Audit to assess the quality of communication between operators and technicians in a fixed prosthodontic laboratory: educational and training implications

OBJECTIVE

This audit aimed to assess the quality of communication between dental students/qualified dentists and dental technicians, increase the percentage of satisfactorily completed laboratory prescriptions and reduce the number of errors that can result from poor communication. A subsidiary aim was to educate students and staff in this respect.

METHOD

An audit of laboratory prescription completion was conducted within Dundee Dental Hospital. Four hundred and eighteen prescriptions for indirect fixed restorations completed by dental undergraduates and qualified staff were audited over a three month period (first audit cycle). Educational reminders on laboratory prescriptions were then provided to undergraduates and qualified staff, a further three hundred and twenty-two prescriptions were audited (second audit cycle) and compared with the first cycle.

RESULTS

Satisfactorily completed prescriptions increased from 28% to 43% following basic educational intervention. However, this percentage still signifies a poor level of completion and the need for improvement. Some aspects of the prescription were completed better than others, but overall the standard remained poor with a significant number failing to comply with guidelines set by the UK General Dental Council, the European Union's Medical Devices Directive and the British Society for Restorative Dentistry (BSRD).

CONCLUSION

Further undergraduate and staff training on laboratory prescription writing will be necessary through staff training events and developments in the undergraduate curriculum.

Inhibition of amiloride-sensitive sodium-channel activity in distal lung epithelial cells by nitric oxide

Distal lung epithelial cells (DLECs) play an active role in fluid clearance from the alveolus by virtue of their ability to actively transport Na+ from the alveolus to the interstitial space. The present study evaluated the ability of activated macrophages to modulate the bioelectric properties of DLECs. Low numbers of lipopolysaccharide (LPS)-treated macrophages were able to significantly reduce amiloride-sensitive short-circuit current (Isc) without affecting total Isc or monolayer resistance. This was associated with a rise in the flufenamic acid-sensitive component of the Isc. The effect was reversed by the addition of N-monomethyl-L-arginine to the medium, implying a role for nitric oxide. We hypothesized that macrophages exerted their effect by expressing inducible nitric oxide synthase (iNOS) in DLECs. The products of LPS-treated macrophages increased the levels of iNOS protein and mRNA transcripts in DLECs as well as causing a rise in iNOS activity. Immunofluorescence microscopy of LPS-stimulated macrophage-DLEC cocultures with anti-nitrotyrosine antibodies provided evidence for the generation of peroxynitrite in macrophages but not in DLECs. These data indicate that activated macrophages in the lung may contribute to impaired resolution of acute respiratory distress syndrome and suggest a novel mechanism whereby nitric oxide might alter cell function by altering its ion-transporting phenotype.

Effects of ethnicity and birth month on localized enamel hypoplasia of the primary canine

Localized enamel hypoplasia of the primary canine (LHPC) is produced by a different mechanism from that causing linear enamel hypoplasia, and yet contributes disproportionately to epidemiological studies of enamel hypoplasia in childhood that do not separate the two etiological types. LHPC results from impact, probably self-inflicted by infants mouthing objects, to the unerupted primary canine crown through abnormally fenestrated cortical bone overlying the crypt. Examination of the primary teeth of ninety-six children whose mothers were enrolled in the Healthiest Babies Possible Program in Vancouver showed an average prevalence of 31 percent with LHPC (ranging from 19 percent in Vietnamese Canadians to 56 percent among Indocanadians). This is much higher than previously reported for unselected samples from Vancouver, but equivalent to studies in the USA. Mean hours of sunshine in the birth month of children with LHPC is 141.7 hours and those without is 169.4 hours; the difference is statistically significant (p = .0383). Seasonal increase in food costs and reduced availability of fresh foods containing vitamin A are thought to contribute to facial osteopenia predisposing the infant to LHPC.

Iron status of French-Canadian children: a three year follow-up study

Dietary iron intake and hematocrit, hemoglobin, serum iron, transferrin saturation and serum ferritin were studied longitudinally in 425 French-Canadian children from upper-middle class families at 3, 6, 9, 12, 15, 18, 24 and 36 months. At 3 to 9 months, the median iron intake exceeded the amount recommended (7 mg/d), at 12 to 36 months it was close to the amount recommended (8 mg). The proportion of anaemic children as diagnosed by low hematocrit and hemoglobin values did not exceed 5 percent except at three months of age. Transferrin saturation lower than 16 percent was detected in 12 percent of the children aged 12-18 months and 8 percent of those aged 24-36 months. Serum ferritin increased from 18 to 36 months of age; between 18 months and 3 years, the proportion of children with deficient serum ferritin (SF less than 10 ng/ml) and low iron reserves (SF 10-20 ng/ml) declined respectively from 29 to 2 percent and 55 to 26 percent. Thus, as the children grew older the iron intake still permitted the improvement of hematologic parameters of iron status in most subjects. The progressive increase of hematological values with age emphasizes the need for more specific standards for children of various ages.