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Individuals with psychosis have poor oral health compared with the general population. The interaction between oral health and psychosis is likely to be complex and have important ramifications for improving dental and mental health outcomes. However, this relationship is poorly understood and rarely studied using qualitative methods.
Aims
To explore patient perspectives on the relationship between oral health and psychosis.
Method
The authors recruited 19 people with experiences of psychosis from community mental health teams, early intervention in psychosis services, and rehabilitation units. Participants completed a qualitative interview. Transcripts were analysed with reflexive thematic analysis.
Results
The analysis resulted in three themes: theme 1, psychosis creates barriers to good oral health, including a detachment from reality, the threat of unusual experiences and increased use of substances; theme 2, the effects of poor oral health in psychosis, with ramifications for self-identify and social relationships; and theme 3, systems for psychosis influence oral health, with central roles for formal and informal support networks.
Conclusions
Psychosis was perceived to affect adherence to oral health self-care behaviours and overall oral health. Poor oral health negatively affected self-identity and social relationships. Clinical implications include a systemic approach to provide early intervention and prevention of the sequelae of dental disease, which lead to tooth loss and impaired oral function and aesthetics, which in turn affect mental health. Participants felt that mental health services play an important role in supporting people with oral health.
La Mina is one of three sites, along with Cueva Millán and La Ermita, located in the middle course of the Arlanza river. La Mina was excavated for the first time in 2006 and three test pits were carried out. In one of them, evidence of two Palaeolithic occupations was identified and several remains of woolly rhinoceros were recovered. Amino acid racemisation dating yielded an age of 52.5 ka BP, the earliest Upper Pleistocene date for Coelodonta antiquitatis on the Iberian Peninsula. This new record may have several implications for understanding the access routes to the Castilian Plateau, together with the definition of a new migratory wave of this species at the end of the Pleistocene. The location of La Mina on the Castilian Plateau may help researchers to complete the movements of this species through the Middle and Upper Palaeolithic on the Iberian Peninsula.
Permian fishes and their isolated microremains are known from many localities in the Zechstein Basin. However, up to date the vertebrates have never been revealed in the southeasternmost part of this ancient sea. The new material consists of euselachian-type dermal denticles,?Listracanthus sp. dermal denticle,?Omanoselache sp. tooth, actinopterygian scales and actinopterygian teeth. Here, the detailed study of euselachian and actinopterygian remains, their stratigraphic distribution and geographical contexts is presented. Based on the qualitative analysis of teeth shapes several ecomorphotypes were described as well as the probable dietary preferences of fishes were reconstructed. These finds confirmed existence of small predators who fed on soft bodied prey as well as durophagous forms which were feeding on small shelly crustaceans or molluscs. The analysis of stratigraphic distribution of microremains, and their comparison with neighbouring sections revealed a spatially correlatable trend in increasing abundance of fishes in the more clayey parts of sections, interpreted to be positively associated with a sea level transgression event.
One shark was landed at the Naval Base Pasha Liman, Bay of Vlore, Albania, the Adriatic Sea. Photographic records only enabled the specimen to be placed in family Odontaspididae or Carchariidae. Later examination of the preserved head, dry jaw and dentition identified the specimen as Odontaspis ferox. This is a rare record and the northernmost Mediterranean observation of this species, and the first Adriatic record for several decades.
Machu Picchu, in Cuzco, is one of the most famous archaeological sites in South America. The precise dating of the monumental complex, however, relies largely on documentary sources. Samples of bone and teeth from individuals buried in caves at four cemeteries around Machu Picchu form the basis for a new programme of AMS radiocarbon-dating. The results show that the site was occupied from c. AD 1420–1532, with activity beginning two decades earlier than suggested by the textual sources that associate the site with Emperor Pachacuti's rise to power in AD 1438. The new AMS dates—the first large set published for Machu Picchu—therefore have implications for the wider understanding of Inca chronology.
This chapter addresses facial surgery and prosthesis.The early modern period saw the development of medical procedures aimed as much at the augmentation and transformation of the face as at its restoration to ‘normality’. These advanced procedures brought into question the morality of changing one’s appearance. These issues were heightened in discussions of the Tagliacotian rhinoplasty. Promising to graft a new nose on to the faces of men afflicted by syphilis, this operation potentially, and controversially, disguised the results of sexual licentiousness. Moreover, satirists suggested not only that the graft might be taken from another person’s flesh, but that the grafted part might retain a sympathetic connection to its original ‘owner’. The nature of the connection (or lack thereof) between a person’s flesh and their ‘true’ identity was foremost in such discussions. Hester Pulter’s poem on the subject is a witty, sharply satirical admonition against sexual incontinence. Anticipating later works by Butler and Addison, it demonstrates how rhinoplasty became a vehicle for voicing larger concerns about embodiment, sociability, and morality.
Ignore anatomy at your peril, and your patients’: a knowledge of relevant anatomy frequently makes procedures more comfortable and safer for patients and easier for their clinicians. This chapter therefore surveys the structures relevant to the rest of the book. It covers the mouth, tongue and teeth, nasal spaces, pharynx, glottis and epiglottis, trachea and more distal airway, as well as the cervical spine. Its emphasis throughout is determinedly practical, rather than obsessively topological.
Megacephalosaurus eulerti is a large macropredatory plesiosaur representing one of the last members of the diverse pliosaurid clade Brachaucheninae. The taxon was established upon a nearly complete skull including the mandible and fragments of the postcranial skeleton originating from the lower middle Turonian (Upper Cretaceous) of Kansas, USA. Owing to its age, reasonable completeness and its state of preservation, M. eulerti bears important anatomical details regarding the last brachauchenines. Here we assess the dentition of the taxon, compare the teeth to those of other thalassophonean pliosaurids and comment on the utility of these results for inferences of the phylogenetic relationships of the last brachauchenines. Additionally, we provide remarks on the cranial anatomy of M. eulerti, revise character scores of this taxon used in current phylogenetic studies and address the phylogenetic relationships within Brachaucheninae. Parsimony analyses, aimed to test different character sampling and tree-search strategy, inferred only a single unambiguous synapomorphy uniting a clade formed by mid- to Late Cretaceous brachauchenines: presence of subcircular rather than subtrihedral/trihedral cross-sectional shape of the teeth. Still, the last brachauchenines (Brachauchenius and Megacephalosaurus) can be roughly characterized by a switch from anisodont to subisodont dentition and reduction of their tooth count. Nevertheless, the overall knowledge of the origin, phylogenetic relationships and distinguishability of brachauchenine pliosaurids remains poor and represents a subject for further extensive studies and modifications in taxon and character sampling.
The mineral component (at least 95 wt. %) of dental enamel is hydroxyapatite (hydroxylapatite) with multiple substitutions. The biogenic origin of enamel is reflected in the unusual ribbon-like morphology of the crystals, which are extremely elongated in the c-axis direction, and their organized arrangement within the tissue. The study of enamel dissolution has been driven by the very high prevalence of dental caries. In enamel caries, the initial demineralization results in subsurface dissolution of mineral. While the surface remains intact, reversal of the lesion by remineralization is possible. Problems of understanding the physico-chemical processes in enamel demineralization include the general problems concerning the structure and chemistry of apatites formed in aqueous media. Added to these are the general problem of dissolution in an inhomogeneous porous medium and the complication that enamel apatite has a naturally variable composition which changes during demineralization. The use of model systems in caries research is illustrated by reference to X-ray absorption studies of enamel and synthetic analogues.
The mineral in bones and teeth is an impure form of hydroxylapatite (HAP), the principal impurity being 2—5 wt.% carbonate. This mineral dissolves during remodelling of bone and also in dental caries as a result of the action of acids produced by osteoclasts and by bacteria, respectively. In enamel, demineralization proceeds with preferential loss of carbonate relative to phosphate. Surprisingly, in the early stages, the demineralization is subsurface. In order to facilitate the understanding of physical chemical aspects of these processes, we have undertaken studies of demineralization in model systems. We give three examples here. The first two used scanning microradiography in which the specimen is stepped across a 10—30 μm diameter X-ray beam. Intensity measurements allow calculation of the mineral mass per unit area in the X-ray path through the specimen. In the first experiment, porous HAP sections were separated from a reservoir of acidic buffer by a column initially filled with water (the diffusion length) and scanned with the X-ray beam perpendicular to the axis of the diffusion length. The rate of total loss of mineral along each profile was calculated from the scans. The rate of demineralization fell as the diffusion length increased. We believe the explanation is that the rate-controlling step is the diffusion of dissolved HAP away from the solid to the buffer reservoir. In the second experiment, demineralizing solution and water were pumped alternately, for equal lengths of time, past blocks of porous HAP or enamel. The X-ray beam was perpendicular to the exposed surface. As the rate of switching between solutions decreased, the mean rate of demineralization also fell. We propose that this effect is due to retention of acid in the pores of the HAP during the time when water flows, allowing further demineralization to take place during this time. The third study used X-ray microtomography, a form of 3D microscopy, to study the loss of mineral in compacted carbonate apatite powders. The powders were packed in six 10 mm internal diameter acrylic cylinders to a depth of 4 mm (after pressing). One end was covered with a porous polyethylene disc and each tube placed in acidic buffer for 70 days. Periodic examination by microtomography showed the development of subsurface demineralization. Infrared spectroscopy of the dissected-out surface layers showed preferential loss of carbonate over phosphate by comparison with deeper layers. Rietveld analysis of X-ray powder diffraction data showed changes in the crystallographic structures of the apatites between the initial and dissected-out apatite.
Chondrichthyan teeth from a new locality in the Scottish Borders supply additional evidence of Early Carboniferous chondrichthyans in the UK. The interbedded dolostones and siltstones of the Ballagan Formation exposed along Whitrope Burn are interpreted as representing a restricted lagoonal environment that received significant amounts of land-derived sediment. This site is palynologically dated to the latest Tournaisian–early Viséan. The diverse dental fauna documented here is dominated by large crushing holocephalan toothplates, with very few, small non-crushing chondrichthyan teeth. Two new taxa are named and described. Our samples are consistent with worldwide evidence that chondrichthyan crushing faunas are common following the Hangenberg extinction event. The lagoonal habitat represented by Whitrope Burn may represent a temporary refugium that was host to a near-relict fauna dominated by large holocephalan chondrichthyans with crushing dentitions. Many of these had already become scarce in other localities by the Viséan and become extinct later in the Carboniferous. This fauna provides evidence of early endemism or niche separation within European chondrichthyan faunas at this time. This evidence points to a complex picture in which the diversity of durophagous chondrichthyans is controlled by narrow spatial shifts in niche availability over time.
During the Holocene, bison (Bison bison) were key components of the Great Plains landscape. This study utilizes serial stable isotope analyses (tooth enamel carbonate) of 29 individuals from five middle Holocene (∽ 7–8.5·ka) archaeological sites to address seasonal variability in movement patterns and grazing behavior of bison populations in the eastern Great Plains. Stable carbon isotopes (δ13C) indicate a bison diet that is similar to the C3/C4 composition of modern tallgrass prairies, while 87Sr/86Sr values generally indicate very little seasonal movement (b50 km) and relatively limited inter-annual movement (b500 km) over the course of 4–5 yr. Analyses of variability in serial stable oxygen isotope samples (δ18O) further substantiate a model of localized bison herds that adhered to upland areas of the eastern Plains and prairie–forest border.
Representations and remains of sharks are found in Mesoamerican art and
archaeology from the first millennium BC onwards. They appear at coastal
sites, but also remarkably far inland, hundreds of kilometres from the
waters where they were sighted or hunted. For the Maya of the interior of
the Yucatán Peninsula, encounters with live sharks would have been an
exceedingly rare occurrence. Yet the animals arrived inland in piecemeal
fashion—as chunks of meat and sets of teeth—and via stories. By following
the procurement, transportation, representation and ritual use of sharks
from the sea to the jungle, the author shows how the ancient Maya drew on
both evidence and myth to imagine and explain these unfamiliar marine
creatures.
Chorion type may significantly influence the prenatal environment of twins. This study explored the associations between chorion type and gestational age, birth weight, birth length, and the timing of emergence of the first primary tooth in two populations of twins, Australian and Dutch. Additionally, we investigated the relationship between chorion type and birth weight discordance (BWD) in order to determine whether a significant relationship existed between discordance in birth weight and discordance in the timing of emergence of the first primary tooth. The two study samples consisted of 409 Australian twin pairs and 301 Dutch twin pairs, all of European ancestry. Data were collected through a combination of questionnaires and recording charts administered to the parents and through linkage with biological databases. In the Australian sample, monozygotic monochorionic (MZMC) twins experienced the shortest mean gestation time (35 weeks), the lowest mean birth length (46 cm) and the lowest mean birth weight (2.3 kg) compared with other twin groups. For the same variables in the Dutch sample, these trends with MZMC twinning were not observed. Chorion type did not significantly affect the mean timing of emergence of the first primary tooth in either sample. Monochorionicity was found to be significantly associated with BWD in both samples, but there was a significant association between BWD in MZMC twin pairs and timing of emergence of the first primary tooth only in the Australian sample. Results from this study support previous findings that the timing of emergence of the first primary tooth is influenced strongly by genetic factors and is well protected from environmental disturbances.
Vikings with artificially modified teeth have previously been documented in the south-eastern parts of Scandinavia and in England. In a project dealing with life in the Mälaren Valley in Sweden during the period AD 750–1100, new cases of people with modified maxillary teeth were observed. The hypothesis that the practice was entirely associated with adult men dating to the Viking Age was tested. The new cases demonstrate that the habit extended to eastern-central Sweden, including the proto-town of Birka, perhaps as early as in the middle of the eighth century. Additionally, cases from Sigtuna show that the practice may have ended as late as the beginning of the twelfth century. A microanalysis, using a scanning electron microscope, showed the heterogeneous character of the modifications. The affected individuals were all adult men, similar to previously published cases. Some of the men are associated with weapons and violent acts and the cases from Sigtuna were all from cemeteries with a possible association with lower social strata. However, discrepancies in archaeological contexts and in the characteristics of the modifications suggest temporal and spatial variation in the social meaning of the modifications.
Mosasaurs are an extinct group of secondarily adapted aquatic lizards that became the dominant marine tetrapods in the Late Cretaceous oceans. They continuously shed and replaced their teeth in order to maintain a functional dentition at all times; however, the process of tooth development in mosasaurs is still incompletely known. Based on incremental line width measurements and growth line counts, we assess dentine formation rates in three mosasaur taxa (Dollosaurus, cf. Platecarpus and Tylosaurus) and one genus of marine crocodylian (Aigialosuchus), all from the lower Campanian (Upper Cretaceous) of southernmost Sweden. Two sets of periodic dentinal markings characterized by concentric, alternating opaque and transparent laminae are recognized: one set comprising thin bands situated 6–34 μm apart (depending on taxon), which is superimposed onto a second set of coarser bands where spaces vary between 102 and 275 μm. Assuming that the finer striations represent daily increments (i.e. lines of von Ebner), it is estimated that the deposition of dentine at the sectioned level of the tooth-crowns took 342 (cf. Platecarpus), 426 (Dollosaurus), 487 (Tylosaurus) and 259 (Aigialosuchus) days, respectively. The coarser bands contain between 11 and 13 thin striations each, and are thus considered to be homologous to similar periodic dentinal markings in extant vertebrates, i.e. Andresen lines. Prolonged tooth development times in large-toothed taxa, such as Tylosaurus, presumably increased the risk of long-term incapacity to capture prey after dental trauma, an evolutionary trade-off which may have been compensated for by allometric modifications of the teeth.
The ability to isolate and perform nucleic acid analyses of individual cells is critical to studying the development of various cell types and structures. We present a novel biological sample preparation method developed for laser capture microdissection-assisted nucleic acid analysis of ultrathin cell/tissue sections. We used cells of the mitotic bed of the tadpole teeth of Lithobates sphenocephalus (Southern Leopard Frog). Cells from the mitotic beds at the base of the developing teeth series were isolated and embedded in the methacrylate resin, Technovit® 9100®. Intact cells of the mitotic beds were thin sectioned and examined by bright-field and transmission electron microscopy. The cytological and ultrastructural anatomy of the immature and progressively more mature tooth primordia appeared well preserved and intact. A developmental series of tooth primordia were isolated by laser capture microdissection (LCM). Processing of these cells for RNA showed that intact RNA could be isolated. The study demonstrates that Technovit® 9100® can be used as an embedding medium for extremely small tissues and from individual cells, a prerequisite step to LCM and nucleic acid analyses. A relatively small amount of sample material was needed for the analysis, which makes this technique ideal for cell-specific analyses when the desired cells are limited in quantity.
The Craniofacial Biology Research Group in the School of Dentistry at The University of Adelaide is entering an exciting new phase of its studies of dental development and oral health in twins and their families. Studies of the teeth and faces of Australian twins have been continuing for nearly 30 years, with three major cohorts of twins recruited over that time, and currently we are working with twins aged 2 years old to adults. Cross-sectional data and records relating to teeth and faces of twins are available for around 300 pairs of teenage twins, as well as longitudinal data for 300 pairs of twins examined at three different stages of development, once with primary teeth, once at the mixed dentition stage, and then again when the permanent teeth had emerged. The third cohort of twins comprises over 600 pairs of twins recruited at around birth, together with other family members. The emphasis in this third group of twins has been to record the timing of emergence of the primary teeth and also to sample saliva and dental plaque to establish the timing of colonization of decay-forming bacteria in the mouth. Analyses have confirmed that genetic factors strongly influence variation in timing of primary tooth emergence. The research team is now beginning to carry out clinical examinations of the twins to see whether those who become colonized earlier with decay-forming bacteria develop dental decay at an earlier age. By making comparisons within and between monozygotic (MZ) and dizygotic (DZ) twin pairs and applying modern molecular approaches, we are now teasing out how genetic, epigenetic, and environmental factors interact to influence dental development and also oral health.
Energy-dispersive X-ray fluorescence was employed to test the hypothesis that beverage consumption or mouthwash utilization will change the chemical properties of dental materials and enamel mineral content. Bovine enamel samples (n = 45) each received two cavity preparations (n = 90), each pair filled with one of three dental materials (R: nanofilled composite resin; GIC: glass-ionomer cement; RMGIC: resin-modified GIC). Furthermore, they were treated with three different solutions (S: saliva; E: erosion/Pepsi Twist®; or EM: erosion+mouthwash/Colgate Plax®). It was found that mineral loss in enamel was greater in GICE samples than in RE > RMGICE > RMGICEM > REM > GICEM. An increased percentage of Zr was found in REM indicating organic matrix degradation. Dental materials tested (R, GIC, and RMGIC) were not able to protect adjacent enamel from acid erosion by the soft drink tested. The use of mouthwash promoted protection of enamel after erosion by the soft drink. To avoid chemical dissolution by mouthwashes, protection by resin composites with surface sealants is recommended.
The aim of this study was to quantify contributions of genetic and environmental factors to variation in timing of emergence of the primary teeth in a sample of monozygotic and dizygotic twins, using univariate model-fitting approaches. The sample comprised 94 pairs of monozygotic twins and 125 pairs of dizygous twins, all of European ancestry, aged from 2–6 years. Tooth emergence timing was based on parental report, with a subset of data validated by clinical assessment. Heritability estimates for tooth emergence timing were generally high, around 90%, however estimates for the lower right lateral incisor and the lower canines were around 50%. These findings confirm a strong genetic influence on observed variation in the timing of emergence of the human primary teeth.