Bleeding Gums: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

BLEEDING GUMS A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES

J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS

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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright 2004 by ICON Group International, Inc. Copyright 2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Bleeding Gums: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-497-00147-0 1. Bleeding Gums-Popular works. I. Title.

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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.

Copyright Notice If a physician wishes to copy limited passages from this book for patient use, this right is automatically granted without written permission from ICON Group International, Inc. (ICON Group). However, all of ICON Group publications have copyrights. With exception to the above, copying our publications in whole or in part, for whatever reason, is a violation of copyright laws and can lead to penalties and fines. Should you want to copy tables, graphs, or other materials, please contact us to request permission (E-mail: [email protected]). ICON Group often grants permission for very limited reproduction of our publications for internal use, press releases, and academic research. Such reproduction requires confirmed permission from ICON Group International, Inc. The disclaimer above must accompany all reproductions, in whole or in part, of this book.

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on bleeding gums. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.

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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.

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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes&Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health

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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON BLEEDING GUMS ....................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Bleeding Gums.............................................................................. 5 The National Library of Medicine: PubMed .................................................................................. 5 CHAPTER 2. ALTERNATIVE MEDICINE AND BLEEDING GUMS ....................................................... 15 Overview...................................................................................................................................... 15 National Center for Complementary and Alternative Medicine.................................................. 15 Additional Web Resources ........................................................................................................... 20 General References ....................................................................................................................... 21 CHAPTER 3. BOOKS ON BLEEDING GUMS ....................................................................................... 23 Overview...................................................................................................................................... 23 Chapters on Bleeding Gums......................................................................................................... 23 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 29 Overview...................................................................................................................................... 29 NIH Guidelines............................................................................................................................ 29 NIH Databases............................................................................................................................. 31 Other Commercial Databases....................................................................................................... 33 APPENDIX B. PATIENT RESOURCES ................................................................................................. 35 Overview...................................................................................................................................... 35 Patient Guideline Sources............................................................................................................ 35 Finding Associations.................................................................................................................... 40 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 43 Overview...................................................................................................................................... 43 Preparation................................................................................................................................... 43 Finding a Local Medical Library.................................................................................................. 43 Medical Libraries in the U.S. and Canada ................................................................................... 43 ONLINE GLOSSARIES.................................................................................................................. 49 Online Dictionary Directories ..................................................................................................... 49 BLEEDING GUMS DICTIONARY .............................................................................................. 51 INDEX ................................................................................................................................................ 67

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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with bleeding gums is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about bleeding gums, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to bleeding gums, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on bleeding gums. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to bleeding gums, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on bleeding gums. The Editors

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From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.

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CHAPTER 1. STUDIES ON BLEEDING GUMS Overview In this chapter, we will show you how to locate peer-reviewed references and studies on bleeding gums.

The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and bleeding gums, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “bleeding gums” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: •

Dental Self-Care Among Dentate Adults: Contrasting Problem-Oriented Dental Attenders and Regular Dental Attenders Source: SCD. Special Care in Dentistry. 20(4): 155-163. July-August 2000. Contact: Available from Special Care Dentistry. 211 East Chicago Avenue, Chicago, IL 60611. (312) 440-2660. Fax (312) 440-2824. Summary: Self-care behaviors are common and can act as substitutes for or supplements to formal health care services. This article reports on a study in which the authors tested the hypothesis that problem oriented dental attenders (POAs, or those persons who go to the dentist only for a specific symptom or problem) report more dental self-care behaviors than do regular dental attenders (RAs, or those persons who go to the dentist on a regular schedule, e.g., every 6 months), presumably as a substitute for professional

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care. The Florida Dental Care Study is a longitudinal cohort study of changes in oral health, in which the authors measured dental self-care behaviors related to three common dental problems: toothache pain, bleeding gums, and tooth loss. Despite using less dental care, POAs were less likely to report 'conventional' methods as means to prevent the three dental problems. However, they were more likely to report that homemade remedies, topical medications, or mouthwashes were ways to prevent or treat these problems. POAs were also more likely to believe that 'nothing can be done' to prevent these problems. Additionally, POAs had more negative dental attitudes, used less dental care during follow up, had more dental disease, were the only persons who extracted at least one of their own teeth, and were more likely to use tobacco. With the exception of dental self extraction, no single self-care belief or behavior distinguished POAs from Ras, nor were POAs likely to have different explanations for dental problems. Instead, the pattern was one of modest differences on a number of items. 2 tables. 41 references. •

Oral Health Behaviour and the Prevalence of Oral Manifestations of HIV Infection in a Group of HIV Positive Adults Source: International Dental Journal. 48(6): 557-562. December 1998. Contact: Available from FDI World Dental Press Ltd. 7 Carlisle Street, London W1V 5RG, United Kingdom. 0171 935 7852. Fax 0171 486 0183. E-mail: [email protected]. Summary: This article reports on a study undertaken to assess the prevalence of oral manifestations of HIV infection, the periodontal health status, and the oral health behavior of a group of 51 adults infected with HIV. The cross sectional descriptive study took place in a community dental clinic in south London dedicated to the treatment of this population. Data were collected through a self administered questionnaire, an interview and a clinical examination. Results showed that 76.5 percent had one or more oral manifestations of HIV infection. These prevalence rates of erythematous candidiasis (21.6 percent), pseudomembranous candidiasis (13.7 percent), angular cheilitis (5.9 percent), Kaposi sarcoma (3.9 percent), and oral ulceration (3.9 percent) were comparable with earlier reported data from London. The prevalence of hairy leukoplakia (45.1 percent) and HIV necrotizing ulcerative gingivitis or periodontitis (15.7 percent) were higher than previously reported data. Intraoral herpes, papilloma, and nonHodgkin's lymphoma were not identified. A very positive attitude towards oral hygiene was identified. Dental plaque levels were low, but all individuals studied had some evidence of bleeding gums. 5 tables. 24 references. (AA-M).

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Dental Care Right From the Start: Modern Medical and Dental Treatment Makes a Healthy Mouth Possible for Everyone Source: Hemalog. 9(2): 2-4. April 1998. Summary: This article, from a periodical for people with bleeding disorders (such as hemophilia), outlines the important role of dental care. The author recognizes that people with bleeding disorders have historically feared dental care, with its accompanying bleeding gums. However, with advances in both dentistry and treatment of bleeding disorders, dental care is no longer anything to fear. Indeed, taking care of one's teeth on a regular basis vastly reduces the likelihood of major dental work in the future. The author emphasizes the importance of preventive care and discusses preventing dental caries (cavities) in children, fluoride, preventing baby bottle tooth decay, foods and nutrition, loss of baby teeth, dental sealants, braces (orthodontic appliances), periodontal disease, and preparing for tooth extraction or other dental

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procedures. The author concludes by reiterating that careful, preventive dentistry and home care can result in a healthy dentition for life for people with bleeding disorders.

Federally Funded Research on Bleeding Gums The U.S. Government supports a variety of research studies relating to bleeding gums. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to bleeding gums. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore bleeding gums.

The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.3 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with bleeding gums, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “bleeding gums” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for bleeding gums (hyperlinks lead to article summaries): •

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A clinical comparison of the efficacy of an electromechanical flossing device or manual flossing in affecting interproximal gingival bleeding and plaque accumulation. Author(s): Anderson NA, Barnes CM, Russell CM, Winchester KR. Source: J Clin Dent. 1995; 6(1): 105-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8694982

Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH). 3 PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

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A comparison of different indices used in the clinical assessment of plaque and gingival bleeding. Author(s): Galgut P. Source: Clinical Oral Investigations. 1999 June; 3(2): 96-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10803118

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A comparison of stabilized stannous fluoride dentifrice and triclosan/copolymer dentifrice for efficacy in the reduction of gingivitis and gingival bleeding: six-month clinical results. Author(s): McClanahan SF, Beiswanger BB, Bartizek RD, Lanzalaco AC, Bacca L, White DJ. Source: J Clin Dent. 1997; 8(2 Spec No): 39-45. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9238872

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A comparison of the efficacy of 2 powered toothbrushes in affecting plaque accumulation, gingivitis, and gingival bleeding. Author(s): Barnes CM, Russell CM, Weatherford TW 3rd. Source: J Periodontol. 1999 August; 70(8): 840-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10476890

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Association between smoking, betel chewing and gingival bleeding in rural Sri Lanka. Author(s): Amarasena N, Ekanayaka AN, Herath L, Miyazaki H. Source: Journal of Clinical Periodontology. 2003 May; 30(5): 403-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12716331

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Case of the month. Persistent gingival bleeding. Author(s): Bhatt AP. Source: J Indian Dent Assoc. 1983 July; 55(7): Inside Front Cover. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6607291

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Cell populations associated with gingival bleeding. Author(s): Cooper PG, Caton JG, Polson AM. Source: J Periodontol. 1983 August; 54(8): 497-502. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6604802

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Cell populations associated with interdental gingival bleeding. Author(s): Thilo BE, Caton JG, Polson AM, Espeland MA. Source: Journal of Clinical Periodontology. 1986 April; 13(4): 324-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3486891

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Clinical comparison of plaque removal and gingival bleeding reduction by two different brush heads on a sonic toothbrush. Author(s): Harpenau L. Source: J Clin Dent. 2000; 11(2): 29-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11460280

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Clinical evaluation of the effect of an ultrasonic toothbrush on plaque, gingivitis, and gingival bleeding: a six-month study. Author(s): Terezhalmy GT, Iffland H, Jelepis C, Waskowski J. Source: The Journal of Prosthetic Dentistry. 1995 January; 73(1): 97-103. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7699607

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Controlling gingival bleeding with tea bags. Author(s): Steele SK. Source: Oncology Nursing Forum. 1992 May; 19(4): 663. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1603679

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Dental caries, visible plaque, and gingival bleeding in young adult Danes in alternative dental programs. Author(s): Schwarz E. Source: Acta Odontologica Scandinavica. 1989 June; 47(3): 149-57. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2756819

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Effect of non-surgical treatment on gingival bleeding in smokers and non-smokers. Author(s): Preber H, Bergstrom J. Source: Acta Odontologica Scandinavica. 1986 April; 44(2): 85-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3487907

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Effect of position of wisdom teeth on the visible plaque index and gingival bleeding index. Author(s): Ylipaavalniemi P, Turtola L, Rytomaa I, Helminen S, Jauhiainen L. Source: Proc Finn Dent Soc. 1982; 78(1): 47-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6980411

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Effect of various toothbrushing techniques on gingival bleeding and dental plaque. Author(s): Carter HG, Barnes GP, Woolridge EW, Ward GT. Source: Va Dent J. 1974 December; 51(6): 18-29. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4534249

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Effects of cetylpyridinium chloride containing lozenges on dental plaque and gingival bleeding. Author(s): Barnes GP, Radentz WH, Perkins BE. Source: J Prev Dent. 1975 September-October; 2(5): 2-4, 6. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1088597

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Epidemiology of angular stomatitis and bleeding gums. Author(s): Buzina R, Brodarec A, Jusic M, Milanovic N, Kolombo V, Brubacher G. Source: Int J Vitam Nutr Res. 1973 April; 43(4): 401-15. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4543807

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Evaluation of 2 methods to assess gingival bleeding in smokers and non-smokers in natural and experimental gingivitis. Author(s): Lie MA, Timmerman MF, van der Velden U, van der Weijden GA. Source: Journal of Clinical Periodontology. 1998 September; 25(9): 695-700. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9763323

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Evaluation of gingival bleeding following 4 types of periodontal therapy. Author(s): Kalkwarf KL, Kaldahl WB, Patil KD, Molvar MP. Source: Journal of Clinical Periodontology. 1989 October; 16(9): 601-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2677058

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Examiner reliability for an invasive gingival bleeding index. Author(s): Blieden TM, Caton JG, Proskin HM, Stein SH, Wagener CJ. Source: Journal of Clinical Periodontology. 1992 April; 19(4): 262-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1569227

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Gingival bleeding after cessation of smoking. Author(s): McMurray CM, Moore GE, Vincent R. Source: J Oral Med. 1969 July-October; 24(3): 131. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5307755

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Gingival bleeding as a manifestation of von Willebrand's disease. A review of the literature and management. Author(s): Zakrzewska J. Source: British Dental Journal. 1983 September 10; 155(5): 157-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6610434

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Gingival bleeding as a presenting symptom in Von-Willebrands' disease--review of literature and report of cases. Author(s): Abbas KE, Prabhu SR. Source: J Oral Med. 1980 October-December; 35(4): 87-90. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6970798

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Gingival bleeding as an indication of periodontal disease. Author(s): Gutweniger CA. Source: J Oreg Dent Assoc. 1983 Spring; 52(3): 37-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6601699

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Gingival bleeding as the presenting feature of multiple myeloma. Author(s): Bennett JH, Shankar S. Source: British Dental Journal. 1984 August 11; 157(3): 101-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6332637

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Gingival bleeding in 848 Army recruits. An assessment. Author(s): Milne AM. Source: British Dental Journal. 1967 February 7; 122(3): 111-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5297376

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Gingival bleeding in an experimental clinical trial design. Author(s): Watts TL, Lennon MA, Davies RM. Source: Journal of Clinical Periodontology. 1979 February; 6(1): 15-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=372255

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Gingival bleeding on probing increases after quitting smoking. Author(s): Nair P, Sutherland G, Palmer RM, Wilson RF, Scott DA. Source: Journal of Clinical Periodontology. 2003 May; 30(5): 435-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12716336

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Gingival bleeding, epistaxis and haematoma three days after gastroenteritis: the haemorrhagic lupus anticoagulant syndrome. Author(s): Schmugge M, Tolle S, Marbet GA, Laroche P, Meili EO. Source: European Journal of Pediatrics. 2001 January; 160(1): 43-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11195017

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Gingival bleeding: initial presentation of prostatic cancer. Author(s): Shepherd SM, Lyon WK. Source: The Journal of Family Practice. 1990 January; 30(1): 98-100. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2294167

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Gingival bleeding: why it's critical and how to stop it. Author(s): Reed OK, Ratcliff P. Source: Dent Today. 1998 February; 17(2): 120-1. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9560678

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Gingival recession, gingival bleeding, and dental calculus in adults 30 years of age and older in the United States, 1988-1994. Author(s): Albandar JM, Kingman A. Source: J Periodontol. 1999 January; 70(1): 30-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10052768

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Idiopathic thrombocytopenic purpura presenting as gingival bleeding. Author(s): Reebye UN, Ogunrinde OA, Cottrell DA. Source: J Mass Dent Soc. 2003 Summer; 52(2): 42-3. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12886581

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Increased tendency towards gingival bleeding caused by joint effect of alphatocopherol supplementation and acetylsalicylic acid. Author(s): Liede KE, Haukka JK, Saxen LM, Heinonen OP. Source: Annals of Medicine. 1998 December; 30(6): 542-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9920356

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Indices to measure gingival bleeding. Author(s): Newbrun E. Source: J Periodontol. 1996 June; 67(6): 555-61. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8794964

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Intra-/inter-examiner reproducibility study of gingival bleeding. Author(s): Van der Weijden GA, Timmerman MF, Saxton CA, Russell JI, Huntington E, Van der Velden U. Source: Journal of Periodontal Research. 1994 July; 29(4): 236-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7932016

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Longitudinal association between plaque and gingival bleeding in smokers and nonsmokers. Author(s): Muller HP, Stadermann S, Heinecke A. Source: Journal of Clinical Periodontology. 2002 April; 29(4): 287-94. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11966925

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Medium- and long-term effectiveness of a counterrotational electric toothbrush on plaque removal, gingival bleeding, and probing pocket depth. Author(s): Quirynen M, Vervliet E, Teerlinck J, Darius P, van Steenberghe D. Source: Int J Periodontics Restorative Dent. 1994 August; 14(4): 364-77. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7814228

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Nadolol-induced painful gingival bleeding. Author(s): Reynaert H. Source: Journal of Hepatology. 2002 August; 37(2): 289. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12127439

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Occurrence of gingival bleeding in smoker and non-smoker patients. Author(s): Preber H, Bergstrom J. Source: Acta Odontologica Scandinavica. 1985 October; 43(5): 315-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3878653

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Perception of gingival bleeding by Nigerians. Author(s): Savage KO, Arowojolu MO. Source: Afr J Med Med Sci. 1997 March-June; 26(1-2): 91-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10895241

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Periodical gingival bleeding as a presenting symptom of periodontitis due to underlying cyclic neutropenia. Case report. Author(s): Yamalik N, Yavuzyilmaz E, Caglayan F, Tezcan I, Berkel I, Ersoy F, Sanal O. Source: Aust Dent J. 1993 August; 38(4): 272-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8216033

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Persistent gingival bleeding in elderly patients. Author(s): Elfenbaum A. Source: Dent Dig. 1970 February; 76(2): 106-8. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5308528

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Relation between control of diabetes and gingival bleeding. Author(s): Ervasti T, Knuuttila M, Pohjamo L, Haukipuro K. Source: J Periodontol. 1985 March; 56(3): 154-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3872936

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Relationship between the presence or absence of gingival bleeding and the enzymatic BANA test. Author(s): Grisi MF, Correa Filho TA, Fanganiello CL, Martins Junior W, Silva-Neto CR, Salvador SL. Source: Brazilian Dental Journal. 2001; 12(1): 23-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11210245

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Relationship of gingival bleeding, gingival suppuration, and supragingival plaque to attachment loss. Author(s): Kaldahl WB, Kalkwarf KL, Patil KD, Molvar MP. Source: J Periodontol. 1990 June; 61(6): 347-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2195151

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Self-assessment of gingival bleeding. Author(s): Kallio P, Ainamo J, Dusadeepan A. Source: Int Dent J. 1990 August; 40(4): 231-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2397955

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Self-reported gingivitis and bleeding gums among adolescents in Helsinki. Author(s): Kallio P, Nordblad A, Croucher R, Ainamo J. Source: Community Dentistry and Oral Epidemiology. 1994 October; 22(5 Pt 1): 277-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7813175

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Severe gingival bleeding in a myelodysplastic patient: management and outcome. Author(s): Pereira CM, Gasparetto PF, Coracin FL, Marques JF, Lima CS, Correa ME. Source: J Periodontol. 2004 March; 75(3): 483-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15088888

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Short-term clinical study comparing supragingival plaque removal and gingival bleeding reduction of the Philips Jordan HP735 to a manual toothbrush in periodontal patients in a maintenance program. Author(s): Steenackers K, Vijt J, Leroy R, De Vree H, De Boever JA. Source: J Clin Dent. 2001; 12(1): 17-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11475708

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Sodium, potassium and calcium in gingival fluid: a study of the relationship of the ions to one another, to circadian rhythms, gingival bleeding, purulence, and to conservative periodontal therapy. Author(s): Kaslick RS, Chasens AI, Mandel ID, Weinstein D, Waldman R, Pluhar T, Lazzara R. Source: J Periodontol. 1970 August; 41(8): 442-8. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5311156

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Spontaneous gingival bleeding in an otherwise asymptomatic patient. Author(s): Tyler MT, Hutchison JL, Rybka WB. Source: Compend Contin Educ Dent. 1999 October; 20(10): 936-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10650374

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The clinical effect of a newly designed electric toothbrush on supragingival plaque, gingivitis and gingival bleeding. Author(s): Stabholz A, Babayof I, Mann J. Source: J Clin Dent. 1996; 7(1): 17-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9238880

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The clinical effect of a stabilized stannous fluoride dentifrice on plaque formation, gingivitis and gingival bleeding: a six-month study. Author(s): Perlich MA, Bacca LA, Bollmer BW, Lanzalaco AC, McClanahan SF, Sewak LK, Beiswanger BB, Eichold WA, Hull JR, Jackson RD, et al. Source: J Clin Dent. 1995; 6 Spec No: 54-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8593194

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The effect of a mouthrinse containing chlorhexidine and fluoride on plaque and gingival bleeding. Author(s): Joyston-Bechal S, Hernaman N. Source: Journal of Clinical Periodontology. 1993 January; 20(1): 49-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8421116

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The effect of a single scaling with or without oral hygiene instruction on gingival bleeding and calculus formation. Author(s): Lembariti BS, van der Weijden GA, van Palenstein Helderman WH. Source: Journal of Clinical Periodontology. 1998 January; 25(1): 30-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9477017

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The effect of baking soda/hydrogen peroxide dentifrice (Mentadent) and a 0.12 percent chlorhexidine gluconate mouthrinse (Peridex) in reducing gingival bleeding. Author(s): Taller SH. Source: J N J Dent Assoc. 1993 Fall; 64(4): 23-5, 27. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8040707

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The effect of cigarette smoking on gingival bleeding. Author(s): Dietrich T, Bernimoulin JP, Glynn RJ. Source: J Periodontol. 2004 January; 75(1): 16-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15025212

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The effect of waxed and unwaxed dental floss on gingival health. Part II. Crevicular fluid flow and gingival bleeding. Author(s): Wunderlich RC, Lamberts DM, Caffesse RG. Source: J Periodontol. 1982 June; 53(6): 397-400. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7050341

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The effectiveness of a counter-rotary action powered toothbrush and conventional toothbrush on plaque removal and gingival bleeding. A short term study. Author(s): Killoy WJ, Love JW, Love J, Fedi PF Jr, Tira DE. Source: J Periodontol. 1989 August; 60(8): 473-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2600755

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The Gingival Bleeding Index. Author(s): Carter HG, Barnes GP. Source: J Periodontol. 1974 November; 45(11): 801-5. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4547795

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The gingival bleeding time index. Author(s): Nowicki D, Vogel RI, Melcer S, Deasy MJ. Source: J Periodontol. 1981 May; 52(5): 260-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7017104

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The onset of diabetes and poor metabolic control increases gingival bleeding in children and adolescents with insulin-dependent diabetes mellitus. Author(s): Karjalainen KM, Knuuttila ML. Source: Journal of Clinical Periodontology. 1996 December; 23(12): 1060-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8997648

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The quantitative gingival bleeding index. Author(s): Garg S, Kapoor KK. Source: J Indian Dent Assoc. 1985 March; 57(3): 112-3. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3878376

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Use of gingival bleeding for reinforcement of oral home care behavior. Author(s): Walsh MM, Heckman BH, Moreau-Diettinger R. Source: Community Dentistry and Oral Epidemiology. 1985 June; 13(3): 133-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3874746

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Variability of gingival bleeding in experimental gingivitis trials. Author(s): Watts TL. Source: Community Dentistry and Oral Epidemiology. 1978 September; 6(5): 253-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=363337

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CHAPTER 2. ALTERNATIVE MEDICINE AND BLEEDING GUMS Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to bleeding gums. At the conclusion of this chapter, we will provide additional sources.

National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to bleeding gums and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “bleeding gums” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to bleeding gums: •

A clinical study of root surface conditioning with an EDTA gel. II. Surgical periodontal treatment. Author(s): Blomlof L, Jonsson B, Blomlof J, Lindskog S. Source: Int J Periodontics Restorative Dent. 2000 December; 20(6): 566-73. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11203593

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A study comparing the efficacy of a toothpaste containing extract of Salvadora persica with a standard fluoride toothpaste. Author(s): Quinlan R, Robson G, Pack AR. Source: J N Z Soc Periodontol. 1994 May; (77): 7-14. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8699489

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A trial of ascorbic acid and of multivitamin supplementation on the oral health of West African children. Author(s): Prentice AM, Lamb WH, Bates CJ. Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 1983; 77(6): 792-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6665832

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An exploration of oral health beliefs and attitudes of Chinese in West Yorkshire: a qualitative investigation. Author(s): Kwan SY, Holmes MA. Source: Health Education Research. 1999 August; 14(4): 453-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10557516

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Cleaning effectiveness of chewing sticks among Tanzanian schoolchildren. Author(s): van Palenstein Helderman WH, Munck L, Mushendwa S, Mrema FG. Source: Journal of Clinical Periodontology. 1992 August; 19(7): 460-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1430280

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Clinical efficacy of an herbal toothpaste. Author(s): Estafan D, Gultz J, Kaim JM, Khaghany K, Scherer W. Source: J Clin Dent. 1998; 9(2): 31-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10518849

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Dental self-care among dentate adults: contrasting problem-oriented dental attenders and regular dental attenders. Author(s): Gilbert GH, Stoller EP, Duncan RP, Earls JL, Campbell AM. Source: Spec Care Dentist. 2000 July-August; 20(4): 155-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11203892

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Effects of ascorbic acid depletion and supplementation on periodontal health and subgingival microflora in humans. Author(s): Leggott PJ, Robertson PB, Jacob RA, Zambon JJ, Walsh M, Armitage GC. Source: Journal of Dental Research. 1991 December; 70(12): 1531-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1663525

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Efficacy of subgingival irrigation using herbal extracts on gingival inflammation. Author(s): Pistorius A, Willershausen B, Steinmeier EM, Kreislert M. Source: J Periodontol. 2003 May; 74(5): 616-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12816293

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Enamel matrix proteins in the regenerative therapy of deep intrabony defects. Author(s): Tonetti MS, Lang NP, Cortellini P, Suvan JE, Adriaens P, Dubravec D, Fonzar

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A, Fourmousis I, Mayfield L, Rossi R, Silvestri M, Tiedemann C, Topoll H, Vangsted T, Wallkamm B. Source: Journal of Clinical Periodontology. 2002 April; 29(4): 317-25. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11966929 •

Factors related to dental health and some salivary factors in Finnish Seventh-Day Adventists. Author(s): Linkosalo E, Halonen P, Markkanen H. Source: Proc Finn Dent Soc. 1988; 84(5-6): 279-89. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3227020

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Gingival bleeding after chlorhexidine mouthrinses. Author(s): Ainamo J, Asikainen S, Paloheimo L. Source: Journal of Clinical Periodontology. 1982 July; 9(4): 337-45. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6985300

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Gingival bleeding after chlorhexidine rinses with or without mechanical oral hygiene. Author(s): Asikainen S, Sandholm L, Sandman S, Ainamo J. Source: Journal of Clinical Periodontology. 1984 February; 11(2): 87-94. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6607936

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Knowledge of dental health and diseases among dental patients, a multicentre study in Saudi Arabia. Author(s): Almas K, Albaker A, Felembam N. Source: Indian J Dent Res. 2000 October-December; 11(4): 145-55. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11307638

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Local application of n-3 or n-6 polyunsaturated fatty acids in the treatment of human experimental gingivitis. Author(s): Eberhard J, Heilmann F, Acil Y, Albers HK, Jepsen S. Source: Journal of Clinical Periodontology. 2002 April; 29(4): 364-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11966935

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Orthodontics and dentistry for the hemophilic patient. Author(s): Grossman RC. Source: Am J Orthod. 1975 October; 68(4): 391-403. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1101695

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Periodontal status of a subject sample of Yemen. Author(s): Mengel R, Eigenbrodt M, Schunemann T, Flores-de-Jacoby L.

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Source: Journal of Clinical Periodontology. 1996 May; 23(5): 437-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8783048 •

Periodontal status of adult Sudanese habitual users of miswak chewing sticks or toothbrushes. Author(s): Darout IA, Albandar JM, Skaug N. Source: Acta Odontologica Scandinavica. 2000 February; 58(1): 25-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10809396

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Periodontal treatment needs among Saudi Arabian adults and their relationship to the use of the Miswak. Author(s): al-Khateeb TL, O'Mullane DM, Whelton H, Sulaiman MI. Source: Community Dent Health. 1991 December; 8(4): 323-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1790476

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Pilot study on n-3 polyunsaturated fatty acids in the treatment of human experimental gingivitis. Author(s): Campan P, Planchand PO, Duran D. Source: Journal of Clinical Periodontology. 1997 December; 24(12): 907-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9442428

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Plaque, calculus, gingival bleeding and type of tooth cleaning device in a Tanzanian child population in 1984, 1986 and 1988. Author(s): Frencken JE, Truin GJ, van 't Hof MA, Konig KG, Lembariti BS, Mulder J, Kalsbeek H. Source: Journal of Clinical Periodontology. 1991 September; 18(8): 592-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1795056

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Plasma cell gingivitis of unusual origin. A case report. Author(s): Serio FG, Siegel MA, Slade BE. Source: J Periodontol. 1991 June; 62(6): 390-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1870070

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PYCNOGENOL chewing gum minimizes gingival bleeding and plaque formation. Author(s): Kimbrough C, Chun M, dela Roca G, Lau BH. Source: Phytomedicine : International Journal of Phytotherapy and Phytopharmacology. 2002 July; 9(5): 410-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12222660

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Root conditioning using EDTA gel as an adjunct to surgical therapy for the treatment of intraosseous periodontal defects. Author(s): Mayfield L, Soderholm G, Norderyd O, Attstrom R.

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Source: Journal of Clinical Periodontology. 1998 September; 25(9): 707-14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9763325 •

Snacking and oral health habits of Washington state WIC children and their caregivers. Author(s): Faine MP, Oberg D. Source: Asdc J Dent Child. 1994 September-December; 61(5-6): 350-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7897005

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The ability of an herbal mouthrinse to reduce gingival bleeding. Author(s): Scherer W, Gultz J, Lee SS, Kaim J. Source: J Clin Dent. 1998; 9(4): 97-100. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10518858

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The effect of controlled ascorbic acid depletion and supplementation on periodontal health. Author(s): Leggott PJ, Robertson PB, Rothman DL, Murray PA, Jacob RA. Source: J Periodontol. 1986 August; 57(8): 480-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3462381

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The effect of herbal extracts in an experimental mouthrinse on established plaque and gingivitis. Author(s): Van der Weijden GA, Timmer CJ, Timmerman MF, Reijerse E, Mantel MS, van der Velden U. Source: Journal of Clinical Periodontology. 1998 May; 25(5): 399-403. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9650877

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The effect of Parodontax dentifrice on gingival bleeding. Author(s): Saxer U, Jaschouz V, Ley F. Source: J Clin Dent. 1994; 5(2): 63-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7999291

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The efficacy of a herbal-based toothpaste on the control of plaque and gingivitis. Author(s): Mullally BH, James JA, Coulter WA, Linden GJ. Source: Journal of Clinical Periodontology. 1995 September; 22(9): 686-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7593698

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The influence of herbal ingredients on the plaque index and bleeding tendency of the gingiva. Author(s): Willershausen B, Gruber I, Hamm G.

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Source: J Clin Dent. 1991; 2(3): 75-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1930700 •

The treatment of acute anxiety and postoperative gingival pain by hypnosis and covert conditioning: a case report. Author(s): Daniels LK. Source: Am J Clin Hypn. 1976 October; 19(2): 116-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=983978

Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •

Alternative Medicine Foundation, Inc.: http://www.herbmed.org/

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AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats

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Chinese Medicine: http://www.newcenturynutrition.com/

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drkoop.com: http://www.drkoop.com/InteractiveMedicine/IndexC.html

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Family Village: http://www.familyvillage.wisc.edu/med_altn.htm

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Google: http://directory.google.com/Top/Health/Alternative/

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Healthnotes: http://www.healthnotes.com/

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MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine

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Open Directory Project: http://dmoz.org/Health/Alternative/

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HealthGate: http://www.tnp.com/

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WebMDHealth: http://my.webmd.com/drugs_and_herbs

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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

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Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/

The following is a specific Web list relating to bleeding gums; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •

General Overview AIDS and HIV Source: Integrative Medicine Communications; www.drkoop.com Atherosclerosis and Heart Disease Prevention Source: Prima Communications, Inc.www.personalhealthzone.com

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Gingivitis Source: Healthnotes, Inc.; www.healthnotes.com HIV and AIDS Source: Integrative Medicine Communications; www.drkoop.com •

Chinese Medicine Duanxueliu Alternative names: Clinopodium Herb; Herba Clinopodii Source: Chinese Materia Medica

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Herbs and Supplements Aspirin Source: Healthnotes, Inc.; www.healthnotes.com Chlorhexidine Source: Healthnotes, Inc.; www.healthnotes.com Loop Diuretics Source: Integrative Medicine Communications; www.drkoop.com Nonsteroidal Anti-Inflammatory Drugs Source: Prima Communications, Inc.www.personalhealthzone.com Raspberry Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Salicylates Source: Integrative Medicine Communications; www.drkoop.com

General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.

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CHAPTER 3. BOOKS ON BLEEDING GUMS Overview This chapter provides bibliographic book references relating to bleeding gums. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on bleeding gums include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

Chapters on Bleeding Gums In order to find chapters that specifically relate to bleeding gums, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and bleeding gums using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “bleeding gums” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on bleeding gums: •

Dental 911: Dealing With Emergencies Source: in Dadoly, A.M., ed. Dental Health for Adults: A Guide to Protecting Your Teeth and Gums. Boston, MA: Harvard Health Publications. 2003. p. 32. Contact: Available from Harvard Health Publications. P.O. Box 421073, Palm Coast, FL 32142-1073. (800) 829-9045. Website: www.health.harvard.edu/SHR. PRICE: $16.00 for subscribers; $24.00 all others. Summary: This brief chapter on dealing with dental emergencies is from a new special health report from Harvard Medical School that outlines a prevention program that can address tooth decay and gum infection. The single-page chapter consists of a chart of suggestions for handling common dental emergencies, including toothache, broken tooth, knocked out tooth, broken or lost filling or crown, bleeding gums, bleeding from cuts in the mouth or after a tooth extraction, mouth sores, and broken dental appliances.

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Bleeding Gums

For each condition, the chart lists strategies to do, what not to do, and the recommended professional care. 1 table. •

Dental Impact on Daily Living Source: in Slade, G.D., ed. Measuring Oral Health and Quality of Life. Chapel Hill, NC: Department of Dental Ecology, University of North Carolina. September 1997. p. 121134. Contact: Available from University of North Carolina. Department of Dental Ecology, Chapel Hill, NC 27599-7450. (919) 966-2787; Fax (919) 966-6761. PRICE: $5.00 each. Summary: This chapter is from the proceedings of a conference, 'Measuring Oral Health and Quality of Life,' held in June 1996 at the University of North Carolina, Chapel Hill. The purpose of the conference was to examine methods for measuring oral health related quality of life (QOL), with the long term objective of promoting the use of those measures in oral health outcomes research. This chapter is one of eleven chapters that each discuss a specific oral health related QOL measure. This chapter covers the Dental Impact of Daily Living (DIDL), a socio-dental measure which assesses five dimensions of QOL: 'comfort,' related to complaints such as bleeding gums and food packing; 'appearance,' consisting of self-image; 'pain'; 'performance,' the ability to carry out daily activities and to interact with people; and 'eating restriction,' relating to difficulties in biting and chewing. The measure consists of a questionnaire of 36 items which assess the oral impacts on daily living. The authors discuss development of the instrument, evaluation of the instrument, and findings from the use of the instrument. A total score on the instrument reproduces the total impact subjects are experiencing, and since dimensions sometimes may not impact separately, it appears important to have this view of the individual as a whole. 1 figure. 3 tables. 7 references.

•

Your Child's Teeth From Babyhood Through Adolescence Source: in Moss, S.J. Growing Up Cavity Free: A Parent's Guide to Prevention. Carol Stream, IL: Quintessence Publishing Company, Inc. 1993. p. 25-70. Contact: Available from Quintessence Publishing Company, Inc. 551 North Kimberly Drive, Carol Stream, IL 60188-1881. (800) 621-0387 or (630) 682-3223; Fax (630) 682-3288; E-mail: [email protected]; http://www.quintpub.com. PRICE: $18.00 plus shipping and handling. ISBN: 0867152567. Summary: This chapter on tooth development is from a parent's guide to preventive dentistry techniques for children from birth through adolescence. Topics covered include tooth eruption; the average ages of tooth eruption; teething; remedies for teething discomfort; drooling; the importance of primary teeth; milestones in the growth and development of the child's teeth; cleaning the first teeth; mouthwashes versus fluoride mouthrinses; bad breath; pit and fissure sealants; tooth position and bad habits, including lip biting, tongue thrusting, fingernail biting, cheek biting, and tooth grinding (bruxism); pacifiers; speech and teeth; cleaning techniques as the child grows older; toothbrushes; toothpastes; water-irrigating devices; dental floss; stains on the dentition; the six-year molars; injuries and trauma; mouth guards; cosmetic dentistry for children and adults; protecting the child's teeth at school and at play; teeth and teenagers; bad breath and bleeding gums; smoking; teenage orthodontics; wisdom teeth; teenage diets; and bulimia. The chapter ends with a report card for parents to fill out for their child at 3, 6, 9, and 12 years of age. The book is written in clear, non-technical language and provides numerous suggestions for parents who want their children to grow up cavity-

Books

25

free. Full-color photographs illustrate many of the dental conditions discussed. 23 figures. 4 tables.

27

APPENDICES

29

APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.

NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute4: •

Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm

•

National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/

•

National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html

•

National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25

•

National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm

•

National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm

•

National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375

•

National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/

4

These publications are typically written by one or more of the various NIH Institutes.

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•

National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm

•

National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/

•

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm

•

National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm

•

National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/

•

National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/

•

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm

•

National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html

•

National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm

•

National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm

•

National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm

•

National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html

•

National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm

•

Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp

•

National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/

•

National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp

•

Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html

•

Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm

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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.5 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:6 •

Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html

•

HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html

•

NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html

•

Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/

•

Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html

•

Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html

•

Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/

•

Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html

•

Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html

•

Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html

•

MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html

5

Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 6 See http://www.nlm.nih.gov/databases/databases.html.

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•

Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html

•

Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html

The NLM Gateway7 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.8 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “bleeding gums” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total

Items Found 1512 3 964 4 25 2508

HSTAT9 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.10 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.11 Simply search by “bleeding gums” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

7

Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.

8

The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 9 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 10 11

The HSTAT URL is http://hstat.nlm.nih.gov/.

Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations.

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Coffee Break: Tutorials for Biologists12 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.13 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.14 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •

CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.

•

Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.

12 Adapted 13

from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.

The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 14 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.

35

APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on bleeding gums can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.

Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to bleeding gums. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to bleeding gums. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “bleeding gums”:

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Bleeding Gums

Bleeding Disorders http://www.nlm.nih.gov/medlineplus/bleedingdisorders.html Dental Health http://www.nlm.nih.gov/medlineplus/dentalhealth.html Gum Disease http://www.nlm.nih.gov/medlineplus/gumdisease.html Heart Attack http://www.nlm.nih.gov/medlineplus/heartattack.html Heart Diseases http://www.nlm.nih.gov/medlineplus/heartdiseases.html Oral Cancer http://www.nlm.nih.gov/medlineplus/oralcancer.html Tooth Disorders http://www.nlm.nih.gov/medlineplus/toothdisorders.html You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on bleeding gums. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •

Cleaning Between Your Teeth Source: Chicago, IL: American Dental Association (ADA). 1998. [2 p.]. Contact: Available from American Dental Association (ADA). Catalog Sales, P.O. Box 776, St. Charles, IL 60174. (800) 947-4746. Fax (888) 476-1880 or (630) 443-9970. Website: www.ada.org. PRICE: $19.00 for 100; nonmembers add 50 percent; bulk rates available. Item number W175. Summary: As calculus forms near the gumline and between teeth, gums may become irritated and inflamed. This leads to swollen and bleeding gums, an early form of periodontal disease called gingivitis. This brochure reviews the importance of and strategies for cleaning between the teeth. The best way to remove plaque and to prevent tooth decay and gum disease is to clean the teeth thoroughly every day. Twice daily brushing is essential, but cannot reach between the teeth. Dental floss and interdental cleaners can help loosen and remove the debris and plaque from between the teeth and

Patient Resources

37

under the gumline. Interdental cleaners may be helpful for people who have difficulty handling floss or for those who wear braces. The brochure describes how interdental cleaners are used, different types of interdental cleaners, and the use of the American Dental Association's Seal of Acceptance. 3 figures. •

Oral Care for People With Diabetes Source: Rancho Dominguez, CA: Laclede, Inc. 1999. [2 p.]. Contact: Available from Laclede, Inc. 2030 East University Drive, Rancho Dominguez, CA 90220. (800) 922-5856 or (310) 605-4280. Fax (310) 605-4288. E-mail: [email protected]. Website: www.laclede.com. PRICE: Contact publisher. Summary: Oral complications related to diabetes can include hard-to-heal mouth sores, bleeding gums, and dry mouth discomfort. In addition, many medications taken by people with diabetes for hypertension, cardiovascular disorders, and kidney disease can cause dry mouth as a major side effect. This brochure describes some of the oral health problems that people with diabetes may encounter, as well as some Biotene products that are available to treat or prevent those problems. The brochure describes toothpaste, mouthwash, mouth gum, moisturizing gel, and denture adhesive products. A final section offers practical tips for coping with a sore mouth. Readers are encouraged to contact their dentists when certain symptoms are experienced. The brochure includes a brief list of helpful web sites for readers who wish to obtain more information. 8 figures.

•

Keep Your Gums Healthy Source: Albany, New York: New York State Department of Health. 1997. [2 p.]. Contact: Available from New York State Department of Health. Publications Department, Box 2000, Albany, NY 12220. (518) 474-5370. PRICE: Single copy free. Summary: Periodontal (gum) disease affects the gums, bones, and other supporting structures of the teeth. This simple brochure outlines the problems associated with periodontal disease. After a brief section on the incidence of periodontal disease, the brochure lists the warning signs: bleeding gums, bad breath or bad taste in the mouth, soft, swollen or tender gums, pus from the gum line, loose teeth, gums shrinking away from the teeth, and changes in the way teeth are positioned. The brochure then describes the causes of periodontal disease, notably plaque, and lists recommendations for preventing periodontal disease.

•

Acne and Isotretinoin: Using Isotretinoin the Right Way Source: American Academy of Family Physicians. 2000. 3 p. Contact: Available from American Academy of Family Physicians. Website: www.familydoctor.org. Summary: This fact sheet discusses precautions when using isotretinoin (Accutane) to treat acne. Isotretinoin is used to treat bad acne and acne that is resistant to other forms of treatment. The initial treatment lasts from 15 to 20 weeks. During this time, patients may not give blood, take vitamin A, have any cosmetic procedures, or take antibiotics. Women need to use two forms of birth control while taking isotretinoin as severe birth defects may occur in a developing fetus. Isotretinoin has many side effects including dry skin and lips, bleeding gums, muscular pain, thinning hair, increased sensitivity to the sun, nosebleeds, headache, nausea, yellow or red eyes, severe stomach pain, and diarrhea. These side effects usually go away after stopping the medication.

38

•

Bleeding Gums

Dental Emergencies: First Aid Procedures Source: Boise, ID: Dental Section, Idaho Department of Health and Welfare. 199x. 1 p. Contact: Available from Idaho Department of Health and Welfare. Dental Section, Statehouse, Boise, Idaho 83720. (208) 334-5964. PRICE: Single copy free. Summary: This fact sheet lists first aid procedures to follow in the event of a dental emergency. Dental problems described include toothache, bleeding gums, tooth eruption pain, cold sores, canker sores and fever blisters, knocked-out tooth, broken or displaced tooth, bitten tongue or lip, objects wedged between the teeth, and possible fractured jaw. The fact sheet also discusses what to do in the event that an emergency occurs after regular dentist office hours. The fact sheet is printed on bright yellow card stock.

•

Daily Dental Care for Seniors in Residential Care Facilities Source: Sacramento, CA: California Dental Association. 2000. [3 p.]. Contact: Available from California Dental Association. 1201 K Street, Sacramento, CA 95814. (916) 443-0505. Fax (916) 443-2943 Email: [email protected]. Website: www.cda.org. PRICE: Single copy free; Full-text available online at no charge. Summary: This fact sheet reviews the importance of daily dental care, particularly for residents in long term care facilities. Written for the caregiver, the fact sheet first reminds readers that some patients are sensitive to having their mouth and head touched and offers some suggestions for handling this situation. Other topics include toothbrushing tips, flossing tips, and suggestions for denture care. The fact sheet concludes with a list of symptoms for which the health care provider should be contacted. These include: bleeding gums, changes in the way the patient's teeth fit together, changes in the way dentures or partials fit, red or swollen gums, pus around a tooth near the gumline, bad breath, loss of taste, gums moving away from the tooth, and loose or chipped teeth.

•

Mouth and Throat Problems Contact: National AIDS Treatment Information Project, Beth Israel Deaconess Medical Center, Beth Israel Hospital, 330 Brookline Ave Libby Bldg 317, Boston, MA, 02215, (617) 667-5520, http://www.natip.org. Summary: This fact sheet, for individuals with the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), discusses opportunistic infections of the mouth and throat. Mouth and throat problems can serve as the first signs of HIV and many become more frequent as the immune system grows weaker. The most common mouth and throat problems include oral candidiasis, herpes simplex virus (HSV), hairy leukoplakia, gingivitis, periodontal disease, Kaposi's sarcoma (KS), and aphthous ulcers (canker sores). Some of the symptoms of mouth and throat problems include pain or difficulty in chewing, swallowing, tasting food; unusual taste, mouth or throat pain; bleeding gums; and bleeding from the mouth. The cause of mouth and throat problems can generally be determined through physical examination, a review of an individual's medical history, and a variety of laboratory studies if needed. The management of mouth and throat problems depends on their cause(s). The fact sheet identifies some of the treatments available for various diseases and disorders of the mouth and throat and provides a table that lists some common mouth and throat problems in people with HIV/AIDS.

Patient Resources

•

39

Preventing the Sexual Transmission of HIV, the Virus That Causes AIDS: What You Should Know About Oral Sex Contact: CDC National Prevention Information Network, PO Box 6003, Rockville, MD, 20849-6003, (800) 458-5231, http://www.cdcnpin.org. Summary: This information sheet provides general information on the transmission of the human immunodeficiency virus (HIV) through oral sex and on the prevention of HIV/acquired immunodeficiency syndrome (HIV/AIDS). Oral sex, which is commonly practiced by sexually active male-female and same-gender couples of various ages, is not considered safe sex. Numerous studies have demonstrated that oral sex can result in the transmission of HIV and other sexually transmitted diseases (STDs). Although the risk of HIV transmission from an infected partner through oral sex is much smaller than the risk of HIV transmission from anal or vaginal sex, several factors can increase the risk of HIV transmission through oral sex, including oral ulcers, bleeding gums, genital sores, and the presence of other STDs. The information sheet discusses the theoretical and documented risk of HIV transmission during oral-penile contact, oral-vaginal contact, and oral-anal contact. To lower the risk of getting HIV through oral sex, individuals should use latex condoms, plastic food wrap, or a dental dam each and every time they engage in oral sex.

•

Frequently Asked Questions Source: in American Academy of Periodontology. Media Resource Guide to Periodontal Diseases (Gum Disease). Chicago, IL: American Academy of Periodontology. 2002. p. 2729. Contact: Available from American Academy of Periodontology. 737 N. Michigan Avenue, Suite 800, Chicago, IL 60611-2690. (312) 787-5518. Fax (312) 787-3670. Website: www.perio.org. PRICE: Contact organization for print copies. Summary: This section of Frequently Asked Questions (FAQs) is from a guide that is intended to serve as a reference and resource for reporters who are covering periodontal diseases and oral health. The guide gives journalists information about these conditions and their impact on public health, as well as current and emerging treatments. In this section, the authors answer questions on topics include the primary reason for toothbrushing, bleeding gums, recommended oral care products, the causes of tooth loss, the role of stress in problems of the mouth, the causes of bad breath, how oral health affects overall health, the relationship between periodontal and respiratory disease, how severe forms of periodontal diseases increase the risk for heart disease, the interplay between periodontitis and the risk of having a premature baby, the relationship between periodontal diseases and diabetes, the relationship between tobacco use and periodontal diseases, and the role of genetics. 1 reference. The NIH Search Utility

The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to bleeding gums. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively

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rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats

•

Family Village: http://www.familyvillage.wisc.edu/specific.htm

•

Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/

•

Med Help International: http://www.medhelp.org/HealthTopics/A.html

•

Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/

•

Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/

•

WebMDHealth: http://my.webmd.com/health_topics

Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to bleeding gums. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with bleeding gums. The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about bleeding gums. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “bleeding gums” (or a synonym), and you will receive information on all relevant organizations listed in the database.

Patient Resources

41

Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “bleeding gums”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “bleeding gums” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “bleeding gums” (or a synonym) into the search box, and click “Submit Query.”

43

APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.15

Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.

Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of

15

Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.

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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)16: •

Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/

•

Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)

•

Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm

•

California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html

•

California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html

•

California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html

•

California: Gateway Health Library (Sutter Gould Medical Foundation)

•

California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/

•

California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp

•

California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html

•

California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/

•

California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/

•

California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/

•

California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html

•

California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/

•

Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/

•

Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/

•

Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/

16

Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.

Finding Medical Libraries

45

•

Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml

•

Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm

•

Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html

•

Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm

•

Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp

•

Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/

•

Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm

•

Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html

•

Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/

•

Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm

•

Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/

•

Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/

•

Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/

•

Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm

•

Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html

•

Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm

•

Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/

•

Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/

•

Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10

•

Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/

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•

Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html

•

Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp

•

Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp

•

Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/

•

Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html

•

Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm

•

Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp

•

Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/

•

Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html

•

Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/

•

Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm

•

Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/

•

Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html

•

Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm

•

Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330

•

Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)

•

National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html

•

National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/

•

National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/

Finding Medical Libraries

47

•

Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm

•

New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/

•

New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm

•

New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm

•

New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/

•

New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html

•

New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/

•

New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html

•

New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/

•

Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm

•

Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp

•

Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/

•

Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/

•

Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml

•

Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html

•

Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html

•

Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml

•

Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp

•

Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm

•

Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/

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•

South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp

•

Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/

•

Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/

•

Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72

49

ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •

ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html

•

MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp

•

Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/

•

Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html

•

On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/

•

Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp

•

Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm

Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a).

Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •

Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical

•

MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html

•

Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/

•

Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine

51

BLEEDING GUMS DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Acne: A disorder of the skin marked by inflammation of oil glands and hair glands. [NIH] Acne Vulgaris: A chronic disorder of the pilosebaceous apparatus associated with an increase in sebum secretion. It is characterized by open comedones (blackheads), closed comedones (whiteheads), and pustular nodules. The cause is unknown, but heredity and age are predisposing factors. [NIH] Acquired Immunodeficiency Syndrome: An acquired defect of cellular immunity associated with infection by the human immunodeficiency virus (HIV), a CD4-positive Tlymphocyte count under 200 cells/microliter or less than 14% of total lymphocytes, and increased susceptibility to opportunistic infections and malignant neoplasms. Clinical manifestations also include emaciation (wasting) and dementia. These elements reflect criteria for AIDS as defined by the CDC in 1993. [NIH] Adolescence: The period of life beginning with the appearance of secondary sex characteristics and terminating with the cessation of somatic growth. The years usually referred to as adolescence lie between 13 and 18 years of age. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Agar: A complex sulfated polymer of galactose units, extracted from Gelidium cartilagineum, Gracilaria confervoides, and related red algae. It is used as a gel in the preparation of solid culture media for microorganisms, as a bulk laxative, in making emulsions, and as a supporting medium for immunodiffusion and immunoelectrophoresis. [NIH]

Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alkaline: Having the reactions of an alkali. [EU] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Alveoli: Tiny air sacs at the end of the bronchioles in the lungs. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of

52

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hemoglobin. [NIH] Anions: Negatively charged atoms, radicals or groups of atoms which travel to the anode or positive pole during electrolysis. [NIH] Anomalies: Birth defects; abnormalities. [NIH] Anorexia: Lack or loss of appetite for food. Appetite is psychologic, dependent on memory and associations. Anorexia can be brought about by unattractive food, surroundings, or company. [NIH] Antibiotics: Substances produced by microorganisms that can inhibit or suppress the growth of other microorganisms. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Anticoagulant: A drug that helps prevent blood clots from forming. Also called a blood thinner. [NIH] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Anti-infective: An agent that so acts. [EU] Antioxidant: A substance that prevents damage caused by free radicals. Free radicals are highly reactive chemicals that often contain oxygen. They are produced when molecules are split to give products that have unpaired electrons. This process is called oxidation. [NIH] Antiseptic: A substance that inhibits the growth and development of microorganisms without necessarily killing them. [EU] Anus: The opening of the rectum to the outside of the body. [NIH] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Aqueous: Having to do with water. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Ascorbic Acid: A six carbon compound related to glucose. It is found naturally in citrus fruits and many vegetables. Ascorbic acid is an essential nutrient in human diets, and necessary to maintain connective tissue and bone. Its biologically active form, vitamin C, functions as a reducing agent and coenzyme in several metabolic pathways. Vitamin C is considered an antioxidant. [NIH] Asymptomatic: Having no signs or symptoms of disease. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bactericidal: Substance lethal to bacteria; substance capable of killing bacteria. [NIH] Bacteriostatic: 1. Inhibiting the growth or multiplication of bacteria. 2. An agent that inhibits the growth or multiplication of bacteria. [EU]

Dictionary 53

Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bleeding Time: Duration of blood flow after skin puncture. This test is used as a measure of capillary and platelet function. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Glucose: Glucose in blood. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bruxism: A disorder characterized by grinding and clenching of the teeth. [NIH] Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the buccal surface of a tooth. [EU] Bulimia: Episodic binge eating. The episodes may be associated with the fear of not being able to stop eating, depressed mood, or self-deprecating thoughts (binge-eating disorder) and may frequently be terminated by self-induced vomiting (bulimia nervosa). [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Candidiasis: Infection with a fungus of the genus Candida. It is usually a superficial infection of the moist cutaneous areas of the body, and is generally caused by C. albicans; it most commonly involves the skin (dermatocandidiasis), oral mucous membranes (thrush, def. 1), respiratory tract (bronchocandidiasis), and vagina (vaginitis). Rarely there is a

54

Bleeding Gums

systemic infection or endocarditis. Called also moniliasis, candidosis, oidiomycosis, and formerly blastodendriosis. [EU] Candidosis: An infection caused by an opportunistic yeasts that tends to proliferate and become pathologic when the environment is favorable and the host resistance is weakened. [NIH]

Capillary: Any one of the minute vessels that connect the arterioles and venules, forming a network in nearly all parts of the body. Their walls act as semipermeable membranes for the interchange of various substances, including fluids, between the blood and tissue fluid; called also vas capillare. [EU] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Case series: A group or series of case reports involving patients who were given similar treatment. Reports of case series usually contain detailed information about the individual patients. This includes demographic information (for example, age, gender, ethnic origin) and information on diagnosis, treatment, response to treatment, and follow-up after treatment. [NIH] Cations: Postively charged atoms, radicals or groups of atoms which travel to the cathode or negative pole during electrolysis. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Central Nervous System Infections: Pathogenic infections of the brain, spinal cord, and meninges. DNA virus infections; RNA virus infections; bacterial infections; mycoplasma infections; Spirochaetales infections; fungal infections; protozoan infections; helminthiasis; and prion diseases may involve the central nervous system as a primary or secondary process. [NIH] Cetylpyridinium: Cationic bactericidal surfactant used as a topical antiseptic for skin, wounds, mucous membranes, instruments, etc.; and also as a component in mouthwash and lozenges. [NIH] Cheilitis: Inflammation of the lips. It is of various etiologies and degrees of pathology. [NIH] Chlorhexidine: Disinfectant and topical anti-infective agent used also as mouthwash to prevent oral plaque. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Circadian: Repeated more or less daily, i. e. on a 23- to 25-hour cycle. [NIH] Circadian Rhythm: The regular recurrence, in cycles of about 24 hours, of biological processes or activities, such as sensitivity to drugs and stimuli, hormone secretion, sleeping, feeding, etc. This rhythm seems to be set by a 'biological clock' which seems to be set by recurring daylight and darkness. [NIH] Clinical study: A research study in which patients receive treatment in a clinic or other medical facility. Reports of clinical studies can contain results for single patients (case reports) or many patients (case series or clinical trials). [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening,

Dictionary 55

prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Coenzyme: An organic nonprotein molecule, frequently a phosphorylated derivative of a water-soluble vitamin, that binds with the protein molecule (apoenzyme) to form the active enzyme (holoenzyme). [EU] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU] Concretion: Minute, hard, yellow masses found in the palpebral conjunctivae of elderly people or following chronic conjunctivitis, composed of the products of cellular degeneration retained in the depressions and tubular recesses in the conjunctiva. [NIH]

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Condoms: A sheath that is worn over the penis during sexual behavior in order to prevent pregnancy or spread of sexually transmitted disease. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Craniocerebral Trauma: Traumatic injuries involving the cranium and intracranial structures (i.e., brain; cranial nerves; meninges; and other structures). Injuries may be classified by whether or not the skull is penetrated (i.e., penetrating vs. nonpenetrating) or whether there is an associated hemorrhage. [NIH] Crowns: A prosthetic restoration that reproduces the entire surface anatomy of the visible natural crown of a tooth. It may be partial (covering three or more surfaces of a tooth) or complete (covering all surfaces). It is made of gold or other metal, porcelain, or resin. [NIH] Cutaneous: Having to do with the skin. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Dementia: An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness. [NIH] Dental Abutments: Natural teeth or teeth roots used as anchorage for a fixed or removable denture or other prosthesis (such as an implant) serving the same purpose. [NIH] Dental Calculus: Abnormal concretion or calcified deposit that forms around the teeth or dental prostheses. [NIH] Dental Care: The total of dental diagnostic, preventive, and restorative services provided to meet the needs of a patient (from Illustrated Dictionary of Dentistry, 1982). [NIH] Dental Caries: Localized destruction of the tooth surface initiated by decalcification of the enamel followed by enzymatic lysis of organic structures and leading to cavity formation. If left unchecked, the cavity may penetrate the enamel and dentin and reach the pulp. The three most prominent theories used to explain the etiology of the disase are that acids produced by bacteria lead to decalcification; that micro-organisms destroy the enamel protein; or that keratolytic micro-organisms produce chelates that lead to decalcification. [NIH]

Dental Plaque: A film that attaches to teeth, often causing dental caries and gingivitis. It is composed of mucins, secreted from salivary glands, and microorganisms. [NIH] Dentists: Individuals licensed to practice dentistry. [NIH] Dentition: The teeth in the dental arch; ordinarily used to designate the natural teeth in position in their alveoli. [EU] Dentures: An appliance used as an artificial or prosthetic replacement for missing teeth and adjacent tissues. It does not include crowns, dental abutments, nor artificial teeth. [NIH] Deuterium: Deuterium. The stable isotope of hydrogen. It has one neutron and one proton

Dictionary 57

in the nucleus. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diarrhoea: Abnormal frequency and liquidity of faecal discharges. [EU] Diastolic: Of or pertaining to the diastole. [EU] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Duct: A tube through which body fluids pass. [NIH] Duodenum: The first part of the small intestine. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Emaciation: Clinical manifestation of excessive leanness usually caused by disease or a lack of nutrition. [NIH] Enamel: A very hard whitish substance which covers the dentine of the anatomical crown of a tooth. [NIH] Endocarditis: Exudative and proliferative inflammatory alterations of the endocardium, characterized by the presence of vegetations on the surface of the endocardium or in the endocardium itself, and most commonly involving a heart valve, but sometimes affecting the inner lining of the cardiac chambers or the endocardium elsewhere. It may occur as a primary disorder or as a complication of or in association with another disease. [EU] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epidermis: Nonvascular layer of the skin. It is made up, from within outward, of five layers: 1) basal layer (stratum basale epidermidis); 2) spinous layer (stratum spinosum epidermidis); 3) granular layer (stratum granulosum epidermidis); 4) clear layer (stratum lucidum epidermidis); and 5) horny layer (stratum corneum epidermidis). [NIH] Epistaxis: Bleeding from the nose. [NIH] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Ether: One of a class of organic compounds in which any two organic radicals are attached

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directly to a single oxygen atom. [NIH] Extraction: The process or act of pulling or drawing out. [EU] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fungistatic: Inhibiting the growth of fungi. [EU] Fungus: A general term used to denote a group of eukaryotic protists, including mushrooms, yeasts, rusts, moulds, smuts, etc., which are characterized by the absence of chlorophyll and by the presence of a rigid cell wall composed of chitin, mannans, and sometimes cellulose. They are usually of simple morphological form or show some reversible cellular specialization, such as the formation of pseudoparenchymatous tissue in the fruiting body of a mushroom. The dimorphic fungi grow, according to environmental conditions, as moulds or yeasts. [EU] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastroenteritis: An acute inflammation of the lining of the stomach and intestines, characterized by anorexia, nausea, diarrhoea, abdominal pain, and weakness, which has various causes, including food poisoning due to infection with such organisms as Escherichia coli, Staphylococcus aureus, and Salmonella species; consumption of irritating food or drink; or psychological factors such as anger, stress, and fear. Called also enterogastritis. [EU] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Genital: Pertaining to the genitalia. [EU] Gingivitis: Inflammation of the gingivae. Gingivitis associated with bony changes is referred to as periodontitis. Called also oulitis and ulitis. [EU] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Habitual: Of the nature of a habit; according to habit; established by or repeated by force of habit, customary. [EU] Haematoma: A localized collection of blood, usually clotted, in an organ, space, or tissue, due to a break in the wall of a blood vessel. [EU] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Headache Disorders: Common conditions characterized by persistent or recurrent headaches. Headache syndrome classification systems may be based on etiology (e.g.,

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vascular headache, post-traumatic headaches, etc.), temporal pattern (e.g., cluster headache, paroxysmal hemicrania, etc.), and precipitating factors (e.g., cough headache). [NIH] Health Status: The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures. [NIH] Hemophilia: Refers to a group of hereditary disorders in which affected individuals fail to make enough of certain proteins needed to form blood clots. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one generation to another. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Herpes: Any inflammatory skin disease caused by a herpesvirus and characterized by the formation of clusters of small vesicles. When used alone, the term may refer to herpes simplex or to herpes zoster. [EU] Herpes Zoster: Acute vesicular inflammation. [NIH] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrogen Peroxide: A strong oxidizing agent used in aqueous solution as a ripening agent, bleach, and topical anti-infective. It is relatively unstable and solutions deteriorate over time unless stabilized by the addition of acetanilide or similar organic materials. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunity: Nonsusceptibility to the invasive or pathogenic microorganisms or to the toxic effect of antigenic substances. [NIH]

effects

of

foreign

Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunosuppression: Deliberate prevention or diminution of the host's immune response. It may be nonspecific as in the administration of immunosuppressive agents (drugs or radiation) or by lymphocyte depletion or may be specific as in desensitization or the simultaneous administration of antigen and immunosuppressive drugs. [NIH] Incision: A cut made in the body during surgery. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the

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microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Intestines: The section of the alimentary canal from the stomach to the anus. It includes the large intestine and small intestine. [NIH] Intracellular: Inside a cell. [NIH] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Irrigation: The washing of a body cavity or surface by flowing solution which is inserted and then removed. Any drug in the irrigation solution may be absorbed. [NIH] Isotretinoin: A topical dermatologic agent that is used in the treatment of acne vulgaris and several other skin diseases. The drug has teratogenic and other adverse effects. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Keratolytic: An agent that promotes keratolysis. [EU] Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH] Leukoplakia: A white patch that may develop on mucous membranes such as the cheek, gums, or tongue and may become cancerous. [NIH] Lip: Either of the two fleshy, full-blooded margins of the mouth. [NIH] Lipid: Fat. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Lupus: A form of cutaneous tuberculosis. It is seen predominantly in women and typically involves the nasal, buccal, and conjunctival mucosa. [NIH] Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphocyte Count: A count of the number of lymphocytes in the blood. [NIH] Lymphocytes: White blood cells formed in the body's lymphoid tissue. The nucleus is round or ovoid with coarse, irregularly clumped chromatin while the cytoplasm is typically pale blue with azurophilic (if any) granules. Most lymphocytes can be classified as either T or B (with subpopulations of each); those with characteristics of neither major class are called null cells. [NIH]

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Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lymphoma: A general term for various neoplastic diseases of the lymphoid tissue. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant tumor: A tumor capable of metastasizing. [NIH] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mental Health: The state wherein the person is well adjusted. [NIH] Micro-organism: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Mucins: A secretion containing mucopolysaccharides and protein that is the chief constituent of mucus. [NIH] Mucosa: A mucous membrane, or tunica mucosa. [EU] Multiple Myeloma: A malignant tumor of plasma cells usually arising in the bone marrow; characterized by diffuse involvement of the skeletal system, hyperglobulinemia, Bence-Jones proteinuria, and anemia. [NIH] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] Neoplasm: A new growth of benign or malignant tissue. [NIH] Nephropathy: Disease of the kidneys. [EU] Neutropenia: An abnormal decrease in the number of neutrophils, a type of white blood cell. [NIH] Neutrophils: Granular leukocytes having a nucleus with three to five lobes connected by slender threads of chromatin, and cytoplasm containing fine inconspicuous granules and stainable by neutral dyes. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Opportunistic Infections: An infection caused by an organism which becomes pathogenic under certain conditions, e.g., during immunosuppression. [NIH] Oral Health: The optimal state of the mouth and normal functioning of the organs of the mouth without evidence of disease. [NIH] Oral Hygiene: The practice of personal hygiene of the mouth. It includes the maintenance of oral cleanliness, tissue tone, and general preservation of oral health. [NIH] Oral Manifestations: Disorders of the mouth attendant upon non-oral disease or injury. [NIH]

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Orthodontics: A dental specialty concerned with the prevention and correction of dental and oral anomalies (malocclusion). [NIH] Palate: The structure that forms the roof of the mouth. It consists of the anterior hard palate and the posterior soft palate. [NIH] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Papilloma: A benign epithelial neoplasm which may arise from the skin, mucous membranes or glandular ducts. [NIH] Patch: A piece of material used to cover or protect a wound, an injured part, etc.: a patch over the eye. [NIH] Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]

Penis: The external reproductive organ of males. It is composed of a mass of erectile tissue enclosed in three cylindrical fibrous compartments. Two of the three compartments, the corpus cavernosa, are placed side-by-side along the upper part of the organ. The third compartment below, the corpus spongiosum, houses the urethra. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Periodontal disease: Disease involving the supporting structures of the teeth (as the gums and periodontal membranes). [NIH] Periodontal disease: Disease involving the supporting structures of the teeth (as the gums and periodontal membranes). [NIH] Periodontitis: Inflammation of the periodontal membrane; also called periodontitis simplex. [NIH]

Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Pit and Fissure Sealants: Agents used to occlude dental enamel pits and fissures in the prevention of dental caries. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plaque: A clear zone in a bacterial culture grown on an agar plate caused by localized destruction of bacterial cells by a bacteriophage. The concentration of infective virus in a fluid can be estimated by applying the fluid to a culture and counting the number of. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins

Dictionary 63

that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Pneumonia: Inflammation of the lungs. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Polyunsaturated fat: An unsaturated fat found in greatest amounts in foods derived from plants, including safflower, sunflower, corn, and soybean oils. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postoperative: After surgery. [NIH] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Preventive Dentistry: The branch of dentistry concerned with the prevention of disease and the maintenance and promotion of oral health. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteinuria: The presence of protein in the urine, indicating that the kidneys are not working properly. [NIH] Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Purpura: Purplish or brownish red discoloration, easily visible through the epidermis, caused by hemorrhage into the tissues. [NIH] Quality of Life: A generic concept reflecting concern with the modification and

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enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Radioactive: Giving off radiation. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Reliability: Used technically, in a statistical sense, of consistency of a test with itself, i. e. the extent to which we can assume that it will yield the same result if repeated a second time. [NIH]

Safe Sex: Sex behavior that prevents or decreases the spread of sexually transmitted diseases or pregnancy. [NIH] Saliva: The clear, viscous fluid secreted by the salivary glands and mucous glands of the mouth. It contains mucins, water, organic salts, and ptylin. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Sarcoma: A connective tissue neoplasm formed by proliferation of mesodermal cells; it is usually highly malignant. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Sex Characteristics: Those characteristics that distinguish one sex from the other. The primary sex characteristics are the ovaries and testes and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to reproduction. [NIH] Sexually Transmitted Diseases: Diseases due to or propagated by sexual contact. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]

Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Soaps: Sodium or potassium salts of long chain fatty acids. These detergent substances are obtained by boiling natural oils or fats with caustic alkali. Sodium soaps are harder and are used as topical anti-infectives and vehicles in pills and liniments; potassium soaps are soft, used as vehicles for ointments and also as topical antimicrobials. [NIH] Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Soybean Oil: Oil from soybean or soybean plant. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH]

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Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stomatitis: Inflammation of the oral mucosa, due to local or systemic factors which may involve the buccal and labial mucosa, palate, tongue, floor of the mouth, and the gingivae. [EU]

Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subarachnoid: Situated or occurring between the arachnoid and the pia mater. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Supplementation: Adding nutrients to the diet. [NIH] Suppuration: A pathologic process consisting in the formation of pus. [NIH] Surfactant: A fat-containing protein in the respiratory passages which reduces the surface tension of pulmonary fluids and contributes to the elastic properties of pulmonary tissue. [NIH]

Systemic: Affecting the entire body. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Teratogenic: Tending to produce anomalies of formation, or teratism (= anomaly of formation or development : condition of a monster). [EU] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrush: A disease due to infection with species of fungi of the genus Candida. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tone: 1. The normal degree of vigour and tension; in muscle, the resistance to passive elongation or stretch; tonus. 2. A particular quality of sound or of voice. 3. To make permanent, or to change, the colour of silver stain by chemical treatment, usually with a heavy metal. [EU] Tooth Loss: The failure to retain teeth as a result of disease or injury. [NIH] Toothache: Pain in the adjacent areas of the teeth. [NIH] Topical: On the surface of the body. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of

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toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Triclosan: A diphenyl ether derivative used in cosmetics and toilet soaps as an antiseptic. It has some bacteriostatic and fungistatic action. [NIH] Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Ulceration: 1. The formation or development of an ulcer. 2. An ulcer. [EU] Vaccines: Suspensions of killed or attenuated microorganisms (bacteria, viruses, fungi, protozoa, or rickettsiae), antigenic proteins derived from them, or synthetic constructs, administered for the prevention, amelioration, or treatment of infectious and other diseases. [NIH]

Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Vaginal: Of or having to do with the vagina, the birth canal. [NIH] Vaginitis: Inflammation of the vagina characterized by pain and a purulent discharge. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]

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INDEX A Abdominal, 51, 58, 62 Acne, 37, 51, 60 Acne Vulgaris, 51, 60 Acquired Immunodeficiency Syndrome, 39, 51 Adolescence, 24, 51 Adverse Effect, 51, 60, 64 Agar, 51, 62 Algorithms, 51, 53 Alkaline, 51, 53 Alternative medicine, 51 Alveoli, 51, 56 Amino Acids, 51, 62, 63 Anal, 39, 51 Anemia, 51, 61 Anions, 52, 60 Anomalies, 52, 62, 65 Anorexia, 52, 58 Antibiotics, 37, 52 Antibody, 52, 55, 59 Anticoagulant, 9, 52 Antigen, 52, 55, 59 Anti-infective, 52, 54, 59, 64 Antioxidant, 52 Antiseptic, 52, 54, 66 Anus, 51, 52, 60 Anxiety, 20, 52 Aqueous, 52, 53, 59 Arterial, 52, 59, 63, 65 Ascorbic Acid, 16, 19, 52 Asymptomatic, 13, 52 B Bacteria, 52, 56, 61, 66 Bactericidal, 52, 54 Bacteriostatic, 52, 66 Base, 53, 60 Benign, 53, 58, 61, 62 Biotechnology, 5, 31, 53 Bleeding Time, 14, 53 Blood Coagulation, 53 Blood Glucose, 53, 60 Blood pressure, 53, 59 Blood vessel, 53, 54, 58, 66 Bone Marrow, 53, 60, 61 Bowel, 51, 53 Bruxism, 24, 53 Buccal, 53, 60, 65

Bulimia, 24, 53 C Calcium, 12, 53, 55 Candidiasis, 4, 38, 53 Candidosis, 54 Capillary, 53, 54 Cardiovascular, 37, 54 Case report, 11, 18, 20, 54 Case series, 54 Cations, 54, 60 Cell, 6, 18, 52, 53, 54, 55, 58, 60, 62, 66 Central Nervous System, 54, 58 Central Nervous System Infections, 54, 58 Cetylpyridinium, 8, 54 Cheilitis, 4, 54 Chlorhexidine, 13, 17, 21, 54 Chronic, 51, 54, 55, 59, 60, 65 Circadian, 12, 54 Circadian Rhythm, 12, 54 Clinical study, 12, 15, 54 Clinical trial, 5, 9, 31, 54, 64 Cloning, 53, 55 Coenzyme, 52, 55 Complement, 55 Complementary and alternative medicine, 15, 21, 55 Complementary medicine, 15, 55 Computational Biology, 31, 55 Conception, 55, 58 Concretion, 55, 56 Condoms, 39, 56 Connective Tissue, 52, 53, 56, 64 Contraindications, ii, 56 Cranial, 56, 58 Craniocerebral Trauma, 56, 58 Crowns, 56 Cutaneous, 53, 56, 60 Cyclic, 11, 56 D Dementia, 51, 56 Dental Abutments, 56 Dental Calculus, 10, 56 Dental Care, 4, 38, 56 Dental Caries, 4, 56, 62 Dental Plaque, 7, 8, 56 Dentists, 37, 56 Dentition, 5, 24, 56 Dentures, 38, 56

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Deuterium, 56, 59 Diabetes Mellitus, 57 Diagnostic procedure, 57 Diarrhea, 37, 57 Diarrhoea, 57, 58 Diastolic, 57, 59 Digestion, 53, 57, 65 Direct, iii, 57, 64 Duct, 57, 64 Duodenum, 57, 65 E Efficacy, 5, 6, 15, 16, 19, 57 Electrolyte, 57, 63 Electrons, 52, 53, 57, 60 Emaciation, 51, 57 Enamel, 16, 56, 57, 62 Endocarditis, 54, 57 Environmental Health, 30, 32, 57 Enzymatic, 12, 53, 55, 56, 57 Enzyme, 55, 57 Epidermis, 57, 63 Epistaxis, 9, 57 Epithelial, 57, 62 Esophagus, 57, 65 Ether, 57, 66 Extraction, 4, 23, 58 F Family Planning, 31, 58 Fat, 53, 58, 60, 63, 65 Fetus, 37, 58 Fungistatic, 58, 66 Fungus, 53, 58 G Gas, 58, 59 Gastroenteritis, 9, 58 Gene, 53, 58 Genetics, 39, 58 Genital, 39, 58 Gingivitis, 4, 6, 7, 8, 12, 13, 14, 17, 18, 19, 21, 36, 38, 56, 58 Glucose, 52, 53, 57, 58, 60 Governing Board, 58, 63 H Habitual, 18, 58 Haematoma, 9, 58 Headache, 37, 58 Headache Disorders, 58 Health Status, 4, 59 Hemophilia, 4, 59 Hemorrhage, 56, 58, 59, 63 Hereditary, 59 Heredity, 51, 58, 59

Herpes, 4, 38, 59 Herpes Zoster, 59 Hormone, 54, 59, 60 Hydrogen, 13, 53, 56, 59, 63 Hydrogen Peroxide, 13, 59 Hypertension, 37, 58, 59 I Immune response, 52, 59, 66 Immune system, 38, 59, 66 Immunity, 51, 59 Immunodeficiency, 38, 39, 51, 59 Immunosuppression, 59, 61 Incision, 59, 60 Infection, 4, 23, 51, 53, 54, 58, 59, 60, 61, 65, 66 Inflammation, 16, 51, 54, 58, 59, 60, 62, 63, 65, 66 Insulin, 14, 60 Insulin-dependent diabetes mellitus, 14, 60 Intestines, 51, 58, 60 Intracellular, 59, 60, 63 Invasive, 8, 59, 60 Ions, 12, 53, 57, 59, 60 Irrigation, 16, 60 Isotretinoin, 37, 60 K Kb, 30, 60 Keratolytic, 56, 60 Kidney Disease, 30, 37, 60 L Leukoplakia, 4, 38, 60 Lip, 24, 38, 60 Lipid, 60 Localized, 56, 58, 59, 60, 62, 66 Lupus, 9, 60 Lymphatic, 60 Lymphocyte Count, 51, 60 Lymphocytes, 51, 52, 60, 61, 66 Lymphoid, 60, 61 Lymphoma, 4, 61 M Malignant, 51, 61, 64 Malignant tumor, 61 MEDLINE, 31, 61 Membrane, 55, 61, 62 Mental, iv, 5, 30, 32, 56, 61, 63 Mental Health, iv, 5, 30, 32, 61, 63 Micro-organism, 56, 61 Modification, 61, 63 Molecular, 31, 33, 53, 55, 61 Motion Sickness, 61

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Mucins, 56, 61, 64 Mucosa, 60, 61, 65 Multiple Myeloma, 9, 61 N Nausea, 37, 58, 61 Neoplasm, 61, 62, 64 Nephropathy, 60, 61 Neutropenia, 11, 61 Neutrophils, 61 Nucleus, 56, 57, 60, 61, 63 O Opportunistic Infections, 38, 51, 61 Oral Health, 4, 16, 19, 24, 37, 39, 61, 63 Oral Hygiene, 4, 13, 17, 61 Oral Manifestations, 4, 61 Orthodontics, 17, 24, 62 P Palate, 62, 65 Pancreas, 51, 60, 62 Papilloma, 4, 62 Patch, 60, 62 Pathologic, 54, 62, 65 Patient Education, 36, 44, 46, 49, 62 Penis, 56, 62 Peptide, 62, 63 Periodontal disease, 4, 9, 36, 37, 38, 39, 62 Periodontitis, 4, 11, 39, 58, 62 Pharmacologic, 62, 65 Phosphorus, 53, 62 Physical Examination, 38, 62 Pit and Fissure Sealants, 24, 62 Plants, 58, 62, 63, 66 Plaque, 4, 5, 6, 7, 10, 11, 12, 13, 14, 18, 19, 36, 37, 54, 62 Plasma, 18, 61, 62, 63 Plasma cells, 61, 63 Pneumonia, 56, 63 Poisoning, 58, 61, 63 Polyunsaturated fat, 17, 18, 63 Posterior, 51, 62, 63 Postoperative, 20, 63 Potassium, 12, 63, 64 Practice Guidelines, 32, 63 Precursor, 57, 63 Prevalence, 4, 63 Preventive Dentistry, 5, 24, 63 Protein S, 53, 63 Proteins, 16, 51, 52, 55, 59, 62, 63, 66 Proteinuria, 61, 63 Protons, 59, 63 Public Health, 32, 39, 63 Public Policy, 31, 63

Purpura, 10, 63 Q Quality of Life, 24, 63 R Radioactive, 59, 64 Randomized, 57, 64 Recurrence, 54, 64 Refer, 1, 53, 55, 59, 64 Regimen, 57, 64 Reliability, 8, 64 S Safe Sex, 39, 64 Saliva, 64 Salivary, 17, 56, 64 Sarcoma, 4, 38, 64 Screening, 54, 64 Secretion, 51, 54, 60, 61, 64 Sex Characteristics, 51, 64 Sexually Transmitted Diseases, 39, 64 Shock, 64, 66 Side effect, 37, 51, 64, 65 Skeletal, 61, 64 Soaps, 64, 66 Social Environment, 64 Somatic, 51, 64 Soybean Oil, 63, 64 Specialist, 40, 64 Species, 58, 65, 66 Stomach, 37, 51, 57, 58, 59, 60, 61, 65 Stomatitis, 8, 65 Stress, 39, 58, 61, 65 Subacute, 59, 65 Subarachnoid, 58, 65 Subclinical, 59, 65 Supplementation, 10, 16, 19, 65 Suppuration, 12, 65 Surfactant, 54, 65 Systemic, 53, 54, 59, 65 Systolic, 59, 65 T Teratogenic, 60, 65 Threshold, 59, 65 Thrush, 53, 65 Tissue, 52, 53, 54, 56, 58, 60, 61, 62, 64, 65 Tone, 61, 65 Tooth Loss, 4, 39, 65 Toothache, 4, 23, 38, 65 Topical, 4, 54, 59, 60, 64, 65 Toxic, iv, 59, 65 Toxicology, 32, 65 Toxins, 52, 59, 66 Transfection, 53, 66

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Trauma, 24, 66 Triclosan, 6, 66 Tuberculosis, 60, 66 U Ulcer, 66 Ulceration, 4, 66 V Vaccines, 66 Vagina, 53, 66

Vaginal, 39, 66 Vaginitis, 53, 66 Vascular, 59, 60, 66 Veterinary Medicine, 31, 66 Virus, 38, 39, 51, 54, 62, 66 W White blood cell, 52, 60, 61, 63, 66

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