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PURPOSE: The Lumbee tribe, North Carolina's largest American Indian tribe, is located in Robeson County, where there is an access to dental care crisis. There is a high incidence of systemic diseases, including coronary heart disease (CHD) and diabetes. The tribe also has a higher rate of adverse pregnancy outcomes compared to Caucasian populations. There is little information available regarding the oral health of this population. The aim of this study was to evaluate access to dental care issues, oral health knowledge and oral health-related quality of life of the Lumbee tribe. METHODS: A self-administered survey was developed to assess factors influencing access to dental care, oral health knowledge and oral health-related quality of life. The survey was administered to a convenience sample of 118 Lumbee Indians at the Lumbee Homecoming Festival in Pembroke, NC. RESULTS: Barriers to accessing dental care included being unable to leave work to find a dentist and cost of dental services. Many believed that it is natural to lose teeth as one ages. There was low oral health knowledge regarding oral and systemic health. Oral Health-related quality of life was affected. There was an association between poor access to dental care and poor oral health-related quality of life. CONCLUSION: Lumbee Indians reported barriers to accessing dental care. There was a significant relationship between difficulty accessing dental care and poor oral health-related quality of life. [ABSTRACT FROM AUTHOR]

Mutants of Pseudomonas aeruginosa PAC1R (serotype O:3) which were resistant to bacteriophage D were isolated and shown to react with O:5d, O:9 and O:13 antisera as well as O:3. Antisera to the parent strain and to the three polyagglutinating (PA) mutants also showed cross-reactions. The mutants differed from the parent strain in their lipopolysaccharide (LPS) composition. The LPS from two of the three mutants yielded high molecular weight polysaccharide fractions. Although the high molecular weight fraction from one of the mutants contained the amino sugars and other components characteristic of the O:3 serotype strains, its mobility on Sephadex G75 was different from that of the parent strain. The high molecular weight material from the second mutant lacked the O-antigenic determinants but these were present in a semi-rough LPS fraction. The third mutant appeared rough and completely lacked the O-antigenic components. These three mutants were compared with the parent strain and with a non-agglutinating LPS-defective mutant which lacked both O-antigenic side chains and all neutral sugars in the outer core. Agglutination with absorbed sera and haemagglutination using purified LPS and ELISA detection suggested that wall components other than LPS were responsible for some of the cross-reactions observed. The components responsible were detected after SDS-PAGE of crude outer membrane fractions by a combination of Coomassie blue and silver-staining and antigenic components were detected by immunoelectrophoresis and ELISA-linked immunoblotting of the gels. The main antigenic determinants detected by antiserum to the parent strain were in the high molecular weight O-polysaccharide fractions and in the semirough fractions of the LPS, with some activity due to the H protein of the outer membrane. O:5d antisera reacted with unidentified high molecular weight polysaccharide fractions. Cross-reactions with the O:9 antiserum appeared to be due mainly to the F porin and, to a lesser extent, to the G and E proteins of the outer membrane. O:13 antiserum reacted with high molecular weight polysaccharide fractions but also with the rough core and F and H protein. Cross-reactivity of the other three mutant antisera could largely be interpreted in terms of the outer membrane components exposed in each strain. One reacted strongly with the F porin and the rough core, while the others reacted with a number of protein and LPS-derived fractions.(ABSTRACT TRUNCATED AT 400 WORDS)