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Treatment of child patients in general practice
1326
QUARTERLY
calcified as a rule to four hours. ”
within
three
REVIEW
to six hours;
OP LITERATTTRE
tiny
fragments
must he checked
within
two
Reference 1. Ducey E. F., and Shippy, Path.
R. T.:
l)ecalcifi~~ntion
of Bone by Electrolysis,
Am. .I. Clin.
20: 85-86, 1950. 7’. .T. C.
Ueber Anenry’smenblidung im Kiefer-Gesichtsbereich. (Formation of Aneurysm in the Region of the Jaws and Face.) W. Holler. Deutsche zahnarztl. Ztschr. 6: 638, 1951. jaw which has not been The formation of aneurysms in the region of an infected traumatized is of very rare occurrence. The infectious process causes an erosion of the vessels and the escaping blood enters the adjacent morbid tissue. More common are erosion hemorrhages which occur on an infectious basis in a traumatic wound which has not received proper primary care. Primary closure may cause stasis of the tissue fluids, and even under antibiotic protection, the walls of the vessels may be destroyed by abscess formation. The most common cause of aneurysm is traumatic injury. In these cases which are described in the article, aneurysm occurred only two to ten weeks after the trauma from Probably the shrapnel splinters which may have entered a muscle cause a shrapnel injury. erosion of the vessels gradually through motion, which explains why hemorrhage occurs so late. Aneurysms should be taken care of as soon as they are discovered in order to prevent injury of nerves and soft tissue, and the danger of external hemorrhage and its consequences. The author treated cases of aneurysm of the temporal, facial, and external carotid arteries. H. R. N.
Tabakrauch 1951.
und ZBhne.
(Tobacco Smoke and the Teeth.)
IX. J. Schmidt.
Stoma 4: 111,
The author concluded from his examinations that the increased use of smoking decreases the incidence of dental caries. The beneficial effect is noted on the palatal, buccal, Tobacco causes a deposit to form on the teeth which and mesial surfaces of the teeth. may penetrate the dental cuticle and is distributed in the enamel in the form of spots. Yellow discoloration may be found to reach as far as the odontoblastic processes. The saturation with the derivatives of tobacco smoke appears to be responsible for the caries resistance. H. R. M.
ORAL Treatment
of Child Patients
40-41, January,
MEDICINE
in General Practice.
W. D. Suthers.
D. J. Australia
23:
1951.
Treatment From the data obtained
Plan ‘and Its Importance
at the first appointment
we know:
a. The attitude of child, temperament, influence of parent, and desirability of premedication. If the child is spoiled and unruly, then the parent can be warned at the outset that that time factor may influence the cost. b. The number in deciduous molars
and extent are usually
c. The questionable
teeth:
simple of cavities: less sensitive than extraction
Class I, Class III, or Class V cavities Class I cavities in permanent molars.
or pulpotomy
1. Number of teeth with pulp-involvement. 2. Number of teeth missing.
depending
on:
3. Vitality
of pulp and extent 4. Health of child. 5. Attitude and cooperation. d. Teeth to be extracted,
of exposure.
and need for space maintenance.
1. The loss of second deciduous molars is more serious than the loss of first molars. 2. The loss of deciduous molars is more serious in a 5-year-old than in an S-year-old. 3. When a Class II malocclusion exists, space maintenance is vital in the mandible and, in a Class III malocclusion, it is equally vital in the maxilla. The adopted:
problem
of
space
maintenance
is
Where teeth have been lost prematurely, space, and check for closure of space at monthly
simplified
if
the
bend a U-shaped intervals.
following wire
procedure staple
to fit
is the
This task can be entrusted to an intelligent parent (suggest a fortnightly check), and if an appliance is needed, you will not have to sell the idea. If the oral hygiene is poor, then restorative work and patient e. Oral hygiene. odontotomy is desirable under and parent education must go hand in hand. Prophylactic these circumstances. f. Caries activity and control. The need for .diet charts trol should be assessed before treatment plan is completed. A little more thought given to planning quire will pay handsome dividends in every associated with children’s dentistry.
or a program
of caries
con-
the treatment which our young patients rerespect and avoid many of the headaches A. J. A.
M&i&e’s Syndrome. Observations on Vitamin Deficiency as the Causative Factor. III. The General Disturbance. Miles Atkinson, Arch. Otolaryng. 51: 150, February, 1950. “Lingual Signs.-The signs of niacin deficiency are manifested mainly in the tongue. For a full and detailed description of the changes which occur, reference should be made to the work of Kruse. In cases of acute niacin deficiency, the first stage is shown by hypertrophy and increased vascularity of the fungiform papillae, producing so-called strawberry tongue, and this is followed by atrophy, producing the smooth, glazed ‘raw beef’ tongue. These are the changes seen in frank pellagra. They are not. seen in the group of cases under consideration here in which the deficiency is chronic and is slowly developed over a number of years before the syndrome of Men&e appears. In chronic niacin deficiency the appearances are very different, though the two stages through which the lingual papillae pass are the same, hypertrophy followed by atrophy. In the earlier stages the most evident change is in the filiform papillae, which enlarge, run together in columns and may fuse into a solid white fur over the dorsum of the tongue. Among these white filiform papillae, the fungiform papillae on the tip and edges of the tongue appear red, swollen and edematous. As atrophy sets in, the heaviness of the fur begins to decrease, many of the filiform papillae disappear, so that those remaining appear discrete (‘cobblestone tongue’), until eventually among them smooth patches appear, in which all papillae have disappeared (I geographic tongue ‘). This smooth atrophy appears first at the edges of the tongue and then moves toward the center. The fungiform papillae also share in the atrophic process, diminish into minute red spots and ultimately disappear almost entirely. Many phases of these two steps may be present in the tongue at the same time, such as smooth edges, a thick dorsal fur of hypertrophied filiform papillae and a tip speckled with red dots of atrophying fungiform papillae. Fissuring of the tongue, occasionally very deep, sometimes also occurs and is said to be due to the atrophic process and to niacin deficiency. Personally, I am inclined to doubt this interpretation, having seen fissuring mainly in association with severe signs of riboflavin deficiency in the eyes and elsewhere; and in tongues with bluish or magenta tint, accepted as being due to riboflavin
QUARTERLY
calcified as a rule to four hours. ”
within
three
REVIEW
to six hours;
OP LITERATTTRE
tiny
fragments
must he checked
within
two
Reference 1. Ducey E. F., and Shippy, Path.
R. T.:
l)ecalcifi~~ntion
of Bone by Electrolysis,
Am. .I. Clin.
20: 85-86, 1950. 7’. .T. C.
Ueber Anenry’smenblidung im Kiefer-Gesichtsbereich. (Formation of Aneurysm in the Region of the Jaws and Face.) W. Holler. Deutsche zahnarztl. Ztschr. 6: 638, 1951. jaw which has not been The formation of aneurysms in the region of an infected traumatized is of very rare occurrence. The infectious process causes an erosion of the vessels and the escaping blood enters the adjacent morbid tissue. More common are erosion hemorrhages which occur on an infectious basis in a traumatic wound which has not received proper primary care. Primary closure may cause stasis of the tissue fluids, and even under antibiotic protection, the walls of the vessels may be destroyed by abscess formation. The most common cause of aneurysm is traumatic injury. In these cases which are described in the article, aneurysm occurred only two to ten weeks after the trauma from Probably the shrapnel splinters which may have entered a muscle cause a shrapnel injury. erosion of the vessels gradually through motion, which explains why hemorrhage occurs so late. Aneurysms should be taken care of as soon as they are discovered in order to prevent injury of nerves and soft tissue, and the danger of external hemorrhage and its consequences. The author treated cases of aneurysm of the temporal, facial, and external carotid arteries. H. R. N.
Tabakrauch 1951.
und ZBhne.
(Tobacco Smoke and the Teeth.)
IX. J. Schmidt.
Stoma 4: 111,
The author concluded from his examinations that the increased use of smoking decreases the incidence of dental caries. The beneficial effect is noted on the palatal, buccal, Tobacco causes a deposit to form on the teeth which and mesial surfaces of the teeth. may penetrate the dental cuticle and is distributed in the enamel in the form of spots. Yellow discoloration may be found to reach as far as the odontoblastic processes. The saturation with the derivatives of tobacco smoke appears to be responsible for the caries resistance. H. R. M.
ORAL Treatment
of Child Patients
40-41, January,
MEDICINE
in General Practice.
W. D. Suthers.
D. J. Australia
23:
1951.
Treatment From the data obtained
Plan ‘and Its Importance
at the first appointment
we know:
a. The attitude of child, temperament, influence of parent, and desirability of premedication. If the child is spoiled and unruly, then the parent can be warned at the outset that that time factor may influence the cost. b. The number in deciduous molars
and extent are usually
c. The questionable
teeth:
simple of cavities: less sensitive than extraction
Class I, Class III, or Class V cavities Class I cavities in permanent molars.
or pulpotomy
1. Number of teeth with pulp-involvement. 2. Number of teeth missing.
depending
on:
3. Vitality
of pulp and extent 4. Health of child. 5. Attitude and cooperation. d. Teeth to be extracted,
of exposure.
and need for space maintenance.
1. The loss of second deciduous molars is more serious than the loss of first molars. 2. The loss of deciduous molars is more serious in a 5-year-old than in an S-year-old. 3. When a Class II malocclusion exists, space maintenance is vital in the mandible and, in a Class III malocclusion, it is equally vital in the maxilla. The adopted:
problem
of
space
maintenance
is
Where teeth have been lost prematurely, space, and check for closure of space at monthly
simplified
if
the
bend a U-shaped intervals.
following wire
procedure staple
to fit
is the
This task can be entrusted to an intelligent parent (suggest a fortnightly check), and if an appliance is needed, you will not have to sell the idea. If the oral hygiene is poor, then restorative work and patient e. Oral hygiene. odontotomy is desirable under and parent education must go hand in hand. Prophylactic these circumstances. f. Caries activity and control. The need for .diet charts trol should be assessed before treatment plan is completed. A little more thought given to planning quire will pay handsome dividends in every associated with children’s dentistry.
or a program
of caries
con-
the treatment which our young patients rerespect and avoid many of the headaches A. J. A.
M&i&e’s Syndrome. Observations on Vitamin Deficiency as the Causative Factor. III. The General Disturbance. Miles Atkinson, Arch. Otolaryng. 51: 150, February, 1950. “Lingual Signs.-The signs of niacin deficiency are manifested mainly in the tongue. For a full and detailed description of the changes which occur, reference should be made to the work of Kruse. In cases of acute niacin deficiency, the first stage is shown by hypertrophy and increased vascularity of the fungiform papillae, producing so-called strawberry tongue, and this is followed by atrophy, producing the smooth, glazed ‘raw beef’ tongue. These are the changes seen in frank pellagra. They are not. seen in the group of cases under consideration here in which the deficiency is chronic and is slowly developed over a number of years before the syndrome of Men&e appears. In chronic niacin deficiency the appearances are very different, though the two stages through which the lingual papillae pass are the same, hypertrophy followed by atrophy. In the earlier stages the most evident change is in the filiform papillae, which enlarge, run together in columns and may fuse into a solid white fur over the dorsum of the tongue. Among these white filiform papillae, the fungiform papillae on the tip and edges of the tongue appear red, swollen and edematous. As atrophy sets in, the heaviness of the fur begins to decrease, many of the filiform papillae disappear, so that those remaining appear discrete (‘cobblestone tongue’), until eventually among them smooth patches appear, in which all papillae have disappeared (I geographic tongue ‘). This smooth atrophy appears first at the edges of the tongue and then moves toward the center. The fungiform papillae also share in the atrophic process, diminish into minute red spots and ultimately disappear almost entirely. Many phases of these two steps may be present in the tongue at the same time, such as smooth edges, a thick dorsal fur of hypertrophied filiform papillae and a tip speckled with red dots of atrophying fungiform papillae. Fissuring of the tongue, occasionally very deep, sometimes also occurs and is said to be due to the atrophic process and to niacin deficiency. Personally, I am inclined to doubt this interpretation, having seen fissuring mainly in association with severe signs of riboflavin deficiency in the eyes and elsewhere; and in tongues with bluish or magenta tint, accepted as being due to riboflavin