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Biomedical subjects

M E Curzon

Publications and source records attributed to M E Curzon.

At least 19 recordsLinked to original sources
PubMed1997

Do we still care about children's teeth?

The level of care for children over the past 5 years has become bimodal, with most children with low levels of dental caries having good maintenance care, but those with moderate to high caries receiving significantly poorer care. Capitation has led to supervised neglect for many children who develop dental decay. This is not at all unexpected considering the general lack of concern by the government and public dental services and the fact that the level of payment of GDPs is such that they cannot afford to treat children. The problems of the dental care of children in the UK are compounded by the lack of specialist paediatric dentists for the more difficult patient.

Capitation Fee↗
PubMed1996

Postgraduate training for specialisation.

With the prospect of changes brought about through the Mouatt Report and the European Union, calls for a more flexible approach to teaching dentistry are being made. This article describes a postgraduate dental education system that involves modules and credits set up at the University of Leeds. The new system moves away from the more traditional methods of educating post-graduate students.

Credentialing↗
PubMed1996

The prevalence of malocclusion in children with cerebral palsy.

The prevalence of malocclusion in children with cerebral palsy was studied by comparison with a normal control group. The prevalence of drooling and prematurity was also assessed as well as the degree of mental handicap. Results showed an increased prevalence of malocclusion in children with cerebral palsy. Cerebral palsied children are likely to have a significantly increased overjet (P < 0.001) when compared with normal children. The comparatively small sample sizes precluded firm conclusions being drawn regarding other group comparisons (such as comparing children with cerebral palsy with and without a mental handicap) but there may be a tendency towards the more handicapped group having a Class II malocclusion.

Adolescent↗
PubMed1996

A comparison of the effects of some extrinsic and intrinsic sugars on dental plaque pH.

The aim of this study was to investigate the effects of some intrinsic and non-milk extrinsic sugars on plaque pH. Three fruits (apple, orange and banana) in three different physical forms (whole, homogenized and juice) were tested. Ten adult volunteers refrained from brushing their teeth for 48 hours and did not eat or drink for at least 2 1/2 hours before each test. Measurements of plaque pH were made at baseline to determine the resting plaque pH and at time intervals of 3, 7, 11, 15, 19, 23 and 27 minutes following a 1-minute rinse/chew of each test fruit. A pooled sample of plaque was removed from the buccal surfaces of six teeth representing all four quadrants of the mouth and thoroughly mixed with 20 microliters of distilled water. Plaque pH was determined using a micro-glass combination electrode. Data were compared with plaque pH changes resulting from rinsing with 10% sucrose solution. Analysis of pH minima and 'area under baseline pH', using ANOVA and multiple Turkey tests, indicated that there was no significant difference in any of the parameters between the different forms of preparation within one fruit, except for the minimum pH of whole orange and orange juice (P < 0.05). The results showed that homogenization of the fruits had little effect on acidogenicity even though the intrinsic sugars had been converted to extrinsic sugars. Both whole and mashed banana were of similar acidogenicity to 10% sucrose. Therefore it was concluded that there was no significant difference in the acidogenic potential between intrinsic sugars and extrinsic sugars derived from fruits.

Adult↗
PubMed1996

Integration of methods for determining the acido/cariogenic potential of foods: a comparison of several different methods.

Assessment of the acido/cariogenicity of 11 fruits and cereals was carried out using methods recommended at the San Antonio Conference: plaque pH by sampling (PS), indwelling electrode (IDE) and intra-oral cariogenicity test (ICT), together with additional tests of the total carbohydrate content of salivary expectorants, acid anion profiles of plaque, liberated maltose in plaque, total food carbohydrate and fluoride concentration. All foods within each test were compared with sucrose and sorbitol as positive and negative controls. Results for foods were ranked against sucrose for cH area under the curve for PS, for mean ratio [H+] of food versus sucrose (IDE) and mean change in indenter penetration length in enamel after exposure (ICT). Results showed that different rankings of foods were obtained with each method, with a greater degree of commonality for PS and ICT versus IDE. Factor analysis identified liberated maltose in plaque, area below the curve (PS), total food carbohydrate and plaque pH drop (PS) as being important in determining the potential cariogenicity of foods. It was concluded that each of the methods was of value and could be used to assess potential acido/cariogenicity of foods. The recommendation that it was desirable that at least two methods should be used was confirmed.

Acids↗
PubMed1996

Acidogenic potential and total salivary carbohydrate content of expectorants following the consumption of some cereal-based foods and fruits.

The acidogenic potential of a group of popular cereal-based foods and fruits and total carbohydrate content of salivary expectorants following their consumption were assessed using an indwelling electrode with telemetry and the anthrone method. Paired t tests indicated that sorbitol did not cause the plaque pH to fall as low as any of the test foods (p <0.05) but there was no significant difference between sucrose and the test foods. Only the fruits produced less acid than sucrose. The breakfast cereals tended to yield the highest levels of total carbohydrate in the salivary expectorants although a greater percentage of original carbohydrate was retained after rice and bread. These results suggest the important effect of carbohydrate retention on plaque pH response.

Acids↗
PubMed1995

A clinical trial comparing two doses of oral temazepam for sedation of paediatric dental patients.

A study was carried out to compare the effectiveness of two doses of temazepam elixir for the behaviour management of paediatric dental patients. Twenty-two children aged 2-5 years (mean 4.06 years), classified as ASA Class I and II (American Society of Anesthesiologists Classification), were assigned to receive either 0.3 or 0.5 mg/kg temazepam elixir in a double-blind randomized cross-over study. All treatment sessions were videotaped and rated independently by three paediatric dentists for the degree of crying, movement, sleep and overall behaviour at 15-minute intervals while being treated. The results showed no statistically significant differences between the two doses.

Anesthesia, Dental↗
PubMed1995

The effect of sucrose in medicines on plaque pH.

An investigation into the acidogenic potential of six of the most commonly used sugar-containing and sugar-free paediatric medicines was carried out on 10 adult volunteers. The guidelines of the Food, Nutrition and Dental Health Committee of the American Dental Association were followed. Subjects refrained from brushing their teeth for 48 hours and did not eat or drink for at least 2 1/2 hours prior to each appointment. pH measurements were taken at baseline to determine 'resting' plaque pH and at time intervals of 5, 10, 15, 20, 25 and 30 minutes following a 1-minute rinse with each medication. A pooled sample of plaque was removed from the buccal surfaces of posterior teeth, thoroughly mixed with 20 microliters of distilled water and plaque pH was determined using a glass combination electrode. Data were compared with plaque pH changes after rinsing with control solutions of 10% sucrose and 10% sorbitol. An ANOVA test indicated all sucrose-containing preparations produced a significantly greater drop in plaque pH than their sucrose-free counterparts (P < 0.001). The study provided evidence in support of prescribing sugar-free preparations for children on long-term medication.

Acetaminophen↗
PubMed1995

Breast feeding, bottle feeding and dental caries in Kuwait, a country with low-fluoride levels in the water supply.

A study was carried out in Kuwait, a country with low levels of fluoride in the water supplies, to determine the prevalence and extent of caries in early childhood, and enquire into associated factors. Mothers of pre-schoolchildren were interviewed, and their children aged 18 to 48 months received a dental examination. Of the 227 children examined, 107 (47 per cent) were caries free, and 41 (18%) had five or more dmf teeth. 'Nursing caries', affecting at least two maxillary incisors, was seen in 19 per cent of the sample. Breast fed children were significantly more likely to be caries free than those who were bottle fed from birth, although 'nursing caries' was positively associated with the practice of breast feeding at night 'at will' after 6 months of age (P < 0.01). Bottle fed children were more likely to develop caries, including 'nursing caries', particularly when the practice was continued to an older age. It was concluded that 'nursing caries' constitutes a significant dental health problem in Kuwait.

Bottle Feeding↗
PubMed1994

The fluoride content of bottled drinking waters.

Sales of bottled drinking waters in the United Kingdom have tripled over the last 5 years. The fluoride content of 12 bottled waters purchased from two Leeds supermarkets was determined by both the direct and acid diffusion methods and found to vary from 0.10-0.80 mg/l fluoride (ie ppm fluoride). This article shows that bottled drinking waters contain differing concentrations of fluoride. There is no apparent difference between the direct and acid diffusion methods for the determination of fluoride concentrations of drinking waters. The manufacturers' labelling of fluoride concentrations are mainly inaccurate. Dentists should be aware of the fluoride concentrations of the drinking water of their child patients, be they municipal or bottled drinking water, when prescribing fluoride supplements. Also, some parents are using bottled waters to prepare baby milk formulations which themselves may contain high levels of fluoride and subject their children to the risk of dental fluorosis.

Fluorides↗
PubMed1994

Cariogenic potential of foods. II. Relationship of food composition, plaque microbial counts, and salivary parameters to caries in the rat model.

A series of rat caries experiments was carried out to test the relative cariogenic potential and to identify the major carcinogenic elements of 22 popular snack foods. Parameters that were measured included rat caries, number of cariogenic bacteria in plaque, salivary parameters including flow rate, buffering capacity, total protein, lysozyme and amylase content, and composition of test foods including protein, fat, phosphorus, calcium, fluoride, galactose, glucose, total reducing sugar, sucrose, and starch. Many interesting relationships were observed between food components, numbers of plaque bacteria, salivary components, and specific types of carious lesions. Protein, fat, and phosphorus in foods were all associated with inhibition of both sulcal and buccolingual (smooth-surface) caries. Food fluoride was associated with inhibition of buccolingual caries, whereas calcium was related to inhibition of sulcal caries. Glucose, reducing sugar, and sucrose in foods were all related to promotion of both sulcal and smooth-surface caries. The numbers of Streptococcus sobrinus in plaque were associated with promotion of smooth-surface caries only, whereas lactobacilli, non-mutans bacteria, and total viable flora were related to promotion of both smooth-surface and sulcal caries. The salivary flow rate was associated with inhibition of both buccolingual and sulcal caries. Salivary buffering capacity (at pH 7) and salivary lysozyme delivery were associated with inhibition of number and severity of sulcal caries, while the salivary amylase content was related to the promotion of the number of sulcal lesions.

Amylases↗
PubMed1994

Effect of a calcium carbonate-based toothpaste with 0.3% triclosan on pH changes in dental plaque in vivo.

The effects of a calcium carbonate-based toothpaste with added 0.3% triclosan on the pH of human dental plaque after a cariogenic challenge with 10% sucrose solution was investigated against a calcium carbonate-based toothpaste without triclosan and an alumina-based toothpaste. A silica-based toothpaste served as a control. Twenty adult volunteers were included in this study. The results showed that the plaque pH drop and the area under the curve for both calcium carbonate-based toothpastes, with and without 0.3% triclosan, were significantly less as compared with the alumina-based toothpaste, with both parameters being least for the toothpaste with added 0.3% triclosan. Calcium carbonate has been shown in previous studies to have a buffering effect on the plaque pH after an acidogenic challenge. The addition of 0.3% triclosan to the calcium carbonate-based toothpaste seemed to enhance this effect.

Adolescent↗
PubMed1994

The use of tobacco and betel quid ('pan') among Bangladeshi women in West Yorkshire.

The high prevalence of oral cancer in South Asia has been linked to tobacco use particularly in conjunction with chewing betel quid or 'pan'. However, it is not known whether and to what extent these habits are practised by Asian people in the United Kingdom. Home based interviews using semi-structured questionnaires were undertaken among 296 first generation Bangladeshi women resident in inner-city Leeds and Bradford, West Yorkshire. 'Pan' was reportedly chewed by 282 (95 per cent) of the women, of whom 174 (62 per cent) added tobacco in leaf form, and 75 (27 per cent) as a component of zarda. Those who consumed more 'pans' daily were significantly older, less literate, had a lower educational attainment, and were more likely to believe that chewing betel quid was beneficial. Cigarette smoking was practised by 9 per cent, this group being older and having lived in the UK longer. Burnt tobacco leaves were used as an oral hygiene aid by 20 per cent. Over half (58 per cent) of the sample had never visited a dentist, the majority deeming it unnecessary. The use of tobacco and 'pan' imply an increased risk for oral cancer and precancer. Since 'pan' chewing is a traditional custom, health promotion within these communities would require a sensitive approach. Health personnel likely to be consulted by Asian groups who chew 'pan' should be aware of the danger to oral health posed by this practice.

Adult↗
PubMed1993

Intravenous sedation for handicapped dental patients: a clinical trial of midazolam and propofol.

A double blind, cross-over study to compare intravenous sedation using continuous infusions of midazolam and propofol was carried out in 18 handicapped patients, aged between 5 and 26 years. Using a syringe pump (Ohmeda 9000) midazolam was delivered at 0.4 mg/kg/h with a bolus dose of 0.02 mg/kg and propofol was infused at 4.0 mg/kg/h with a bolus dose of 0.2 mg/kg. Sequential analysis showed that induction and recovery times were shorter with propofol (P < 0.05 and P < 0.01 respectively) and more work was performed over unit time (P < 0.05), with 15.7 units of work being completed per hour on patients under propofol sedation compared to 11.0 units under midazolam. The quality of sedation was assessed as better in patients receiving propofol; eight cases were abandoned under midazolam infusion due to failure of induction, uncontrolled movement and/or emotional outbursts compared with none under propofol. All parents/patients preferred propofol sedation, because recovery was faster and smoother.

Adolescent↗
PubMed1993

The effect of amoxycillin versus penicillin V in the treatment of acutely abscessed primary teeth.

A clinical study was carried out to compare the efficacy of a short course, high dose amoxycillin versus a conventional penicillin regimen in the treatment of acute abscessed primary teeth. In a blind way children were assigned to either group A (amoxycillin) or group B (penicillin). The efficacy of the antibiotics was assessed using the clinical parameters of pain, swelling, tenderness, mobility and lymphadenitis. The results showed a general trend of less swelling in patients in group A as compared with patients in group B. This was significant at days 1 and 7 for the operators assessment (Mann Whitney U test; z = 2.48 and z = 2.12). More teeth in group A were considered suitable for first stage pulpectomy by day 7 (c2 test; P 0.037 pounds). A short course, high dose amoxycillin regimen proved as efficacious as a conventional penicillin regimen.

Amoxicillin↗