Lisa A. Tedesco

Self-efficacy, reasoned action, and oral health behavior reports: A social cognitive approach to compliance

The usefulness of a social cognitive approach to compliance with brushing and flossing behavior recommendations was tested with 39 patients recruited from the State University of New York at Buffalo Periodontal Disease Clinical Research Center. Participants completed mailed study instruments assessing Fishbein and Ajzens theory of reasoned action variables, Banduras self-efficacy variables, and frequency of brushing and flossing behavior. Results indicated positive attitudes, beliefs, and norms for brushing and flossing and positive intentions to brush but less intention to floss. Hierarchical regression analyses supported the basic usefulness of the theory of reasoned action for oral health behavior reports. Addition of self-efficacy variables to theory of reasoned action variables significantly increased the explained variance of brushing and flossing behavior reports. These results establish a strong basis for future clinical studies investigating social cognitions and the prediction of oral health behavior.

A dental-facial attractiveness scale

Since the decision to seek orthodontic treatment is frequently the result of concerns about appearance, assessment of need for treatment should include an impartial evaluation of dental-facial appearance. While some of the standardized techniques for assessing malocclusion have included a consideration of esthetic impairment, they tend to confound this with functional impairment. The purpose of this study was to develop a valid and reliable index that provides relatively objective judgments of dental-facial attractiveness. The subjects in this study were eighth- and ninth-grade children seeking orthodontic treatment and their siblings, and eighth- and ninth-grade children not seeking treatment and their siblings. Photographs of the children were rated for dental-facial attractiveness by lay and dental judges. Children were also assessed for severity of malocclusion by means of the Treatment Priority index. Children seeking treatment were perceived as significantly less attractive than children not seeking treatment. Dental judges rated children seeking treatment as more attractive than did nondental judges. Intraclass reliability coefficients were moderate to high.

Variables Discriminating Individuals who Seek Orthodontic Treatment

Characteristics differentiating two groups of adolescents were identified: those planning orthodontic treatment and a comparison group not planning treatment. Two separate analyses, for psychosocial and dental-related variables, were completed. Additional analyses were applied using salient variables for each group. Eighty-two percent of the subjects were correctly categorized using the resulting discriminant function.

Patient perceptions of dental-facial esthetics: Shared concerns in orthodontics and prosthodontics

D ental-facial esthetics and problems in patients’ perceptions and expectations regarding their appearance represent a major issue in prosthodontic treatment. Many prosthodontic failures are the result, not of technical difficulties, but of mismatches between patient expectations for a restoration or prosthesis and the dentist’s goals for the same treatment. Similar conflicts between the expectations of patients and their doctors occur in orthodontic treatment, and some recent research in that field may offer insights into questions of esthetics in prosthodontics. In this article relevant orthodontic research will be reviewed and a framework for exploring patient perceptions of esthetics in prosthodontics will be developed from it. With this perspective, the available literature on patient expectations in prosthodontics can be discussed and expanded.

A dental-facial attractiveness scale: Part II. Consistency of perception☆

A previous report describes the reliability and validity of a scale designed to assess perceptions of dental-facial attractiveness, independent of occlusal function. The purpose of the present study was to assess the consistency of judgments of dental-facial attractiveness (DFA) for sex and race differences in photographed children. Using a five-pont DFA scale, twelve college freshmen (three black females, three black males, three white females, three white males) rated ninety-six photographs of the mouths and jaws of 13- to 14-year-old children (twenty-four black females, twenty-four black males, twenty-four white females, twenty-four white males). No significant mean differences were found between the black and white photographed or between the female and male children photographed. However, means were significantly different for DFA judgments by race and sex of the raters. Black raters judged all photographs to be more attractive than did white raters, and female raters judged all photographs to be more attractive than did male raters. Correlational data are presented describing consistency of perception within rater groups and photographed groups of children.

Clinical discrimination between autoglazed and polished porcelain surfaces

Precementation refinements of porcelain-fused-to-metal crowns often require reglazing or polishing of the porcelain surface. This study was done to determine whether visual inspection differences exist between glazed and polished porcelain surfaces. Prosthodontists, general dentists, and students (six in each group) rated esthetic properties of 12 porcelain-fused-to-metal crowns. All crowns were initially autoglazed. For phase 1 observations, six crowns were air abraded and polished and six retained their glazed surface. For phase 2 observations, the surface treatments were reversed. At both observations, crowns were rated on 5-point Likert scales for outline form, porosity, smoothness, reflectance, texture, dullness, defects, and general esthetic appearances. Phase 1 polished and glazed crowns had different means for outline form sharpness, porosity, reflectance, dullness, and general esthetic appearance. Phase 2 crowns were different for dullness. Polished and glazed crowns alike were more dull at phase 1 than at phase 2. Glazed crowns were different between phases for reflectance and general esthetic appearance. All reported differences were significant at p less than .01. Significant differences occurred among raters with polished and glazed crowns for several variables.

Reliability and validity of clinical assessments of malocclusion

The purpose of this research was to determine the reliability and validity of selected clinical judgments of malocclusion, including general evaluations of occlusal status and more specific aspects of dentofacial malrelations. Study casts of twenty-one adolescents planning orthodontic treatment and twenty-nine not planning treatment were examined and rated. The examiners were five dentists in an orthodontic specialty-training program. They completed ratings on six dimensions: (1) need for treatment, (2) degree of malocclusion, (3) potential for tissue loss, (4) negative effect on occlusal stability, (5) negative effect on dental-facial attractiveness, and (6) negative effect on masticatory function. Six weeks later the same five rates scored the fifty casts, using the standardized Treatment Priority Index (TPI). Three weeks later, or 9 weeks after the initial ratings, the casts were again rated on the two general dimensions: need for treatment and degree of malocclusion. Correlations among all the measures were examined. Inter-rater reliability was highest for the ratings of impact on dental-facial attractiveness (r = 0.88). The two general assessments also yielded relatively high rater reliabilities, and the second rating yielded stability coefficients of 0.84 for both of these ratings. Correlations with total TPI scores were 0.70 for the dental-facial attractiveness measure and 0.65 and 0.64, respectively, for assessments of need for treatment and degree of malocclusion. The data indicate that clinical evaluations of the severity of malocclusions are comparable to objective measures in terms of inter-rater reliability. Clinical evaluations are also relatively stable over time. Correlations with the TPI scores also provide evidence of the concurrent validity of clinical judgments.

The gagging problem in prosthodontic treatment. Part I: Description and causes

E very dentist and most dental students and paradental personnel have had experience with the patient whose gag reflex is abnormally active. For all concerned, an episode of gagging can be regarded, at best, as an unpleasant experience. Gagging reactions range from mild choking when the palate is inadvertently touched with a mouth mirror to violent, uncontrolled retching during impression making. Some clinical descriptions are more graphic than others. Feintuch,’ for example, offers the following: “As the body trembles and the foot rest is stamped, large tears roll down from the eyes. The face of the victim takes on the hue of apoplectic purple and the patient gasps for breath, at the same time attempting to eject the intruders from his mouth and his insides with them.”

Self-efficacy and reasoned action: Predicting oral health status and behaviour at one, three, and six month intervals

Abstract This study tested the usefulness of the theory of reasoned action and the addition of self-efficacy to this model for the prediction of oral health behaviour as part of a larger intervention at the State University of New York at Buffalo School of Dental Medicine. Self-efficacy is a belief in ones ability to perform a particular behavior. The theory of reasoned action is an attitudinal model focused on predicting behavior. One hundred and sixty-six patients volunteered for an intervention and assessment program at the Oral Health Enhancement Clinic. Participants visited the clinic 7 times over a 14 month period. Relationships among social cognitive model variables and clinical and self-report outcome measures were examined at three different time points over increasingly longer time spans. Results indicated that the theory of reasoned action model was useful in predicting oral health behavior, and adding self-efficacy to the model significantly increased the reliability of predictions of outcome...

The gagging problem in prosthodontic treatment. Part II: Patient management

The most serious problem associated with the patient with an overactive gag reflex is the strong potential for compromised treatment. A complete oral examination, medical history, and conversation with the patient are important sources of information that assist with the management of gagging problems. Many techniques are available for controlling the exaggerated gag reflex, and no single technique will solve each patients problem. The technique or techniques used should be dictated by the cause or causes involved. If organic disturbances, anatomic anomalies, or biomechanical inadequacies of existing prostheses are not key causes, the services of trained specialists are needed to help with behavioral management of the problem.