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Biomedical subjects

I G Chestnutt

Publications and source records attributed to I G Chestnutt.

At least 19 recordsLinked to original sources
PubMed2006

The orthodontic condition of children in the United Kingdom, 2003.

BACKGROUND: The 2003 Children's Dental Health Survey is the fourth in a series of decennial national children's dental health surveys in the United Kingdom. AIMS: This paper reports on the orthodontic condition of children aged 12 and 15 years. METHODOLOGY: A representative sample of children across the UK were invited to participate in a clinical dental examination in school. Two thousand, five hundred and ninety-five 12-year-olds and 2,142 15-year-olds were examined. Current and past orthodontic treatment and type of appliance worn were recorded. Orthodontic treatment need was assessed by the Modified IOTN in those not undergoing treatment. A postal questionnaire sought parents' views on the orthodontic condition of their children and perceived need for treatment. RESULTS: At age 12, 35% were judged to have an orthodontic treatment need, 57% had no need and 8% were wearing an appliance. The corresponding figures at age 15 were, 21% (need), 65% (no need) and 14% (wearing appliance). A higher proportion of girls (p < 0.05) were wearing an appliance than boys. A greater proportion of 15-year-olds were undergoing treatment than in the 1993 and 1983 surveys and the use of fixed appliances had increased. CONCLUSIONS: In this representative sample of UK children, one in five were still judged as having an orthodontic treatment need at age 15 years, as determined by the modified index of orthodontic treatment need. However, considerable variation was observed between professional and lay perceptions of need.

Adolescent↗
PubMed2006

Oral health habits amongst children in the United Kingdom in 2003.

BACKGROUND: The 2003 Children's Dental Health Survey is the fourth in a series of decennial national children's dental health surveys. AIMS: This paper presents data on parental attitudes towards the care of children's teeth and gums, reported oral hygiene behaviours and clinical measures of hygiene and periodontal health in 2003 and highlights trends since previous surveys. METHOD: A total of 10,381 children were examined in schools by trained and calibrated examiners. Four measures of hygiene and periodontal health were recorded as part of the clinical examination. In addition, 3,342 questionnaires were completed by parents of a sub-sample of these children. The questionnaire enabled information to be collected about reported oral health behaviours and parental attitudes. RESULTS: About three quarters of children across all age groups are reported to brush their teeth twice daily. A range of oral health products was reported as being used in addition to toothbrushes and toothpaste. There is a trend in parental preferences towards restoration of teeth rather than extractions and towards a better understanding of dental caries prevention. Although overall a higher proportion of children in this survey appeared to have gingival inflammation, plaque and calculus than 10 and 20 years ago, there was no change in the proportion of older children with gingivitis. CONCLUSIONS: Dental practitioners have a role to play in reinforcing these positive attitudes and encouraging appropriate and effective oral hygiene behaviours in their child patients.

Adolescent↗
PubMed2006

Patterns of care and service use amongst children in the UK 2003.

BACKGROUND: The 2003 Children's Dental Health Survey is the fourth of the 10-yearly surveys of children's oral health in the United Kingdom. AIM: To detail the reported experience of dental services and dental treatment amongst children in the UK. METHOD: A self-completion questionnaire was distributed to a 50% sub-sample of parents or carers of the children who were clinically examined in the 2003 UK Child Dental Health Survey. This included questions relating to parental and child experience of dental services and dental treatment. RESULTS: The proportion of UK five-year-olds reported as not having visited the dentist fell from 14% in 1983 to 6% in 2003 and the proportion reported as having visited the dentist before the age of two rose from 7% in 1983 to 31% in 2003. Over 80% of all children were reported to seek regular dental check-ups. Around 10% were reported to have had some difficulty in accessing NHS dental care while 5% of five-year-olds were reported to have experienced a general anaesthetic for dental procedures in 2003. Dental attendance was associated with social class and mothers' reported attendance patterns. CONCLUSIONS: In line with previously reported trends, the 2003 survey of children in the United Kingdom shows improvements in several areas but some aspects of attendance pattern continue to be associated with social class and mothers' attendance pattern. It is of concern that 10% of five-year-olds reported having experienced extractions and 5% general anaesthesia for dental treatment.

Adolescent↗
PubMed2006

The dentinal caries experience of children in the United Kingdom, 2003.

BACKGROUND: The 2003 Children's Dental Health Survey is the fourth in a series of decennial national children's dental health surveys. AIMS: This paper reports the survey-derived estimates of dentinal caries experience of children aged five, eight, 12 and 15 years, considering the trends over recent decades and the position in 2003 following changes in disease presentation and the use of additional criteria. METHODOLOGY: A representative UK sample of children in the four specified age groups were invited to participate in a clinical dental examination in school. A total of 12,698 children were sampled and 10,381 were examined (82%). Examinations were undertaken in school by trained and calibrated examining teams using reclining chairs and portable lights, the criteria were visual, limited to dentine caries and no diagnostic aids were employed. In order to compare trend data with 1993 and earlier surveys the criteria allowed the re-classification of the full 2003a results (those including cavities and visual dentine caries - D(3cv)MFT/d(3cv)mft) according to the previous criteria to produce results labelled 2003b (those restricted to dentinal cavities--D(3c)MFT/d(3c)mft). RESULTS AND CONCLUSIONS: The experience of obvious dentinal caries in children within the UK has continued to change over the last decade and patterns are different for the two dentitions. While continuing overall improvements are evident for permanent teeth across the UK (D(3c) for 15-year-old children falling from 42% in 1983, via 30% in 1993 to 13% in 2003 for example), trends amongst those experiencing dentinal caries are more concerning and there have been no statistically significant improvements for primary teeth (the mean number of teeth with obvious dentine decay (d(3c)) at age five years being 1.3 in 1983 and 1.4 in both 1993 and 2003). The inclusion in the criteria of visual dentinal caries resulted in higher estimates of mean caries and mean caries experience in the permanent dentition (at age 15 years D(3) increasing from 0.2 to 0.8, D(3)MFT increasing from 1.6 to 2.0 for example) but not the primary dentition (where the estimates for % d(3)mft at age five years were identical at 43%). Geographic variations also persist across the UK (% with D(3cv)MFT at 12 years being 41% for England, 54% Wales, 73% Northern Ireland and 43% for the UK; % with d(3cv)mft at age 5 years: 41% for England, 52% Wales, 61% Northern Ireland and 43% for the UK). These survey results have implications for planning and for daily practice, but must be interpreted carefully acknowledging the specific survey conditions and diagnostic criteria employed.

Adolescent↗
PubMed2006

Perceptions of how the Internet has impacted on dentistry.

OBJECTIVES: This study sought to identify how patient information on the Internet has influenced the delivery of oral care and the use practitioners themselves make of the Internet. METHODOLOGY: Data were collected via a self completed 18 item postal questionnaire, sent to a random sample of 620 dentists on the GDC register in Wales. RESULTS: In total 457 (74%) of the questionnaires were returned. One half of all practitioners stated that patients had asked them about material of relevance to dentistry obtained from the Internet, although in the majority of cases this happened less frequently than once a month. The most common topics enquired after were cosmetic procedures, dental amalgam and implants. A minority of dentists, 47 (11%) viewed the Internet as a threat to the dentist-patient relationship. However, 169 (39%) agreed information gained from the Internet had led to patients demanding inappropriate care or more complex treatment (135/31%). Having to take time to discuss Internet material was viewed as a burden by 93 practitioners. The potential of the Internet to widen inequalities in access to oral health information was agreed upon by one third of respondents. Concerns over the quality and reliability of Internet derived information, together with a lack of knowledge of appropriate sites, prevented dentists using the Internet as an oral health education resource. However, only 18.7% claimed never to use the Internet for their own Continuing Professional Development. Access for CPD purposes was mainly from home. Of those working in general practice, 54 had their own practice website, and a further 103 said this was something they were considering. Email was used to communicate with patients by 42 dentists, mainly to make appointments. CONCLUSIONS: Views on the impact of the Internet were generally positive, but there is a long way to go before its full potential is realised.

Appointments and Schedules↗
PubMed2006

Attitudes to fluorosis and dental caries by a response latency method.

BACKGROUND: Understanding socially relevant attitudes to fluorosis and dental caries is important. Previous studies have concentrated mainly on aesthetic implications. AIMS: To investigate social judgements beyond the aesthetic, made when viewing digitally manipulated extraoral images of dental fluorosis of varying degrees of severity and images of dental caries. METHODOLOGY: Using a response latency technique, which allowed both the direction and strength of attitudes to be measured, 40 volunteers made judgements on 144 image/characteristic combinations. RESULTS: Participants made social judgements which extended beyond the aesthetic to factors such as sociability, reliability and cleanliness. Judgements on mild fluorosis were not markedly different from those made about the same individual with normal enamel, but severe fluorosis had a significant negative impact on social judgements. Untreated dental caries was judged less favourably than normal enamel and mild fluorosis. CONCLUSIONS: Attribution of characteristics that go beyond the aesthetic are significantly influenced by altered tooth appearance.

Adolescent↗
PubMed2005

The use of the Internet to access oral health-related information by patients attending dental hygiene clinics.

BACKGROUND: The degree to which patients access the Internet for oral health-related information is unknown. OBJECTIVES: This study was designed to determine if patients attending student dental hygiene clinics had: (1) accessed the Internet, (2) used the Internet as a source of information on both general health and oral health, (3) bought oral health care products on-line, and (4) were interested in being directed to appropriate on-line oral health resources by dental professionals. METHODS: A self-complete questionnaire was administered to a quota sample of 280 new and returning patients attending the student dental hygiene clinic at either the Cardiff Dental Hospital or a nearby Primary Dental Care Unit. RESULTS: A total of 269 (96%) patients consented to participate in the study. Of these, 147 (54.6%) had accessed the Internet, the majority (61.2%) from home. Internet use was significantly related to both patient age and level of education (P < 0.001). In total, 59 patients claimed accessing the Internet for information on general health topics. Only eight respondents had used the Internet for information on oral health/dental topics, with seven reporting that they found the information useful. On-line purchase of oral health products was reported by seven patients. However, 117 (43.5% of all respondents) patients indicated that they would be interested in the Internet as a future source of oral health information and 112 (41.6%) would appreciate being directed to appropriate sites by their dentist or dental hygienist. CONCLUSIONS: Patients attending student dental hygiene clinics make little use of the Internet for oral health information. However, reported interest in future access is such that dental professionals should develop and harness the potential of the Internet as an educational resource.

Adolescent↗
PubMed2004

The current working patterns and future career aspirations of specialist trainees in dentistry.

OBJECTIVES: To determine current demographic details of dental specialist registrars in the UK, to examine their current working patterns and ascertain their future career aspirations. METHODS: A cross-sectional survey, using a self-administered postal questionnaire of all 418 dental specialist registrars (SpRs) in the UK. RESULTS: The response rate was 78%. Of the SpRs who responded 59% were male, the majority were aged under 36, 54% were married and over one third had dependants. Orthodontics had the greatest number of SpRs with 141, followed by maxillofacial surgery (70) and restorative dentistry (52). On completion of training, 80% of SpRs intended to work full time. Significantly more women intended to work part-time. Only a fifth of SpRs said they would consider an academic appointment compared with 54% for specialist practice. Three quarters intended to work partly in the public sector and partly in a private capacity. London was the most popular choice of location for a post in the future. Access to a wide range of clinical work, continuing professional development, autonomy and sociability were the most important factors when considering their future choice of career. CONCLUSION: Changes in the demographic profile of dental specialists and increasing opportunities for providing care within primary care may lead to difficulties in recruitment to academic and hospital posts. Increasing provision of specialist services in the 'high street' might improve access but could lead to inequalities unless these services are commissioned according to the needs of the population.

Adult↗
PubMed2004

Fluid for thought: availability of drinks in primary and secondary schools in Cardiff, UK.

OBJECTIVE: While adequate hydration is undoubtedly essential for health, well-being, performance and learning, it is important to recognize that drinks may also have significant detrimental effects on both general and dental health. Since, on weekdays, at least half of a child's recommended daily fluid intake must be imbibed at school, this study sought to examine the provision of drinks in that setting. SUBJECTS AND METHODS: A self-administered postal questionnaire study was sent to the head teachers of all 107 state primary and all 20 state secondary schools in Cardiff, South Wales, UK. RESULTS: A response rate of 81.9% was achieved. Children had access to fresh drinking water from at least one drinking fountain in 69 (66.4%) of the 104 schools who responded to the questionnaire. Milk was available in 69 (80.2%) of the 86 responding primary schools. Sixteen (88.9%) of the 18 responding secondary schools had drink vending machines selling a variety of drinks. CONCLUSIONS: While primary schools appear largely to restrict the availability of drinks to those conducive to the maintenance of good general and dental health, secondary schools appear to foster the use of vending machines. Guidelines should be developed on the use and content of vending machines in schools in order to both meet school objectives and promote healthy choices.

Adolescent↗
PubMed2003

Parents and carers' choice of drinks for infants and toddlers, in areas of social and economic disadvantage.

BACKGROUND: Sugar rich drinks are a recognised risk factor in early childhood caries. Currently, in depth knowledge of factors influencing parents' choice of infant drinks is incomplete. OBJECTIVES: This study investigated parents and carers understanding of feeding practices potentially detrimental to oral health; barriers to adopting safe feeding practices and commercial factors influencing feeding bottle and cup contents. METHODOLOGY: A qualitative approach using semi-structured interviews was employed. Interviews were conducted by an experienced researcher and tape recorded. Following full transcription, emerging themes were identified, systematically explored and validated within the verbatim accounts. Thirty-three parents/carers of children aged three years and under, resident in areas of high caries prevalence in Cardiff, Wales, were interviewed. RESULTS: Overall understanding of the prolonged effect of exposure to sugared drinks in feeding bottles and cups was poor. Greater concern was expressed over the use of bottles on the development of the occlusion. Milk was viewed as a food rather than as a drink. Many barriers to giving water were described: children reject it; mothers don't like it; it was 'cruel' to offer water instead of sweet drinks; water in feeding bottles or cups was seen as a sign of poverty. Commercial influences on choices were strong. Products offered by baby food manufacturers were viewed as safe, but a recently marketed "Toothsafe" drink was viewed with suspicion. CONCLUSIONS: There are significant barriers to adopting the traditional oral health education message, that only milk and water are truly safe for teeth. Future oral health education and promotion programmes must recognise and account for these factors.

Adolescent↗
PubMed2002

The nature and quality of periodontal related patient information on the world-wide web.

BACKGROUND: The internet provides a potentially invaluable source of health education material for members of the public. OBJECTIVES: This study aimed to investigate the nature and quality of periodontal-related patient information on the world-wide web. METHODS: The search term ' "gum disease" AND "patient information" ' was entered into three common internet search engines. The top 50 sites identified by each search engine were downloaded and assessed for authorship, content, accord with accepted dental practice, currency, and references to peer reviewed data. RESULTS: The search term returned in excess of 3,615 hits across the three search engines. Of the top 150 identified, 68 were deemed relevant to patients seeking information on periodontal disease. Of these, 17 were duplicated either within or between search engines, therefore the following analysis is based on the remaining 51 sites. The majority of sites (25) were authored by individual dental practitioners, with sites originating in the USA predominating (80%). Information on the aetiology, signs and symptoms, and treatment options for periodontal disease was provided by 38, 38, and 29 sites respectively. This information was deemed in accordance with conventional periodontal practice in 27, 33, and 23 cases respectively. Only seven sites indicated the currency of the information and five provided peer-reviewed references for further reading. The rank order identified by the search engines meant that sites providing comprehensive and authoritative information, were not readily differentiable from sites whose primary objective was promoting attendance at specific dental practices. CONCLUSIONS: Judicious and active support from professionals is required to aid patients' interpretation of the information identified and to direct them to the most instructive sites.

Dentist-Patient Relations↗
PubMed2002

The York review--a systematic review of public water fluoridation: a commentary.

Following the election of the British government in May 1997, a policy document outlining proposals to improve the health of the nation was published. This document placed a major emphasis on reducing inequalities in health and recognised the continuing poor state of oral health in deprived communities. However, whilst acknowledging the benefits of water fluoridation as a caries preventive measure, the Department of Health suggested that most of the research had been carried out some years ago and furthermore, recognised that strong views were held both for and against fluoridation.

Cariostatic Agents↗
PubMed2002

Television advertising of foodstuffs potentially detrimental to oral health--a content analysis and comparison of children's and primetime broadcasts.

OBJECTIVES: The study aimed to examine the nature, content and duration of advertisements broadcast during children's television; determine the proportion of advertisements promoting food; identify the potential of the food advertised to be detrimental to oral health; and to compare the nature and content of advertisements aimed at children with those transmitted during evening 'primetime' television. BASIC RESEARCH DESIGN: Children's and primetime television, broadcast on a main independent terrestrial channel in South Wales were video recorded, 237 and 42 hours being analysed in total. RESULTS: Analysis of the recording resulted in a total of 3,236 commercials, of which 2,345 were broadcast during children's television and 891 in primetime. During children's TV, 62.5% of advertising time was devoted to foodstuffs, significantly greater (P< 0.001) than the 18.4% of time spent advertising foods during primetime. Of the time spent advertising foods, during children's television 73.4% was devoted to products deemed potentially detrimental to oral health (primarily high in sugar), compared to 18.6% similarly categorised during evening television. CONCLUSIONS: Commercials for products which have the potential to adversely affect oral health constitute a large proportion of advertising time during children's television. Current codes of the Independent Television Commission governing advertising directed at children should be reviewed.

Advertising↗
PubMed2001

Focus groups--what are they?

The use of focus groups has become common in many spheres of research, including dental research. This article provides an update on the history of focus groups, defines focus groups in the context of academic research and highlights their possible uses. Practical advice is provided on the conduct of focus groups and ethical considerations are discussed.

Attitude to Health↗
PubMed2000

Reasons for tooth extraction in Scotland.

OBJECTIVES: A 1984 study investigated the reasons underlying the extraction of teeth in Scotland. The survey described in this paper, used a similar methodology and aimed to determine the reasons for the extraction of permanent teeth by general dental practitioners and investigate changes in the influences on tooth extraction over a 10 year period. METHODS: During a 1 week period in November 1994, 139 general dental practitioners working throughout Scotland, recorded the reasons for all permanent tooth extractions. RESULTS: A total of 917 permanent teeth were extracted from 613 patients, the reason for extraction being stated as dental caries (51%), periodontal disease (21%), orthodontics (11%) and failed endodontics (4%). Trauma, pericoronitis and other reasons accounted for 5.5% of extractions whilst, in 7.5% of cases, patients requested extraction in preference to other treatments. The proportion of extractions attributed to periodontal disease increased from age 31-60 years, but declined thereafter. CONCLUSIONS: Comparing the results with those obtained in the 1984 study, whilst the mean number of teeth extracted by each practitioner had reduced, the overall relative contribution of different reasons for extraction was similar.

Adolescent↗
PubMed2000

Smoking and periodontal disease.

Numerous investigations of the relationship between smoking and periodontal disease have been performed over the last 15 years, and there now exists a substantial body of literature upon which this current review is based. From both cross-sectional and longitudinal studies, there appears to be strong epidemiological evidence that smoking confers a considerably increased risk of periodontal disease. This evidence is further supported by the data emanating from patients who stop smoking. These patients have levels of risk similar to those of non-smokers. Numerous studies of the potential mechanisms whereby smoking tobacco may predispose to periodontal disease have been conducted, and it appears that smoking may affect the vasculature, the humoral immune system, and the cellular immune and inflammatory systems, and have effects throughout the cytokine and adhesion molecule network. The aim of this review is to consider the evidence for the association between smoking and periodontal diseases and to highlight the biological mechanisms whereby smoking may affect the periodontium.

Bone Regeneration↗