Thesis (M.S.P.H.)--University of Michigan, 1942.

Thesis (D.P.H.)--University of Michigan.

Thesis (D.P.H.)--University of Michigan.

Thesis (M.S.P.H.)--University of Michigan, 1942.

Thesis (M.D.S.)--University of Hong Kong, 1993.

Thesis (M.D.S.)--University of Hong Kong, 1993. / Also available in print.

Individuals with advance-stage illnesses frequently face illness or treatment-related adverse effects in the mouth. These adverse effects can have serious consequences. Despite that, the importance of oral care in this population is often overlooked and there are no definitive guidelines as to what kind of oral care should be provided to these individuals. Given that, our study aims were to explore and better understand the oral health-related concerns, perceived oral care needs of palliative care patients and the berries that face in accessing dental care services. We conducted a qualitative description study by recruiting a purposive sample of 11 participants with advanced stage health conditions from the outpatient palliative care services of the University of Iowa Hospitals and Clinics. Data were collected using in-depth, semi-structured interviews using an interview guide. All interviews were fully transcribed, with the data managed with Atlas.ti software to facilitate the analysis. All participants had oral concerns although they varied widely from person to person and their illness statuses. The most significant concerns were related to dry mouth, loose dentures, and eating difficulties. Among those who stated that they would seek dental care if required, they were not planning on seeking dental care even though they had treatable oral problems, suggesting a mismatch between their oral health status and their perceived needs. The frequently observed barriers that prevented them from seeking dental care were their illness and illness related priorities, finances, feeling discriminated against by the dentist, and a dislike towards the dentist. Providing information to the palliative care clinicians about the significance of oral health and its impact, incorporating a dental care provider in palliative care team, and providing timely information to individuals with advanced health conditions may enhance the understanding of their oral health problems and help them better manage their oral health and may enhance their dental care seeking behavior.

Thesis (M. Sc. (Microbiology)) -- University of Limpopo, 2022 / Dental diseases are among the most prevalent diseases worldwide. A recent epidemiological survey has shown that about 49 to 83% people are affected by dental caries. Carissa bispinosa (L.) Desf. ex Brenan is one of the medicinal plants used traditionally to treat dental diseases. This study aims to investigate the effectiveness of antimicrobial compounds from the leaf and stem extracts of C. bispinosa on oral pathogens. Nine solvents (n-hexane, chloroform, dichloromethane, ethyl acetate, acetone, ethanol, methanol, butanol and water) were used for the extraction of the leaf and stem powder of C. bispinosa. Biochemical tests were performed to determine the presence of phytochemical constituents and the phytochemical profile was generated through thin layer chromatography (TLC). TLC- 2, 2-diphenyl-1-picrylhydrazyl (TLC-DPPH) assay was used to determine the qualitative antioxidant activity while DPPH free radical scavenging and ferric reducing power assay were used for the quantification of antioxidant activity. The antimicrobial activity was tested on five pathogens (Staphylococcus aureus, Enterococcus faecalis, Streptococcus pyogenes, Candida albicans and Candida glabrata) qualitatively using the TLC-bioautography assay and quantitatively using the minimum inhibitory concentration (MIC) assay. Cytotoxicity was tested on the THP-1 cell line using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. The active compound was isolated through open column chromatography and preparative-TLC guided by bioassays. Structural elucidation was achieved from the analysis of spectral data generated by nuclear magnetic resonance (NMR) techniques. A variety of phytochemicals were detected on the leaf and stem extracts. The extracts had high antioxidant activity, especially those extracted with polar solvents. All the pathogens, except C. glabrata, demonstrated susceptibility to the extracts on the qualitative assay. For the leaf extracts, methanol extract had the lowest average MIC value (0.81 mg/ml) making it the most activity across the microorganisms, whereas hexane had the highest MIC value (1.63 mg/ml). C. albicans demonstrated higher susceptibility with an average of 0.73 mg/ml while C. glabrata displayed the least (2.8 mg/ml). Compared to the leaf extracts, lesser activity was observed for the stem extracts on bioautography and MIC. The percentage viability was decreasing as the concentration of the extract was increasing. However, the highest concentration resulted xxiv in more than 50% cell viability. The compound was isolated as a white powder (10.5 mg). It was identified based on its physical properties, spectroscopic data and comparing the data with scientific literature and was found to be β-Sitosterol, a member of plant steroids (Phytosterols). The study is the first to detect the presence of the antimicrobial compound (β-Sitosterol) and isolate it from the leaves of Carissa bispinosa. / Department of Science and Innovation-Council for Scientific and Industrial Research

Not many studies have been conducted in the past to determine patients' level of satisfaction in academic dental hygiene settings. This patient satisfaction study analyzed the level of patient satisfaction with the dental hygiene clinic at East Tennessee State University, Johnson City, TN. The purpose of the study was to determine if there was a statistically significant influence of demographic characteristics of the patients and the affective behavior of the care providers on level of patient satisfaction. It was concluded that except for age, other demographic variables did not have any statistically significant influence on patient satisfaction. Also, care provider's affective behavior significantly influenced patient satisfaction. Overall, the dental hygiene patients were satisfied with the clinic. As patients' needs are prioritized in this customer-driven industry, such positive patient satisfaction data can be used for the welfare of the patients, the care providers, and the health care organization.

Dental caries is the most common chronic disease in children, and prevalence rates are disproportionately higher in American Indian/Alaska Native (AI/AN) populations. The Association of State and Territorial Dental Directors (ASTDD) recommends annual oral health screening for children in Head Start programs using the Basic Screening Survey (BSS). The 2014 study was a follow-up to a 2010 national survey of AI/AN children ages five and under that assessed oral health outcomes such as untreated decay, decay experience, urgent need for treatment, presence of sealants and decayed, missing and filled deciduous teeth (dmft) scores, and investigated the changes in Early Childhood Caries (ECC) prevalence from 2010 to 2014 in the Indian Health Service (IHS) Nashville Area. A gap analysis was completed comparing current recommended practices among dental clinics that participated in the IHS ECC Collaborative ASTDD Framework to Prevent and Control Childhood Tooth Decay (ASTDD Framework). Due to historical mistreatment of AI/AN populations in research, and out of respect for the sovereignty of the Tribal Nations that participated in the study, there limited data was made available for this study. In 2010, 579 children were screened in the Nashville Area; 1231 children participated in 2014. While there was a statistically significant, yet clinically small 9.36% reduction of untreated decay from 2010 (30.33%) to 2014 (27.49%), the ECC Collaborative did not reach their objective of a 25% reduction. There was also a significant increase in urgent need for treatment (3.17% in 2010 to 4.35% in 2014), and in presence of sealants (4.54% in 2010 to 10.01% in 2014). Gaps in best practices identified were related to need for increased risk assessments and enhancing policy development. Based on study findings and the limited access to data on Tribal and Area levels, development of culturally appropriate policies that are unique to individual Tribal needs, and focus on perinatal care, is recommended. Individual Tribal programs also need to be evaluated and surveillance needs to be continued to establish trend data. All program evaluations and research should be conducted in an ethical manner that is community-based and considerate of the needs of the Tribe.