Biomedical subjects

D C Hassall

Publications and source records attributed to D C Hassall.

9 recordsLinked to original sources

PubMed2001

The sealant restoration: indications, success and clinical technique.

In this paper we have considered the available literature which demonstrates that sealant restorations perform at least as well as amalgam restorations and are more conservative. Success depends on retention of the overlying sealant and if this is fully retained it is unlikely that any residual caries will progress. The diagnosis of occlusal caries and indications for sealant restorations are discussed and the clinical technique is described. We have concluded that sealant restorations are the optimum restoration in small and discrete occlusal cavities.

Composite Resins↗

PubMed2001

An investigation into sealant restoration usage in general dental practice in England.

AIM: A study was undertaken to investigate attitudes to sealant restorations and their usage in general dental practice in England. METHOD: Seventy three dentists in three areas (Doncaster, Hereford/Worcester and Wycombe) provided retrospective details of treatment provided over a one year period for 4,250 6-12 and 13-15 year old subjects. Fifty nine of these dentists then completed a telephone questionnaire relating to their treatment patterns and attitudes to sealant restorations. RESULTS: The treatment data indicated that only 59 of the 4,250 children received a sealant restoration during the study period. Of the 44 dentists who claimed in the questionnaire to be using sealant restorations, only 28 had placed them in their selected patients. CONCLUSIONS: Positive attitudes to sealant restorations were expressed but also concerns that may be prejudicing usage.

Adolescent↗

PubMed2001

Case report: the transmandibular implant system.

This series of case reports outlines the use of the transmandibular implant system to rehabilitate 10 patients with severely resorbed mandibles. The implants were placed according to manufacturers' guidelines with the patient under a general anaesthetic and reviewed bi-annually thereafter. Three patients experienced problems: in two of these this involved the loss of integration of the distal posts, in the other patient the transmandibular implant was removed in its entirety. Distal locking screws became loose shortly after placement in three patients. Prosthetic complications included difficulty in obtaining passive fit of the superstructure in 7 patients and a high long-term maintenance commitment.

Aged↗

PubMed2000

A chemomechanical method for caries removal.

Over recent years the dental profession has shifted towards practising preventive dentistry and adopting more conservative and tooth-preserving procedures. Such progression is considered to be a response to the decline in the level of dental caries and advances in materials science. This shift in caries management will no doubt continue over the coming decades, based on rational clinical and scientific principles. Chemomechanical caries removal involves the application of a solution that selectively softens the carious dentine, thus facilitating its removal. This limits the removal of sound tooth structure, the cutting of open dentinal tubules, pulpal irritation and pain compared with conventional mechanical methods.

Dental Caries↗

PubMed1999

Prevalence and attitudes to fissure sealants in the general dental service in England.

OBJECTIVES: The study objectives were to investigate changes in the prevalence of fissure sealants over a 5-year period among a comparable group of 14-15-year-old regular dental attenders registered with general dental practitioners in 1989 and 1994, and to investigate attitudes towards this form of care amongst general dental practitioners in 1994. METHODS: Random samples of 14-15-year-old pupils were selected from school lists in three areas in England (Doncaster, Hereford/Worcester and Wycombe) in 1989 and 1994. Once parental consent had been gained to examine the children, the Dental Practice Board (DPB) indicated which subjects were 'regular attenders', only these subjects were included in the study. All the subjects in each area were examined by a single trained and calibrated examiner using a standardized technique. In 1994, a group of randomly selected dentists in each area completed a telephone questionnaire assessing attitudes and treatment patterns regarding fissure sealants. RESULTS: In 1989, 2836 letters were posted to parents asking for consent to examine their child and 2174 positive responses were received (response rate 77%). Of the 1919 children examined, 459 were classed as regular attenders, 140 in Doncaster, 159 in Hereford/Worcester and 160 in Wycombe. In 1994, 2560 consent letters were distributed to children in school to pass to their parents and 1587 positive responses were received (response rate 62%). Of the 1388 children examined, 891 were classed as regular attenders, 294 in Doncaster, 318 in Hereford/Worcester and 279 in Wycombe. Large rises in sealant prevalence were observed in all areas, but particularly in Doncaster where sealant prevalence increased from 13% in 1989 to 50% in 1994. In Hereford/Worcester it increased from 25% to 47% and in Wycombe it increased from 16% to 30%. There was also a fall in mean DMFT in all areas. In Doncaster it fell from 2.97 in 1989 to 1.82 in 1994, in Hereford/Worcester it fell from 2.60 to 1.83 and in Wycombe it fell from 1.86 to 1.29. In all three areas the changes in sealant prevalence and DMFT were statistically significant. The questionnaire revealed positive attitudes towards fissure sealants and their usage as well as a number of areas of concern that could potentially hinder sealant usage. CONCLUSIONS: Dramatic increases in sealant prevalence and considerable reductions in dental caries among these regularly attending adolescents have been demonstrated. Some concerns were highlighted regarding sealant usage, which may be prejudicing further increases in their application.

Adolescent↗

PubMed1998

Levels of restorative care under capitation.

OBJECTIVES: 1. To compare the prevalences of fissure sealants in similar groups of 14-15-year-old, regularly-attending patients treated under fee-for-service in 1989 and capitation in 1994. 2. To calculate the effect of including sealants in the restorative index on estimates of interventional treatment carried out on 14-15-year-old regularly attending patients treated by general dental practitioners in 1994. DESIGN: A randomised epidemiological study. SETTING: Secondary schools in the Wycombe, Doncaster and Hereford/Worcester areas. METHOD: Random samples of 14-15-year-old, regularly attending patients treated by dentists practising under capitation in three contrasting areas of England were examined in 1994 for the presence of decayed, missing and filled teeth and fissure sealants. Restorative indices were calculated with and without the inclusion of sealants. The latter were compared with restorative indices calculated without the inclusion of sealants on regularly attending patients of the same age group when the dentists in the same three areas were working under fee-for-service in 1989. RESULTS: The prevalence of fissure sealants increased between 1989 and 1994 from 16% to 30% in Wycombe, from 13% to 50% in Doncaster and from 25% to 47% in Hereford/Worcester. Without fissure sealants the restorative indices fell between 1989 and 1994 from a range of 76.5-94.4 to 63.3-87.1. When sealants were included in the restorative indices for 1994, they ranged from 79.5-92.9. CONCLUSIONS: There were increases in the prevalences of fissure sealants between 1989-1994. When these sealants were included in the calculation of restorative indices for 1994, the level of restorative care provided by general dental practitioners remained relatively high since the introduction of capitation. Although there has been some increase in the level of untreated disease, if the restorative index is calculated without the inclusion of sealants then there is a risk of underestimating the treatment provided by general dental practitioners to control the carious process. Dentists appear to be redirecting their efforts into newer treatment/preventive items.

Adolescent↗

PubMed1997

An assessment of capitation in the General Dental Service contract 2. Patterns of treatment provided to regularly attending patients.

OBJECTIVE: To compare the patterns of treatment of general dental practitioners working under fee-for-service in 1987/88 with those working under capitation in 1992/93. DESIGN: 73 randomly selected general dental practitioners working under capitation in three contrasting areas in England retrospectively recorded the treatment provided during 1992/93 to a random selection of their regularly attending 6-12- and 14-15-year-old patients. RESULTS: Mean numbers of examinations per year reduced in the three areas from 1.7-1.8 in 1987/88 to 1.2-1.4 in 1992/93. Mean numbers of visits per patient dropped from 2.5-2.9 to 1.8-2.2. Mean numbers of fillings in permanent teeth reduced from 0.15-1.04 to 0.09-0.52 and in deciduous teeth from 0.28-0.53 to 0.24-0.31. Mean percentages of children per dentist having extractions fell from 9.3-28.1% to 4.7-16.2% while the radiographs reduced from 14.0-9.0% to 6.0-10.6%. Mean percentages of children per dentist receiving oral hygiene instruction rose from 18-31% in 1987/88 to 26-33% in 1992/93. Dietary advice increased from 3-18% to 11-20% and fissure sealants from 3-6% to 3-12%. CONCLUSIONS: In 1992/93, dentists working under capitation were carrying out fewer examinations, fillings and extractions and were taking fewer radiographs for their regularly attending child and adolescent patients than dentists working under fee-for-service in 1987/88. These patients also attended less frequently for treatment but received marginally more preventive care and advice.

Adolescent↗

PubMed1997

An assessment of capitation in the General Dental Service Contract. 1. The level of caries and its treatment in regularly attending children and adolescents.

OBJECTIVE: To assess the dental health of regularly attending 7-8- and 14-15-year-olds registered under capitation in 1994. To compare the dental health of regularly attending 14-15-year-olds registered under capitation in 1994 with regularly attending patients of a similar age treated under fee-for-service in 1989. DESIGN: Random samples of 7-8- and 14-15-year-olds. Data were recorded on decayed and filled teeth, extracted for caries and teeth fissure sealed. RESULTS: Prevalence of caries in first permanent molars of 7-8-year-olds was 15-16%. Mean caries experience of deciduous posterior teeth was 1.78-2.51. 83-86% had no more than two untreated, decayed, posterior deciduous teeth. Prevalence of caries in 14-15-year-olds was 44-60% while mean caries experience was 1.29-1.83. Reductions in caries experience of 30-39% in 14-15-year-olds for 1989-1994 were due mainly to falls of 42-45% in mean numbers of teeth filled. Increases in mean numbers of decayed, untreated teeth were 0.07-0.11. The proportion of patients with teeth extracted because of caries was 2.4-3.8%. 30-50% had fissure sealants in 1994 compared with 13-25% in 1989. CONCLUSIONS: Dental health of regularly attending capitation patients is generally satisfactory with little evidence of 'supervised neglect'. Prevalence of fissure sealants has increased while the numbers of filled teeth has reduced. Numbers of decayed, untreated teeth have increased but the numbers of teeth extracted for caries have remained low.

Adolescent↗

PubMed1996

An assessment of capitation in the new General Dental Service contract.

A 2-year study has been completed to examine the dental health and patterns of treatment of samples of children registered under capitation in three areas of England. The opportunity was taken to compare some of these results with those reported in the same areas in 1989 when the dentists were remunerated under fee-for-service. In addition, the validity of the dental health information supplied by general dental practitioners on the FP17C form was assessed. The dental health of 14-15-year-old patients registered for more than a year was compared with that of similar patients in the same areas in 1989. There was a large reduction in the caries experience (mean DMFT) in these patients in all areas between 1989 and 1994 mainly due to a significant fall in the mean numbers of teeth filled. The mean number of teeth extracted for caries remained low in all areas. There was a small increase in the mean number of decayed, untreated teeth in all areas. There was a large increase in the proportion of patients with one or more fissure sealants present. The dental health of 7-8-year-old patients registered for more than a year was examined but, as this age group were not examined in 1989, no comparative data were available. Regularly attending child patients had, on average, one untreated decayed deciduous tooth, but few had more than two. Caries experience in first permanent molars was low in all areas. Data were collected from a sample of general dental practitioners in three areas on the treatment provided over a 12-month period for random samples of patients in two age groups: 6-12 and 13-15 years. There was an increase in two of the three areas in the provision of oral hygiene instruction and dietary advice. The level of fissure sealant use was maintained or increased. There was a reduction in the numbers of both deciduous and permanent teeth filled. Fewer children had teeth extracted. The proportions of patients having bitewing radiography reduced. The mean number of both visits and check-up examinations reduced. There validation of the dental health information on the FP17C was carried out by comparing the data collected for 7-8 and 14-15 year old patients during the dental health examinations with that submitted by general dental practitioners on FP17C forms to the Dental Practice Board for the same children. For the permanent dentition, agreement was good for missing and filled teeth but poor for decayed, untreated teeth. For deciduous teeth, levels of agreement were generally poor except for filled teeth where it was fair.

Adolescent↗