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Biomedical subjects

M L Hunter

Publications and source records attributed to M L Hunter.

At least 37 records · Page 2Linked to original sources

Erosion of deciduous and permanent dental hard tissue in the oral environment.

OBJECTIVES: The objectives of this study were two-fold: (1) to determine (by surfometry) loss of deciduous and permanent enamel and dentine following consumption of a single low pH orange drink for 15days; and (2) to determine (by surfometry) loss of deciduous and permanent enamel and dentine following consumption of the product 2 versus 4 times per day for 15days. METHODS: Sixteen healthy volunteers participated in a single centre, single blind, 2-phase crossover study, conducted according to Good Clinical Practice, and employing the validated model described by West and co-workers (Journal of Dentistry 1998; 26:329-335). RESULTS: In all tissues, erosion was progressive over time, the pattern being more linear in enamel than in dentine. In general, erosion of deciduous enamel was greater than that of permanent enamel, though this difference was significant only for those specimens exposed to 4 drinks per day. Conversely, erosion of dentine was generally greater in the permanent tissue, though differences rarely reached conventional levels of statistical significance. Increasing frequency of consumption resulted in increased loss of tissue, but this difference was neither proportional nor consistently statistically significant. CONCLUSIONS: It is concluded that statistically significant differences in susceptibility of deciduous and permanent enamel to erosion appear to emerge over time and with increasing frequency of consumption. This is of importance clinically given the reduced dimensions of the deciduous dentition and the element of 'abuse' of soft drinks by the child population. Further development of soft drinks with low erosive potential is recommended.

Adult↗

Consumer demand in the purchase and prescription of sugar-free medicines.

OBJECTIVES: To determine the current level of consumer demand in the purchase and prescription of sugar-free paediatric medicines. DESIGN: Data were collected by administered questionnaire. SETTING: The study was conducted in a Hospital Paediatric Dentistry Unit and a Community Dental Clinic, both within the Bro Taf area of south-east Wales. SAMPLE AND METHODS: The parents of 240 children attending for routine dental care responded to one of two short questionnaires, depending on whether their child had received a liquid oral medicine in the preceding month. RESULTS: Although aware of the benefits of sugar-free medicines, parents did not appear to be attempting to exercise the power of consumer demand to its full potential. They were more likely to ask a pharmacist (or pharmacist's assistant) than their general medical practitioner for a sugar-free medicine. CONCLUSIONS: We must continue to promote sugar-free medicines. While increasing the importance that health professionals attach to such products, future campaigns should also aim to increase consumer demand.

Administration, Oral↗

Oral health advice: reported experience of mothers of children aged 5 years and under referred for extraction of teeth under general anaesthesia.

AIMS: To examine the reported receipt of oral health education among mothers of children who required the extraction of teeth under general anaesthesia. DESIGN: Cross-sectional study using questionnaires completed at interview. SAMPLE: 150 mothers of children aged 5 or younger who had been referred for extraction of teeth under general anaesthesia. SETTING: Dental School, University of Wales College of Medicine. RESULTS: 27% of mothers recalled receiving advice from their dentist about dental care during their pregnancy. With regard to their child's oral health, 48% had received dietary advice and 31% oral hygiene advice from the same source. All children lived in areas with suboptimal water fluoride levels; 27% of mothers had been advised by their dentist to give their child fluoride supplements. Few of the mothers recalled receiving advice about oral health from their health visitor.

Adult↗

Demographic characteristics, oral health knowledge and practices of mothers of children aged 5 years and under referred for extraction of teeth under general anaesthesia.

AIMS: To examine the demographic characteristics, oral health knowledge and practices of mothers of children who required the extraction of teeth under general anaesthesia. DESIGN: Cross-sectional study using questionnaires completed at interview. SAMPLE: 150 mothers of children age 5 years and under who had been referred for extraction of teeth under general anaesthesia. SETTING: Dental School, University of Wales College of Medicine. RESULTS: Over three-quarters of mothers had finished their full-time education at or before the age of 16 years. Although generally well-informed about the causes of caries, mothers were less sure of preventative methods. There was a widespread ignorance of the causes and prevention of periodontal disease, with just under half of the sample being unable to identify any causative or preventive factors. 40% of the sample admitted to attending a dentist only when in pain or not at all.

Adolescent↗

Reported infant feeding, oral hygiene and dental attendance patterns in children aged 5 years and under referred for extraction of teeth under general anaesthesia.

This study was designed to examine reported infant feeding, oral hygiene, and dental attendance practices in children who had established dental disease before attaining school age. Data were collected by structured interview from the mothers of 150 children aged 5 years and under who were referred to a hospital Paediatric Dentistry Unit for the extraction of teeth under general anaesthesia. Few children in this study had been exclusively breast-fed, and, although unconfirmed by data derived from matched caries-free controls, the development of dental caries would appear to be related to prolonged bottle-feeding, including the use of a night-time bottle until just before weaning, the early introduction and regular consumption of larger than average amounts of confectionery, coupled with reportedly regular but unsupervised toothbrushing. Although decay was already established in over a third of children before they visited a dentist for the first time, little evidence of restorative care was found. It would appear that the primary care services fail this youngest age-group.

Age Factors↗

A computerised method of monitoring and assessing undergraduate clinical activity.

This article describes the development and use of an electronic data acquisition system for monitoring and assessing the clinical activity of undergraduate dental students. The advantages of such a system over a paper-based one is that it can generate reports quickly and easily, showing the variety of clinical experience gained by the undergraduates and an assessment of the level of skill displayed. It also relieves academic staff of the tedious, repetitive task of collecting and collating data by hand.

Clinical Competence↗

The current status of dental health education in the training of midwives and health visitors.

In some areas of the United Kingdom, the dental health of young children is deteriorating, with levels of disease reverting to those of ten years ago. The recent enquiry into the education and training of personnel auxiliary to dentistry recognised that other health care staff working in primary care have an important role to play in the education of parents with young children and should be trained accordingly. This study sought to investigate, by questionnaire survey, the current status of dental health in the education of midwives and health visitors. It was found that the majority of courses in health visiting but only two-thirds of those in midwifery now include dental health in their curricula. The use of inappropriately qualified tutors may place these professionals at a disadvantage in providing advice on the prevention of oral disease to parents and prospective parents.

Adolescent↗

Delayed circulatory failure due to the induction of nitric oxide synthase by lipoteichoic acid from Staphylococcus aureus in anaesthetized rats.

1. This study investigates the effect of lipoteichoic acid (LTA) from the cell wall of Staphylococcus aureus, a micro-organism without endotoxin, on haemodynamics and induction of nitric oxide synthase (iNOS) in the anaesthetized rat. 2. Intravenous injection of LTA (10 mg kg-1) resulted in a decrease in blood pressure from 123 +/- 1 mmHg to 83 +/- 7 mmHg after 270 min (P < 0.001) and a reduction of the pressor response to noradrenaline (1 microgram kg-1) from 33 +/- 1 mmHg.min to 23 +/- 3 mmHg.min after 270 min (P < 0.05). 3. The delayed circulatory failure (hypotension and vascular hyporeactivity) caused by LTA was prevented by pretreatment of rats with dexamethasone (10 mg kg-1, 60 min prior to LTA) or the nitric oxide synthase inhibitor NG-monomethyl-L-arginine (L-NMMA, 10 mg kg-1 h-1, i.v. infusion starting 30 min prior to LTA). 4. In contrast, treatment of rats with polymyxin B (0.05 mg kg-1), an agent which binds endotoxin (lipopolysaccharides, LPS), did not affect the delayed circulatory failure caused by LTA. Polymyxin B, however, attenuated the hypotension and vascular hyporeactivity to noradrenaline afforded by endotoxaemia (2 mg kg-1 LPS, i.v.) for 270 min. 5. The delayed circulatory failure caused by LTA was associated with a time-dependent increase in (i) the expression of iNOS protein in the lung (Western blot analysis), and (ii) iNOS activity. This increase in iNOS protein and activity was prevented by pretreatment of LTA-rats with dexamethasone (10 mg kg-1). 6. Intravenous injection of LTA resulted in an increase in serum tumour necrosis factor (TNF)-alpha(maximum at 90 min after LTA), which was attenuated by pretreatment of rats with dexamethasone(10 mg kg-1, 60 min prior to LTA). The magnitude of the rise in TNF-alpha caused by LTA was similar to the one elicited by LPS (10mgkg-', i.v.).7. Thus, an enhanced formation of nitric oxide following the induction of iNOS contributes importantly to the delayed vascular failure (hypotension and vascular hyporeactivity) caused by LTA in the anaesthetized rat. We suggest that the endogenous release of TNF-alpha contributes to the induction ofiNOS caused by LTA in vivo.

Amino Acid Oxidoreductases↗

An 8-year study of changes in oral hygiene and periodontal health during adolescence.

This study reports data collected from a cohort of 405 South Wales adolescents examined at the ages of 11-12, 15-16 and 19-20 years. Dental plaque and gingivitis scores decreased markedly between the ages of 11-12 and 15-16 years, and to a lesser extent between 15-16 and 19-20 years. There was a decrease in the mean depth of the gingival sulcus between the ages of 11-12 and 15-16 years, perhaps reflecting a decrease in false pocketing and gingival oedema associated with puberty and tooth eruption. Conversely, there was an increase in the mean depth of the gingival sulcus between the ages of 15-16 and 19-20 years, possibly indicating the initiation of periodontal breakdown and the appearance of true pocketing. Gender was found to be an important determinant of the level of oral hygiene practised, the boys having consistently poorer oral hygiene than did the girls. At the commencement of adolescence this was not reflected in higher gingivitis scores, but by the age of 15-16 years the boys exhibited significantly more gingivitis than did the girls.

Adolescent↗

A longitudinal study of the condition of first permanent molars in a group of adolescents with special reference to elective orthodontic tooth extraction.

The aim of this study was to investigate changes in the condition of first permanent molars over the teenage years, with special reference to adolescents who lost premolar teeth for orthodontic purposes. A total of 453 South Wales schoolchildren (219 males and 234 females) were examined at the ages of 11-12 and 19-20 years. At 11-12 years, 89.6 per cent of the cohort had all four first permanent molars, while 3.3 per cent had already lost these teeth. Of those first permanent molars present, 61.7 per cent had some caries experience. At age 19-20, 80.6 per cent of subjects retained four first permanent molars while 4.4 per cent had none. Of the first permanent molars present, 80.6 per cent had been affected by caries. In 60 per cent of the 186 subjects (75 males and 111 females) who had lost premolar teeth in the course of orthodontic treatment, a sound premolar was extracted in preference to a first permanent molar which already had evidence of dental disease. At age 19-20 years, the majority of the first permanent molars were restored and otherwise sound, though a small number which had been restored at age 11-12 years had been lost due to caries.

Adolescent↗

Traumatic injury to maxillary incisor teeth in a group of South Wales school children.

This study examines, from photographic records, the prevalence of accidental damage to maxillary incisor teeth in a group of 968 11/12-year-old South Wales school-children; 15.3% showed evidence of trauma ranging from enamel fractures or discolouration to actual loss of a tooth. Boys (19.4%) showed a higher prevalence of trauma than girls (11%). Maxillary central incisors were the most at risk from trauma, with coronal fractures being the most commonly sustained injury. Those subjects who showed evidence of trauma had an statistically (p less than 0.001) but not clinically significantly greater overjet than did those who had none. The percentage of subjects suffering trauma increased significantly with increasing overjet, but lip incompetence did not affect the prevalence of accidental damage. Though statistically unsupported due to the small numbers involved in this cohort, it appeared that the rougher nature of boys activities and their more active participation in sports were of greater importance than the magnitude of their overjet in determining whether their teeth were at risk from trauma. In contrast, it was the magnitude of the overjet which was the dominant factor in girls. Despite the wide availability of relatively simple means of restoration and, in the majority of cases, regular dental examinations, only 14.8% of traumatised teeth had received treatment at this age.

Child↗

The effect of toothbrushing frequency, toothbrushing hand, sex and social class on the incidence of plaque, gingivitis and pocketing in adolescents: a longitudinal cohort study.

Reported toothbrushing frequency and the effect of toothbrushing frequency, toothbrushing hand, sex and social class on the incidence of plaque and periodontal disease in a group of 720 adolescents examined at age 11-12 years and again at 15-16 years is presented. At 11-12 years, the mean toothbrushing frequency was 11.5 times per week. By age 15-16 years, it had risen to 13.3 times per week. Children from social class I were less likely to brush once per day or less and more likely to brush twice daily than those from social class V. At both examinations, consistently low negative correlations were seen between reported toothbrushing frequency and the mean scores for buccal and lingual plaque, buccal, mesial and total bleeding. Few significant differences were seen between left- and right-handed toothbrushers at age 11-12 years. These were almost entirely due to differences between the boys. By age 15-16 years, no significant differences existed between the two groups. At both examinations, the boys had higher plaque, bleeding and pocketing scores than did the girls. At 15-16 years of age, all social classes exhibited lower mean total pocketing scores than at age 11-12 years. At 11-12 years of age, the social class differences were mainly contributed by the girls, while at re-examination plaque and bleeding scores for both sexes showed an overall trend to increase from social class I through to social class V. At 11-12 years of age, the boys showed a trend for pocketing to increase from social class I through to social class V. This was absent at 15-16 years of age. The girls showed no such trend at 11-12, but it had emerged by age 15-16. The results again demonstrate the influence of social class and sex rather than toothbrushing frequency and handedness on oral hygiene and gingival health. However, in view of the high number of statistical tests employed, some caution must be exercised in the interpretation of differences significant at the 5 per cent level.

Adolescent↗

Management of conical midline supernumerary teeth in a young child.

The authors report a case of a young patient with conical midline supernumerary teeth. In cases where such supernumeraries are likely to erupt, early surgical intervention, often necessitating the administration of a general anaesthetic, should be avoided if possible. Extraction under local anaesthesia on eruption was preferred for this patient, and resulted in the normal eruption of the permanent central incisors.

Child, Preschool↗