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Biomedical subjects

E J Kay

Publications and source records attributed to E J Kay.

At least 19 recordsLinked to original sources
PubMed2006

Academic dentistry--where is everybody?

If someone had told us, when we were undergraduates, that there was a career which allowed you the time, and gave you the support, to pursue and research the things about your profession which most interested you, we would have been intrigued. If we had then been informed that there was paid employment which encouraged you to travel extensively abroad, talking about your work, and also gave you the brightest young minds in the country to engage with, teach and learn from, we would have thought this job sounded very tempting. If we had then been told that it also provided secretaries and administrators to help you do your job, and was carried out in a non-hierarchical, collegiate environment where equality and diversity are valued--we would have jumped at the chance! And did! Because what is described above is the life of a clinical academic. Although all the above are part of the role of the academic, there is also immense value and joy to be obtained through scholarship, education and teaching, which are sometimes forgotten because so much of our time and energy is directed to dealing with our patients' problems, while wrestling with the intricacies of new contracts, clinical governance, evidence based practice, and so forth.

Academic Medical Centers↗
PubMed2003

Prevention. Part 8: The use of pit and fissure sealants in preventing caries in the permanent dentition of children.

This paper reviews evidence concerning the use of pit and fissure sealants in preventing caries in the permanent dentition of children. While the evidence with respect to some sealant types and application techniques is incomplete, systematic reviews have clearly demonstrated that sealants are an effective preventive technology when used in high risk children, and that with proper application techniques long-term retention rates can be achieved. However, careful selection of patients and teeth for sealant placement is required to ensure cost-effectiveness.

Child↗
PubMed2003

Prevention. Part 7: professionally applied topical fluorides for caries prevention.

This paper reviews the use of professionally applied topical fluorides (PATF) in caries prevention. PATFs are indicated for children and adults with one or more decayed smooth surfaces and/or those who are at high caries risk. Frequency of administration depends on the patient's caries risk, and is usually every 6 months. The effectiveness of fluoride varnish and gel applications has been well established in caries prevention trials involving permanent teeth. Although both types are effective, varnish may be preferred because it is easier to apply, reduces the risk of fluoride over-ingestion, and has greater patient acceptance. Fluoride foams are similar products to gels, but have not been tested clinically. The use of in-office two-part rinses is not recommended because they have not been proven effective. A cleaning, or prophylaxis, is not necessary before the application of topical fluoride for caries prevention. In conclusion, when used appropriately, PATFs are a safe, effective means of reducing caries risk among high-risk populations.

Acidulated Phosphate Fluoride↗
PubMed2003

Prevention. Part 3: prevention of tooth wear.

Non-carious destruction of teeth has been observed in archaeological material from various parts of the world and clearly pre-dates the first appearance of dental caries. Attrition, abrasion and erosion are also described in the classic text of Pindborg on the pathology of the dental hard tissues. Whilst the dental profession, at least in affluent parts of the world, was engaged in diagnosing, treating and later preventing dental caries these other causes of tooth destruction were largely ignored.

Humans↗
PubMed2003

Prevention. Part 1: smoking cessation advice within the general dental practice.

Smoking remains the largest single preventable cause of death and disability in the UK and costs the NHS 1.7 billion pound each year. More than 120,000 people die prematurely due to smoking related diseases. Worldwide smoking is the single most important public health problem. The detrimental effects of smoking and tobacco use on oral health are well recognised. Oral cancers and pre-cancers, periodontal diseases and poor wound healing are the most significant and serious effects of smoking on the mouth. In addition, staining of the teeth, soft tissue changes and halitosis are aesthetic and social impacts of smoking directly related to oral health.

Communication↗
PubMed2003

A general dental practice research network: impact of oral health in general dental practice patients.

OBJECTIVE: To measure the subjective impact of oral health in a group of patients attending general dental practices in the North West of England and to investigate the attributes of dentists and practices in order to examine how such attributes might relate to patients' subjective perceptions of oral health. DESIGN: Fifteen general dental practices conducting a simultaneous survey of attending patients and 15 practitioners from these practices providing information about their attitudes to treatment, prevention and various aspects of their surgery. SETTING: General dental OUTCOME MEASURES: Patient subjective impact scores. Relationships between practice and practitioner variables and patients' subjectively perceived oral health. RESULTS: Fifteen practitioners with diverse practice attributes provided data on 718 patients. The mean total oral health impact score was 18.4. Twenty two per cent of patients had experienced pain in the four weeks before the survey and 11% had been unable to chew some foods. Fifty five per cent of the surveyed population had, in the previous year, worried about the appearance of their mouth and 65% had worried about their oral health in general. Dentists' beliefs were related to patient impact scores but practice attributes were not significantly associated with patients' impacts. CONCLUSIONS: Fourteen percent of the differences in patients' subjectively perceived oral health can be attributed to dentist attitudes and attributes. Further research regarding the influence of dentists personality and professional beliefs on patients well-being needs to be undertaken.

Adolescent↗
PubMed2003

A general dental practice research network--philosophy, activities and participant views.

The importance of building research capability among general dental practitioners was highlighted when in 1996 a large tranche of money was released to support research and development in primary dental care. As a result of the links forged by this research opportunity, a group of primary dental care practitioners was recruited into a Primary Dental Network. This network was closely allied to an academic department and the aim was to develop the practitioners' research interest into research skills and finally into a research project. The group therefore attended a series of structured workshops, designed specifically to augment the practitioners' skills using a 'learning by doing' approach. Once the practitioners had acquired the relevant skills, they undertook a research project, which will be reported in a later paper.

Attitude of Health Personnel↗
PubMed2003

Exploring dental patients' preferred roles in treatment decision-making - a novel approach.

AIMS: To assess the transferability of the Control Preferences Scale to dental settings and to explore patients' preferred and perceived roles in dental treatment decision-making. SETTING AND PARTICIPANTS: A convenience sample of 40 patients, 20 recruited from the University Dental Hospital of Manchester and 20 from a general dental practice in Cheshire. METHODS: A cross-sectional survey, using the Control Preferences Scale, a set of sort cards outlining five decisional roles (active, semi-active, collaborative, semi-passive, passive), slightly modified for use in dental settings. A second set of cards was used to identify perceived decisional role. Rationale for choice of preferred role was recorded verbatim. RESULTS: The Control Preferences Scale was found to be transferable to dental settings. All patients in the sample had identifiable preferences regarding their role in treatment decision-making. A collaborative decisional role, with patient and dentist equally sharing responsibility for decision-making, was most popular at both sites. However, patients at both sites typically perceived themselves as attaining a passive role in treatment decisions. Lack of knowledge about dentistry and trust in the dentist were reported contributors to a passive decisional role preference, whilst those with more active role preferences gave rationales consistent with a consumerist stance. CONCLUSIONS: This exploratory study's findings suggest that dental patients have distinct preferences in relation to treatment decision-making role and that these may not always be met during consultations with their dentist. The Control Preferences Scale appears to be appropriate for use in dental settings.

Adult↗
PubMed2003

Customer care.

Everyone who is in business knows that the most important thing one can achieve is attracting and retaining customers. Now, before the BDJ is bombarded with complaints about ivory-tower academics talking theoretically about something of which they have no experience, I need to tell you that I do have real, live practical experience of business. Okay, it's not a business to do with dentistry, it's a business to do with horses, but nevertheless, it is a business and the basic premises of businesses apply to both dentistry and to riding stables. Remarkably also, there are a number of interesting analogies between running a riding school and running a dental practice!

Aged↗
PubMed2003

A comparison of sensation-seeking between dental and biological science students.

AIM: The aim of this study was to compare sensation-seeking behaviour amongst dental students and age-, sex-matched students studying for a standard 3-year degree in biological sciences at the Manchester University. METHODS: A total of 268 sensation-seeking questionnaires were distributed to second- and third-year male and female dental and biological science students, studying for a degree at the University of Manchester. Each questionnaire was scored against Zuckerman's sensation-seeking scale. RESULTS: A total of 268 questionnaires were distributed, 175 were returned. The return rate was 65%. The primary findings were: Biological Science students were more sensation-seeking in the dimensions of disinhibition and experience-seeking than dental students (P < 0.05). There was a significant gender bias in sensation-seeking. Males were significantly more sensation-seeking than females in both courses (P < 0.05). Males in both courses had similar sensation-seeking tendencies (NS). Females in the biological sciences course were less inhibited than their dental counterparts (P < 0.05). CONCLUSIONS: There was a clear difference in sensation-seeking within and between groups of dental students and students studying biological sciences.

Adolescent↗
PubMed2001

The reasons for extraction of permanent teeth in Scotland: a 15-year follow-up study.

AIMS: Although Scotland has the highest proportion of edentulous adults in the UK, the frequency of edentulousness has fallen by 21% during the last 20 years. This study, carried out in 1999, was designed to establish whether the reasons for tooth loss have also changed since 1984 when they were last determined. METHODS: The Scottish Dental Practice Board provided the names of every fourth dentist on its list among which 425 general dental practitioners were identified. They were asked to record permanent tooth extractions for 1 week, specifying the age, sex and dental attendance of patients who underwent extractions and the reasons for these extractions. 352 dentists took part: a response rate of 82.8%. RESULTS: The study confirmed that there has been a reduction in the number of extractions between 1984 and 1999: there were 25% fewer teeth extracted per patient and 30% fewer per dentist per week. From 0-20 years of age, orthodontics has replaced caries as the commonest reason for extraction and in all age groups over 20 years, caries has become the commonest reason in contrast to 1984 when periodontal disease was the principal reason in patients over 40 years old. CONCLUSIONS: Caries and its sequelae remain the most important cause of tooth loss throughout adult life in Scotland and, therefore, caries prevention and maintenance of restorations are of great importance at all ages.

Adolescent↗
PubMed2001

Evaluation of computer aided learning in developing clinical decision-making skills.

AIM: The aim of this study was to determine whether an educational intervention delivered by a computer aided learning package improved the sensitivity and specificity of dentists' restorative treatment decisions. METHOD: The study was a randomised controlled study using a Solomon three-group design. Ninety-five dentists were randomly allocated to the three study groups. One group of dentists read the radiographs pre and post an educational intervention, a second group read the radiographs once, after the intervention, and a third group read the radiographs twice, but received no intervention. On each occasion the dentists read 24 surfaces on each of 15 radiographs and made 360 decisions on how certain they were about restoring the tooth surface. Comparisons of mean sensitivity, specificity and areas under ROC curves were made within and between the study groups. Kappa values were used to assess changes in the level of agreement between dentists. RESULTS: There were no significant changes in sensitivity, specificity or area under ROC curves caused by the intervention. There was no evidence that the level of agreement between the dentists improved after the intervention. CONCLUSION: A computer aided learning package had no effect on dentists' treatment decision-making behaviour.

Computer-Assisted Instruction↗
PubMed2001

Management information failings and future requirements for dental commissioning groups.

OBJECTIVE: To examine existing secondary care management information systems for dental specialities, and to determine their completeness and suitability for supporting effective primary care led purchasing decisions. DESIGN: An observational cross-sectional study of current information systems in selected secondary care provider units and the applicability of their data for contracting dental services. A comparative study of two information systems in two settings (primary and secondary care) and the utility of the data gathered for contracting for dental services. SUBJECTS: Secondary care activity data was sought from the key secondary dental care providers (hospitals) in two dental total purchasing localities. Referral data were also collected directly from general dental practitioners. MAIN OUTCOME MEASURES: The integrity, quality and accuracy of current secondary care activity data in dental specialities, in comparison to data supplied from primary dental care. RESULTS: The secondary care activity data was found to be incomplete, inadequate and inaccurate. It was found that due to data retrieval insufficiency, indicative budgets for secondary providers may be reduced to less than half of their actual entitlement. The data inflated individual dental outpatient attendance by 3.3 times between 1995/6 and by 2.5 times between 1996/7. CONCLUSION: Existing management information systems within secondary care providers are not structured in a way which will adequately inform future commissioning by the dental profession. Communication between primary and secondary care must be increased and data inputting methods in secondary care provider units must be substantially improved.

Budgets↗
PubMed2001

An investigation into the value and relevance of oral health promotion leaflets for young adolescents.

OBJECTIVES: To determine if oral health promotion leaflets of a novel design and content would be read by, acceptable to and influence 11-12-year-old children. METHOD: Three related leaflets were incorporated into a dental health education programme aimed at 11-12-year-old children. The leaflets were designed specifically, following consultation with focus groups. They had a romantic story line and emphasised the immediate gains from good dental health, relevant to this age group. A random sample of pupils completed a written questionnaire on the impact of the leaflets at the end of the one-year programme. These sample pupils underwent a clinical examination to measure plaque before and after the programme. RESULTS: 2,678 pupils with a mean age of 12.1 years participated in the programme. 895 were randomly selected to join the assessment study. Most pupils 81%, (725) reported they had read the leaflets; 61% (442) finding them enjoyable to read, 51% (370) attractive to look at and 71% (515) finding the story lines interesting. However, girls appreciated the leaflets more than the boys. There was some suggestion that the leaflets played a positive role in the overall success of the programme in that most pupils 83% (602) reported they thought more about caring for their teeth after reading the leaflets and 58% reported their brushing frequency had increased. CONCLUSION: The results indicate that for adolescents, leaflets which feature interpersonal relationships are well accepted and can stimulate better oral health behaviour.

Adolescent↗