ich is a series o f n o rm a l em b ry o s ra n g in g in ages fro m 35 days to b irth . T h e second m a jo r division, u s ing fro n ta l sectio n s sim ilar to th e n o rm a l series, consists o f cleft lip a n d p a late em b ry o s fro m 41 days to b irth . T h e te ch n ical p re p a ra tio n an d p re se n ta tio n o f these tw o series is ex cellent. D ivisio n th re e co n sists o f a n in tere stin g a rra y o f associated m a lfo rm a tio n s th a t o c c u rre d in th e c left sp ecim en s illu strated in division tw o. T h e fo u rth a n d final division, e n title d “S pecial to p ic s,” p resen ts
A co g en t and u p -to -th e -m in u te dis cussion o f th e n a tu re o f th e su p e r visory p ro cess a n d a d e tailed p res e n ta tio n o f th e case m e th o d o f in stru c tio n e x ten d this b o o k ’s a p p li cability b ey o n d the n u rsin g situ ation. Its c o n te n t should be o f p a rtic u la r in te re st fo r those te a c h in g p ro fe s sional stu d en ts, n o t o n ly b ecau se th e case m e th o d is an effective w ay o f teac h in g , b u t also b ecau se th e p ro fe s sional p ra c titio n e r w ill so o ften be in a p o sitio n w h ere su p e rv iso ry skills a re n eeded. S u pervision is d escrib ed as a dy n am ic p ro cess b ased o n an u n d e r sta n d in g of hum an in te ra c tio n , w herein th e su p e rv iso r “ en co u ra g es a n d p a rtic ip a te s in th e d ev elo p m en t o f (h is) su b o rd in a te s.” R eq u isite k n o w led g e a n d sen sitiv ity can be g a in ed th ro u g h sem in ars w h e re a “c a se ” is analyzed. In m a n y w ays, th e ty p e o f sem in ar sug g ested fo l low s th e tra d itio n a l m ed ical m o d el o f case p re se n ta tio n an d b rain -sto rm in g BOOKS " 1 1 3 5
for a solution or an understanding of why there was a failure. The em phasis here is psychological however: “one collects the facts and analyzes how people behaved, what their needs were, what happened, what seemed to precipitate the incident, and what were the positive learnings from this incident that can prevent a recurrence.” The case method thus takes a problem-solving approach, attempting through fact-finding and discussion to build up a body of knowledge for the group and to in crease the understanding of each in dividual member. When successful, the experience for the individual could best be described as sensitivity training. Particular attention is paid to the role of the seminar leader. The ma jor technic suggested is a judicious asking of questions, which makes it necessary for participants to examine the foundations on which many of their attitudes and response tenden cies are based. Some “do’s” and “dont’s” are also offered the group leader and an attempt made to use one case as a demonstration. At that point, the authors relinquish their expository task and merely present a series of cases to be used as the content of the supervisory training seminars. The major failing of the book is that these materials are not used to demonstrate the learning process. Presenting case content for future seminars is not a particularly valuable contribution, since the most worthwhile discussions center about situations in which the participants have first-hand experience. A trans cription of an entire seminar session, including the case material, leader’s questions and comments, and mem bers’ reactions, would have made the whole process of learning by the case method much clearer. In spite of this shortcoming, De veloping the Supervisory Skills of the Nurse provides a good introduc tion to a method of teaching that is rapidly coming into widespread use. Both authors, faculty members at Boston University, were well qualified for the undertaking. Jane Moosbruker 1136 ■ JA D A , Vol. 73, Nov. 1966
Drugs of Choice: 1966-1967 W a lte r Model I, editor. Fifth edition. 969 pages. Index. $16.75. St. Louis, The C. V. Mosby Co., 1966.
An excellent reference book for the health-oriented individual, this current edition, although not dras tically different, has been revised and updated in several areas. Without being unduly cautious, the various contributors have continued to cen ter their discussions around the proved drugs of therapy but do not fail, in most instances, to mention the new but as yet incompletely test ed agents. The book is written for the phy sician and is heavily oriented to the regimen of drug therapy as these drugs apply to the medical patient. There is no section on dentistry as such. Many chapters, however, have information of great value to the dentil clincian. Such sections as the principles of drug choice, adverse drug reactions, local antiseptics, anti bacterial agents, sedatives, and so on are of importance and interest to all health practitioners. Those areas where the mechanics of therapy of cardiovascular disease and other medical problems are discussed give insight into the problems of the pa tient and how these problems can relate to the dental treatment. As a result, although the book is not di rected to dentistry, the dentist will find it an excellent reference addition to his library. James W. Smudski
M aking the Most of Radio-TV Roy E. Johnson. 56 pages. Appendix. $2. New York, National Public Relations Council on Health and W elfare Services, Inc., 1966.
Although a “how to” publication, this book sets no rigid guidelines for the novice or professional public relations practitioner. Rather, the book clearly defines the method in whioh radio and television can be
used effectively to convey a health agency’s public information program to the public. The author has had muoh experi ence in health agency public rela tions; he recently retired after 27 years as an official of the Amerioan Red Cross. During that time, he served as director of its office of public information and as head of its radio and television department. Mr. Johnson is also a member of the board of directors of the National Public Relations Council of Health and Welfare Services, Inc. Throughout his career, Mr. John son was aware that the success of a health agency’s national public in formation program depends on the efforts of the novice public relations chairman charged with coordinating the program at the local level. Mr. Johnson realized that, though the novice may never become as adept as the professional, there are certain steps that could make his job easier, especially in using radio-television stations for public service purposes. Mr. Johnson provides readers with information about preparing such items as news releases, radio-TV spot announcements, interviews, and other scripts. He also discusses the proper methods of contacting stations to ob tain public service time and inter views. The author presents methods of evaluating local radio and televi sion to determine if they are the proper mediums for use in convey ing one’s message. The book will present no solutions for public relations problems that plague all organizations. It will, however, give the professional an interesting refresher course on how radio and television oan best serve the public information program. It will also aid the novice faced for the first time with the responsibility of using radio and television to com municate effectively with the public. Making the Most of Radio-TV is a good primer for the fledgling pub lic relations chairman of dental component and constituent societies and their women’s auxiliary organi zations. Dean D ranias
Additions to the Library The books listed here have been added recently to the Bureau collection. Re quests for this material, available on loan to all members of the Association, should be addressed to the Bureau of Library and Indexing Service. There is no charge for borrowing books, but there is a minimal charge of one dollar ($1.00) for each package library. Illi nois residents should add 4 per cent Retailers Use Tax to the purchase price of books and to the rental fee for a package library. Book prices are subject to change without notice in accordance with changes in publishers' prices. Practically all the dental journals pub lished in the world at present are av ail able to members on loan. Lists of books, package libraries, and journals are available on request.
Books American A ssociation of Orthodontists. Council on Orthodontic Education. Orthodontics: principles and policies, educational requirements, organizational structure. St. Louis [1966] 20 p. American D ental Associaton. Bureau of D ental H ealth Education & Amer ican Association of P ublic H ealth D entists. National conference on pa tient education, Las Vegas, November 6, 1965. Chicago, 1966. 32 p. American D ental Society of E urope. Transactions, 1965. London, 1965. 55 p. Mimeo. Ârruda, J. V. Uma técnica cirürgica para aprofundamento dos sulcos vestibulares e linguais nos desdentados totais.
ances. London, Pitman Medical Publish ing Co., 1965. 133 p. $2.40. The E conomics of H ealth and M edical Care; proceedings of the conference, May 10-12, 1962. Sponsored by Bureau of Public Health Economics and Depart ment of Economics University of Mich igan. Ann Arbor, 1964. 321 p. European Organization for R esearch on F luorine and D ental Caries Preven tion . Advances in fluorine research and dental caries prevention; proceedings of the 12th congress, Utrecht, the Nether lands, 9th-llth June 1965. Edited by P. M. C. James [et al] Oxford, New York, Pergamon Press, 1966. 246 p. $18.50. International Academy of Oral Pathol ogy. Second proceedings; a conference held at Melbourne University, Australia, September 1-4, 1965. New York [1966] 147 p. $5. International A nesthesiology C linics, August 1965. European trends in anes thesiology. Boston, Little, Brown [1966]. J archo, Saul, ed. Human paleopathology; proceedings of a symposium on human paleopathology held in Washington, D. C., January 14, 1965, under the auspices of the Subcommittee on Geo graphic Pathology, National Academy of Sciences—National Research Council. New Haven, Yale University Press, 1966. 182 p. $7.50. Jensen, J. R. Pulpal problems and their detection. (Practical dental monographs, May-June 1966.) Chicago, Year Book Medical Publishers, 1966. 28 p. K reshover, S. J., & M cClure, F. J., ed. Environmental variables in oral disease; a symposium presented at the Montreal meeting of the American Association for the Advancement of Science, Decem ber 1964. Washington, American Asso ciation for the Advancement of Science, 1966. 312 p. $8.75. • K unzel, Walter, & T oman, J aroslav, ed. Kinderzahnheilkunde und ihre Grenzgebiete. Berlin, Volk und Gesundheit, 1965. 544 p. . K umar, V inod. Configuration of periodon tal pockets in relation to age, sex and location. (M. S. thesis—New York Uni versity.) New York, 1966. 74 p. Mimeo. BCuriakose, V. K. The incidence of torus palatinus in American population. (M. S. thesis—University of New York.) New York, 1965. 42 p. Typewritten. Lammie, G. A. Dental orthopaedics. Ox ford, Alden Press, 1966. 301 p. $10.10. M anson, J. D. Periodontics for the gen eral practitioner; a manual of practical periodontics. Chicago, Year Book Med ical Publishers, 1966. 220 p. $12.50. M arsh all, J. D., ed. Approaches to li brary history; proceedings of the second library history seminar, Florida State University Library School, Tallahassee, March 4, 5, and 6, 1965. Tallahassee, Journal of Library History, 1966. 183 p.
$8.
Merck Manual of D iagnosis and T her apy. 11th ed. Rahway, N. J., Merck Sharp & Dohme Research Laboratories, 1966. 1,850 p. $7.50. Metse, P. I. Estologiki metabolai ton polphoi othonton kliythn ex epitthrasethe phsiko-chmikthn tinthn aitithn epi tes apokekalgmmenes odontines. Athens, 1965. 96 p. English summary. M itchell, G. E., & Others. Selected local dental health programs; Contra Costa County, California, Hartford, Connecti cut, Jefferson County, Alabama. (U. S. Public Health Service Publication No. 1402.) Washington, U. S. Division of Dental Health, 1965. 26 p. M ollin, A. D. Universal light arch tech nique for treatment of malocclusion. Brooklyn, N. Y., Bruder, 1966. 200 p.
$20. M ontgomery, G. L. Pathology for stu dents of dentistry. 3d ed. Edinburgh, Livingstone, 1966. 399 p. $8. M oraes, P. A. Occorrencia de dermatófitos em solos do municipio de Piraci caba. (Docente livre thesis—Faculdade de Farmácia e Odontologia de Piraci caba.) Piracicaba, 1965. 48 p. N ascimento, Aparecido. Estudo macro scópico do periodonto de sustentado de peixes do genero leporinus (piavas). (D. C. thesis—Faculdade de Farmácia e Odontologia de Piracicaba.) Piracicaba, 1965. 81 p. Mimeo. R enci, J ose. Prevalencia de maloclusoes em escolares de Piracicaba, de 7 a 12 anos de idade, segundo os indices de Draker e da OMS. (D. C. thesis—Facul dade de Farmácia e Odontologia de Piracicaba.) Piracicaba, 1965. 87 p. Mimeo. San D iego C ounty D ental Society. The roster, 1966. San Diego, Calif., 1966. 84 p. Schwarz, A. M., & G ratzinger, Max. Re movable orthodontic appliances. Phila delphia, Saunders, 1966. 355 p. $18. Smith , M aurice. A short history of den tistry. Translated into Korean by Choe Jin-hwan. Seoul, Korean Academy of the History of Dentistry, 1966. 215 p. T okvam, Otto. Maxillo-facial injuries; eti ology, clinical features and treatment. Bombay, Popular Prakashan, 1965. 193 p. $14. U. S. N ational C enter for H ealth Sta tistics. Volume of dental visits, United States, July 1963-June 1964; statistics on volume of dental visits by type of dental service, age, sex, residence, geo graphic region, family income, color, education of head of family, usual activ ity status, and marital status. (U. S. Public Health Service publication No. 1000—Series 10—No. 23.) Washington, Govt. Print. Off., 1965. 55 p. $0.45. Walther, D. P., ed. Current orthodontics. Bristol, Wright, 1966. 546 p. $21.75. Woodruff, M. F. A. Surgery for dental students. 2d ed. Oxford, Blackwell, 1966. 326 p. $8.
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