Open Access. Powered by Scholars. Published by Universities.®

Dentistry Commons™

Open Access. Powered by Scholars. Published by Universities.®

Articles 181 - 210 of 214

Full-Text Articles in Dentistry

Clinical Evaluation Of Treatment Of White Spot Lesions With Icon, Candace A. Cronan Jan 2012

Clinical Evaluation Of Treatment Of White Spot Lesions With Icon, Candace A. Cronan

All ETDs from UAB

Introduction: Despite an increased awareness by clinicians and their attempt to aid patients in the prevention of white spot lesions, enamel demineralization continues to be a problem associated with orthodontic treatment. Current treatment options for these unaesthetic scars on the teeth range from conservative options for remineralization such as the use of fluoride and CPP-ACP to more aggressive treatment involving loss of tooth structure with microabrasion or restorations. An innovative option for treatment has recently been introduced in the form of the infiltrant resin, Icon. Icon infiltration is a minimally invasive procedure performed by a dentist that is claimed to …


Three-Dimensional Magnetic Resonance Imaging Of The Natural Dentition, Ryan Jeffery Cox Jan 2012

Three-Dimensional Magnetic Resonance Imaging Of The Natural Dentition, Ryan Jeffery Cox

All ETDs from UAB

The purpose of this study was to determine if ultra short echo time magnetic resonance imaging (UTE-MRI) technology could be used to image teeth in orthodontics. The objectives of this study were to determine the accuracy and resolution of UTE-MRI on dental morphology and its application to the field of orthodontics with respect to appliance affect on morphology. Teeth were collected from the Orthodontic clinic at the University of Alabama at Birmingham and the Institutional Review Board of the University of Alabama at Birmingham approved the study. High-resolution 3-Tesla UTE-MRI was preformed on sixty extracted human premolar teeth with fixed …


The Effects Of Runx2 Deficiency In Cartilaginous And Mineralized Craniofacial Element, David Summerford Jan 2011

The Effects Of Runx2 Deficiency In Cartilaginous And Mineralized Craniofacial Element, David Summerford

All ETDs from UAB

The development of the orofacial structure in mammals is a highly ordered process that is coordinated activity of epithelial and mesenchymal cells. Chondrocytes and osteoblasts work in close association for development of many cartilaginous skeletal structures and cartilaginous orofacial structures. Two major orofacial structures are the palate and the temporomandibular joint (TMJ). The transcription factor, Runx2, is obligatory for differentiation of mesenchymal cells into chondrocytes and osteoblasts. However, specific contributions of chondrocyte in cartilaginous and mineralized structures of the craniofacial skeleton are not known. Thus, the objective of this study was to discover the regulatory role of Runx2 in chondrocyte …


Enamel Demineralization Around Bonded Orthdontic Appliances Using Resin Coatings, Michael Brett Wood Jan 2011

Enamel Demineralization Around Bonded Orthdontic Appliances Using Resin Coatings, Michael Brett Wood

All ETDs from UAB

Introduction: Orthodontists work to achieve a favorable esthetic and functional result, only to have the outcome tainted by the presence of demineralization upon appliance removal. The presence of WSL's is a disappointment to both orthodontists and patients. Several products have been developed to prevent this unfortunate damage to tooth structure, including "Opalseal" and "Ortho-coat". Opalseal is a 38% filled primer that releases and recharges fluoride. Ortho-coat is a fluoride releasing, light cure, hydrophilic resin that coats both the bracket and tooth surface preventing decalcification. The aim of this study was to investigate the barrier effect of Opalseal and Ortho-coat compared …


Increased Cutting Efficacy Of Diamond Burs With Biochemical Solution Spraying, Ramtin Sadid Zadeh Jan 2011

Increased Cutting Efficacy Of Diamond Burs With Biochemical Solution Spraying, Ramtin Sadid Zadeh

All ETDs from UAB

CAD/CAM units are becoming increasingly popular for milling all ceramic restorations from ceramic blocks. The solution used to spray the diamond cutting instrument also improves cutting effectiveness and also lubricates the diamond, which may not only prolong the cutting life of the diamond instrument but also provide smoother cuts on the ceramic block. The purpose of this study is to evaluate cutting efficacy of diamond burs with three solutions and to compare roughness produced by each solution on the glass-ceramic block. Material and methods: 15 Empress CAD blocks, 30 fine diamond burs, two solutions and distilled water were used. Each …


Thesis- Clinical Evaluation Of Non-Carious Cervical Lesion- A Longitudinal Study., Shreya D. Shah Jan 2011

Thesis- Clinical Evaluation Of Non-Carious Cervical Lesion- A Longitudinal Study., Shreya D. Shah

All ETDs from UAB

Non-carious cervical lesions (NCCL) are non-bacterial in origin and defined as the loss of tooth substance at the cemento-enamel junction (Mair, 1992). There is growing evidence that NCCLs may be associated with occlusal and lateral. OBJECTIVE: To develop a non invasive, highly reproducible technique to measure the occlusal forces (biting pressure) and to correlate it with lesion progression. MATERIALS & METHODS: Twenty-six subjects and 60 teeth were measured for biting force. Digital images and elastomeric impressions were made ateach of three visits (baseline restoration, one and two years). Casts were prepared and a fixture which aligned each patients cast in …


Effect Of Different Percentages Of Silica Nanofibers Filler Loads On Mechanical And Physical Properties Of Flowable Composite Resins, Shashikant Singhal Jan 2011

Effect Of Different Percentages Of Silica Nanofibers Filler Loads On Mechanical And Physical Properties Of Flowable Composite Resins, Shashikant Singhal

All ETDs from UAB

Dental composites are important in the spectra of restorative materials. Ability to match the color of natural dentition is an appealing characteristic of composite restorations. Additionally, they can be bonded physically to the tooth, which limits the amount of tooth preparation required and thereby conserves healthy tooth structure. In relation to other restorations like amalgams, non-metallic compositions of dental composites have exhibited good biocompatibility. The dental composites are composed of a resin matrix containing a blend of bis-GMA (bis-phenol A-glycidyldimethacrylate) or urethane dimethacrylate (UDMA) along with TEGDMA (tetraethylglycidylmethacrylate). Novel techniques for the reinforcement of these resin-based composites continue in a …


Fracture Strength Of All-Ceramic Restorations After Fatigue Loading, Balasudha Baladhandayutham Jan 2011

Fracture Strength Of All-Ceramic Restorations After Fatigue Loading, Balasudha Baladhandayutham

All ETDs from UAB

Fracture strength of monolithic and bilayered LAVA and e. max lower molar crowns after load cycling was measured and compared. The study included three groups (n = 8) from LAVA zirconia and three groups from e. max lithium disilicate to compare influences of different layers, thicknesses and manufacturing techniques. Prefabricated anatomically designed crowns were cemented to dies made from Z 100 composite resin using Rely X Luting Plus resin modified glass ionomer cement. Cemented crowns were stored at 37° C for 24 hours then cyclic loaded to test fatigue properties. The crowns were loaded to 200,000 cycles at 25N at …


Antimicrobial Effectiveness Of Silver-Releasing Elastomeric Ligature Ties, Matthew Christopher O'Dell Jan 2011

Antimicrobial Effectiveness Of Silver-Releasing Elastomeric Ligature Ties, Matthew Christopher O'Dell

All ETDs from UAB

Introduction: Fixed appliances make satisfactory oral hygiene a greater challenge for the orthodontic patient. Improper oral hygiene during orthodontic treatment can cause enamel demineralization resulting in unesthetic white spot lesions. A new approach to providing protection against demineralization during treatment has been to incorporate antimicrobial agents into elastomeric ligature ties. A recent elastomeric ligature tie uses the antimicrobial characteristic of silver to help prevent formation of white spot lesions. The purpose of this in vitro study is to determine the antimicrobial effectiveness of a silver-releasing elastomeric ligature tie (OrthoShield Safe-T-Tie) against Streptococcus mutans and compare its results with a selenium-containing …


Impact Of Site Development Techniques In The Soft Tissue Height On Single Implant Supported Prosthesis In The Anterior Maxilla, Juan Francisco Pardo Jan 2011

Impact Of Site Development Techniques In The Soft Tissue Height On Single Implant Supported Prosthesis In The Anterior Maxilla, Juan Francisco Pardo

All ETDs from UAB

Background: Implant placement should be based on a restoration-oriented treatment plan with correct three-dimensional positioning to allow optimal support and stability of surrounding hard and soft tissues. After tooth extraction the alveolus remodels producing changes in the soft tissues contours. This may translate into the inability to place the implant or in a non-esthetic restoration. In contemporary esthetic implant dentistry, the main objective is to maintain the socket dimensions and soft tissue contours to allow ideal implant placement and to provide a harmonious restoration. Objective: To evaluate if socket grafting with FDBA with or without PRP or rhPDGF in site …


Role Of Vdr In Host Immune Response To Porphyromonas Gingivalis Infection, Gulam Yezdani Jan 2011

Role Of Vdr In Host Immune Response To Porphyromonas Gingivalis Infection, Gulam Yezdani

All ETDs from UAB

Porphyromonas gingivalis is one of the etiologic factors of periodontal disease, a chronic inflammatory disorder characterized by the destruction of periodontal connective tissue and the subsequent loss of alveolar bone. Epidemiological and genetic studies have indicated an association between periodontal disease and the vitamin D system. However, little is known regarding how vitamin D signaling regulates the inflammatory immune process of this disease. The purpose of the study was to understand the role of the vitamin D receptor (VDR) in regulating the host response to P. gingivalis infection by using a dual chamber mouse model. These chambers served both as …


Three Dimensional Comparison Of Facial Morphology Of A Native Egyptian Population And A Native Brazilian Population, Ethan Larson Jan 2011

Three Dimensional Comparison Of Facial Morphology Of A Native Egyptian Population And A Native Brazilian Population, Ethan Larson

All ETDs from UAB

Introduction: The purpose of this study was to assess the use of three dimensional facial averages in determining facial morphological differences between a native adult Egyptian population and a native adult Brazilian population. Methods: Three- dimensional images were acquired through a commercially available stereo-photogrammetric camera system. The 3dMDfaceTM system was used to capture images from 186 subjects from two population groups (Egypt and Brazil). Each image was obtained as a facial mesh and orientated along a triangulated axis. All facial images were overlaid and superimposed, and a complex mathematical algorithm was performed to create a composite facial average of one …


Efficacy Of Sterisil In The Treatment Of Dental Unit Waterlines, Don Schmidtke Jan 2011

Efficacy Of Sterisil In The Treatment Of Dental Unit Waterlines, Don Schmidtke

All ETDs from UAB

Introduction: Dental unit waterlines (DUWL) are an ideal home for bacterial microorganisms to grow, multiply, and develop complex living colonies commonly known as "biofilm." The American Dental Association (ADA) and the Centers for Disease Control and Prevention (CDC) have recommendations to maintain DUWL heterotrophic plate count bacteria levels below 500 colony forming units per milliliter (CFU/ml) of water. The aim of this study is to determine whether Sterisil PureTube is able to control the bacterial load in the orthodontic clinic to recommended levels. Methods: Waterline samples from the twelve dental chairs in the orthodontic clinic were used in this study. …


Diversity, Commonality, And Stability Of Mutans Streptococci In High Caries Risk Children, Kyounga Cheon Jan 2010

Diversity, Commonality, And Stability Of Mutans Streptococci In High Caries Risk Children, Kyounga Cheon

All ETDs from UAB

Mutans streptococci (MS), Streptococcus mutans and Streptococcus sobrinus are associated with the initiation of dental caries in humans. Initially, a single S. mutans genotype has been shown to colonize primary molars soon after eruption. More genotypes can be acquired with age and further dental development. Current methods used to genotype isolates from an individual have not systematically determined the minimum number required to demonstrate an individual's genetic diversity. The purpose of this study was to determine the optimum number of oral isolates of MS (i.e., from plaque samples) to genotype in order to demonstrate diversity. This study also initiated a …


Genotyping Of Streptococcus Mutans Using Multilocus Sequence Typing, Stephanie Momeni Jan 2010

Genotyping Of Streptococcus Mutans Using Multilocus Sequence Typing, Stephanie Momeni

All ETDs from UAB

ABSTRACT The role of Streptococcus mutans has been extensively studied using a variety of genotyping techniques. Repetitive extragenic palindromic polymerase chain reaction (rep-PCR) is an effective tool for screening large-scale epidemiological studies with high discriminatory power and reproducibility. For this study, multilocus sequence typing (MLST) analysis is used to evaluate genotypes previously identified as unique using rep-PCR. Twenty-two unique S. mutans rep- PCR genotypes were selected from a longitudinal study. Four additional isolates were selected from each genotype group of the 6 most commonly occurring genotypes (n=30) for further analysis. Real-time PCR was performed using eight housekeeping S. mutans gene …


Friction Produced By Esthetic Brackets With Varying Ligation, Christine Knox Abenoja Jan 2008

Friction Produced By Esthetic Brackets With Varying Ligation, Christine Knox Abenoja

All ETDs from UAB

Controlling friction is an important aspect of orthodontics because it allows more predictable tooth movement with less anchorage loss. Friction at the bracket/archwire/ligation interface can reduce the force available for desired tooth movement. Initial stages of orthodontic treatment depend on the ability of the archwire to slide freely through the bracket, making friction an important aspect of all orthodontic brackets in the early phases of orthodontic treatment. The purpose of the present in vitro study was to measure the force to move esthetic brackets over an archwire using different ligation methods. A stainless steel model reproducing the maxillary right dentition …


A Comparative Study Of Extraction Treatment Efficiency Using Conventional Edgewise Brackets And Self-Ligating Brackets, Stan C. Cox Jan 2008

A Comparative Study Of Extraction Treatment Efficiency Using Conventional Edgewise Brackets And Self-Ligating Brackets, Stan C. Cox

All ETDs from UAB

The purpose of the present study was to assess treatment efficiency of one selfligating bracket system (In-Ovation, GAC International, Bohemia, NY) compared to a conventional ligating bracket system (Ovation, GAC International, Bohemia, NY) in extraction cases used in the same practice. Treatment duration, number of appointments, and number of arch wires used per patient were compared within one private orthodontic practice. The total sample size was 155 patients, 83 consecutively finished with conventionally-ligated Ovation brackets and 72 consecutively finished with In-Ovation self-ligating brackets. After applying the exclusion criteria, there were 68 patients in the self-ligated (SL) group and 79 patients …


Variability Of Two Sampling Methods In Plaque Samples, Kuei C. Hsu Jan 2008

Variability Of Two Sampling Methods In Plaque Samples, Kuei C. Hsu

All ETDs from UAB

Introduction: Dental caries remain the most common infectious disease in children, and is in fact, on the rise in the U.S. among 2 to 5 year olds. Among hundreds of oral bacteria, mutans streptococci (MS) are considered the major species associated with dental caries. Studies have shown that increased MS in saliva or plaque is an important indicator for caries. The use of standard plate count (SPC) from plaque samples particularly yield variable quantitative results because of complexities of sample collection and processing. Objectives: This study was undertaken to determine collection reproducibility in plaque samples from permanent first molars using …


Success Rates Of Temporary Anchorage Devices Placed In An Orthodontic Clinic, Alex C. Schreiber Jan 2008

Success Rates Of Temporary Anchorage Devices Placed In An Orthodontic Clinic, Alex C. Schreiber

All ETDs from UAB

In recent years, the use of a variety of temporary placed implants to attain absolute anchorage has been described in the orthodontic literature. The use of temporary implants, fixed to bone, overcomes some of the limitations of traditional anchorage and their reliance on patient compliance. The purpose of this study was to evaluate factors relating to the successful placement of miniscrew temporary anchorage devices in an orthodontic clinic. The orthodontic records of patients who had miniscrews placed during their treatment at the University of Alabama at Birmingham School of Dentistry Postgraduate Orthodontic Clinic were selected. After application of the inclusion …


Potential Iatrogenic Effects On Enamel Treated With A Light Cured Flouride Releasing Filled Resin, Henry G. Griggs Jan 2008

Potential Iatrogenic Effects On Enamel Treated With A Light Cured Flouride Releasing Filled Resin, Henry G. Griggs

All ETDs from UAB

White spot lesions have long been a problem in fixed appliance orthodontic treatment. Various methods of prevention have been used in the past, most requiring patient compliance. The use of non-compliant orthodontic sealants to form a barrier on the facial surface of the tooth has been attempted in the past with limited success due mainly to the inability of composite resins to fully polymerize. Pro Seal(Reliance Orthodontic Products, Inc, Itasca, IL) is new product which claims to fully polymerize and provide protection from white spot lesions during orthodontic treatment. In vitro studies support this claim. The side effects of acid …


Endodontic Sealers-Their Properties And Effects On Fiber Post Retention, Farrah Huthail Najib Jan 2008

Endodontic Sealers-Their Properties And Effects On Fiber Post Retention, Farrah Huthail Najib

All ETDs from UAB

Zinc oxide eugenol sealers have been used clinically for several years. Glass ionomer sealers were introduced due to their adhesion to the dental hard tissues and excellent sealing ability. During the process of endodontic treatment a post, core and final restoration is required for tooth restoration. Recently fiber reinforced composite posts have become more popular because of their mechanical properties and esthetics. However, fiber posts have to be adhesively cemented into root canal which can be affected by the endodontics sealers. The purpose of this study was to evaluate the effect of eugenol and non-eugenol containing sealers on the retention …


Bone Formation Around Implants In Adult Transgenic Mice With Selective Runx2-Ii Deficiency, Jaime Rodrigo Rivera Jan 2008

Bone Formation Around Implants In Adult Transgenic Mice With Selective Runx2-Ii Deficiency, Jaime Rodrigo Rivera

All ETDs from UAB

Titanium-aluminum-vanadium (Ti-6Al-4V) tacks were placed in the tibiae of 10 female wild type (Runx2 flox/+ or Runx2 flox/flox) and heterozygous (Runx2+/-, ColII Cre) mice littermates to examine healing and bone response. Animals were divided into control and test groups of 5 each. A novel generation of Runx2 knock-out mice where the gene is only deleted in chondrocytes was used. Ten days after implant surgery, specimens were recovered and prepared for histological, histomorphometric, and micro-CT morphometric analysis. Histological examination revealed that wild type animals presented larger regions of bone formation and endochondral ossification when compared to heterozygous mice. Micro-CT morphometric analysis …


Oral Mucositis In Children Receiving Bone Marrow Transplantation, Francisco Jose Rodriguez Jan 2008

Oral Mucositis In Children Receiving Bone Marrow Transplantation, Francisco Jose Rodriguez

All ETDs from UAB

Purpose: The purpose of this retrospective study was to identify the factors that influence the incidence, severity, onset, and resolution of oral mucositis in children undergoing bone marrow transplantation (BMT). Methods: One hundred and fifty medical records were reviewed of patients that received BMT. Daily values of white blood cell (WBC) counts were obtained to associate it’s correlation with the incidence, severity, onset, and resolution of oral mucositis. Age group and gender of the patients, type of bone marrow transplant, the use of methotrexate, the use of total body irradiation, and the previous treatment with chemotherapy were obtained to analyze …


Ca 2+ /Calmodulin-Dependent Protein Kinase Ii Regulates The Growth Of Human Osteosarcoma Cells In Vivo, Hyeran Choo Jan 2007

Ca 2+ /Calmodulin-Dependent Protein Kinase Ii Regulates The Growth Of Human Osteosarcoma Cells In Vivo, Hyeran Choo

All ETDs from UAB

Osteosarcoma is the most predominant primary bone cancer among pediatric patients. The pathogenesis and mechanism of osteosarcoma, however, as yet remains unclear. This study investigated the hypothesis that Ca2+/calmodulin-dependent protein kinase II (CaMK II), activated by Ca2+ and its intracellular receptor, calmodulin, plays a critical role in the growth of human osteosarcoma cells. The inhibition of CaMK II with its pharmacologic antagonist KN-93 was used to investigate the role of CaMK II in the growth of human osteosarcoma cells because our preliminary data showed that =-CaMK II is expressed in several human osteosarcoma cell lines. To examine the in vivo …


Isolation And Characterization Of Human Periodontal Ligament Stem Cells, Isabel C. Gay Jan 2007

Isolation And Characterization Of Human Periodontal Ligament Stem Cells, Isabel C. Gay

All ETDs from UAB

The periodontal ligament (PDL) is thought to include progenitor cells capable of forming fibroblasts, osteoblasts and cementoblasts. However, characterization of PDL stem cell populations (SC) remains undetermined due in part, to the diversity of cell types that conform to the periodontal apparatus. Objective: To isolate and characterize PDLSC and assess their pluripotent capabilities to differentiate into bone, cartilage and adipose cell types. Methods: PDL was scraped from human teeth, enzymatically digested, and cells stained for STRO- 1 (SC marker) using fluorescent immunohistochemistry. Positive cells were FACS sorted and expanded in culture. Human bone marrow SC (BMSC) served as a positive …


A Case Series Study Of Vitapex Pulpectomy Treatment In Primary Teeth Ii, Hsin-Ju Hsieh Jan 2007

A Case Series Study Of Vitapex Pulpectomy Treatment In Primary Teeth Ii, Hsin-Ju Hsieh

All ETDs from UAB

Purpose. The aim of this case series study was to conduct a long-term follow-up and review of subjects with previous Vitapex® pulpectomies, to evaluate outcomes clinically and radiographically, and to ascertain whether there was any interference with exfoliation of deciduous teeth or abnormal development of succedaneous teeth. Methods. This case series study was conducted by following target groups of pediatric patients who had received Vitapex® pulpectomies in their primary teeth. Data were collected by reviewing charts, identifying patients who met our criteria, and recalling them for follow-up appointments. After sufficient data were accumulated, survival analysis was applied and presented by …


The Effect Of Cementation Technique On The Retention Of Adhesively Cemented Prefabricated Posts, Carlos A Polo Montes Jan 2007

The Effect Of Cementation Technique On The Retention Of Adhesively Cemented Prefabricated Posts, Carlos A Polo Montes

All ETDs from UAB

Adhesively cemented prefabricated posts are frequently employed for the restora-tion of endodontically treated teeth. Bonding agents may improve the post and core per-formance. Correct dentin bonding procedures are a critical factor in the bonded post re-tention, but adequate bonding in the canal space has been reported difficult to achieve. The operator is unable to visualize the depth of conditioner gel penetration into the canal, and its removal cannot be easily confirmed. Additional potential problems include excess water removal after rinsing the canal, inadequate primer coverage and/or removal, and poor curing methods for the resin luting agent. A technique to avoid …


Outcome Assessment On Skeletal Stability After Rigid External Distraction Osteogenesis In Cleft Lip And Palate Patients, Julio Enrique Tabarini Jan 2007

Outcome Assessment On Skeletal Stability After Rigid External Distraction Osteogenesis In Cleft Lip And Palate Patients, Julio Enrique Tabarini

All ETDs from UAB

Purpose: Distraction osteogenesis (DO) using an external distraction device in the correction of maxillary hypoplasia (MH) in cleft lip and palate patients has been shown to be an effective and stable technique. The purpose of this study is to determine the outcome of skeletal stability for this procedure using the Rigid External Distraction (RED) System in patients with cleft lip and palate (CLP). Materials and methods: Twenty CLP patients with moderate to severe maxillary hypoplasia were treated between June 2000 and June 2006. Their average age at the time of the surgery was 12.6 years. DO was started after a …


Vitamin D Receptor Deficiency And Postnatal Tooth Formation, Xueming Zhang Jan 2007

Vitamin D Receptor Deficiency And Postnatal Tooth Formation, Xueming Zhang

All ETDs from UAB

The reduction of caries is one of the major objectives of Healthy People 2010 (USDHHS, 2000). For individuals at risk for caries, early identification and interception before the occurrence of the disease are crucial to preventing the cariogenesis. However, host genetic variants that compromise the mineralization of dental enamel and dentin are unclear. The vdr mutation has been reported to be associated with bone loss. Therefore, it is likely that vitamin D resistance may affect dental enamel and dentin formation. The objective of this study was to investigate the effects of VDR deficiency on postnatal tooth formation in a vdr …


The Impact Of A Community Health Advisor-Based Intervention On Self-Reported Frequency Of Dental Visits In A Rural, Low-Income African American Alabama Community, Stephen J. Clarke Jan 2007

The Impact Of A Community Health Advisor-Based Intervention On Self-Reported Frequency Of Dental Visits In A Rural, Low-Income African American Alabama Community, Stephen J. Clarke

All ETDs from UAB

Oral health disparities are wide and increasing for rural Southern African- Americans. This project trained 13 experienced Community Health Advisors (CHAs) from Uniontown, Alabama, in the basics of oral health, including regular dental visits, and assigned them to spread this information among their fellow community members. We tested whether a 1-year CHA-based oral health education intervention was associated with increased routine/preventive use of available dental services as measured by pre-post self-report, relative to a comparison community. We also hypothesized that any detected association between the intervention and use of dental services was mediated by attitudes toward dental visits. No direct …