PubMed Health⌕ Search

Biomedical subjects

S Gelbier

Publications and source records attributed to S Gelbier.

At least 19 recordsLinked to original sources
PubMed1998

The National Health Service and social inequalities in dental health.

Since establishment of the NHS, remarkable improvements in oral health have been seen. Social differences still remain, but in absolute terms they are far smaller than those which existed prior to creation of the service. Although the improvements have not been unique to the UK, and in consequence may not be entirely ascribed to the NHS, the overall costs to society have been remarkably small when compared with other countries. Furthermore other inequities that existed, such as the availability of services, appear to be less pronounced today than before. The NHS, established as one component of a welfare system to deal with the inequalities within society, has evolved over the last 50 years to remain a highly efficient mechanism to deal with oral health problems. The arguments for maintaining dental services within the NHS must be based upon the contribution they make to improving oral health. Judged on the past 50 years, it has helped to make major inroads into reducing the current inequalities. For the next 50 years, as the service adapts, the profession must remember that it is there for those with least resources not just those with the ability to pay.

Adolescent↗
PubMed1998

The emotional effects of tooth loss in edentulous people.

AIM: To explore the range of reactions to, and feelings about, tooth loss. METHOD: In this qualitative study, 50 edentulous people undergoing routine prosthetic dental care were interviewed privately using a reflexive, in-depth technique. All the interviews were tape-recorded and transcribed. The transcripts were scrutinised to identify the common themes related to tooth loss. Interpreter bias was minimised by two researchers scrutinising the transcripts independently. RESULTS: The participants had a mean age of 69.9 years (range 51 to 86) and had been edentulous for a mean of 18.4 years (range 0.25 to 57 years). The main themes identified in reaction to tooth loss were: bereavement, lowered self-confidence, altered self-image, dislike of appearance, an inability to discuss this taboo subject, a concern about prosthodontic privacy, behaving in a way that keeps the tooth loss secret, altered behaviour in socialising and forming close relationships, premature ageing, and lack of preparation. CONCLUSION: Tooth loss can be disabling and handicapping. It has a profound impact on the lives of some people, even those who are apparently coping well with dentures. The profession needs to consider how it can prepare people for the effects of tooth loss.

Adaptation, Psychological↗
PubMed1998

Parental perceptions and attitudes on orthodontic care.

The objective of this paper is to determine whether an association existed between parents' attitudes to orthodontic issues affecting themselves and their attitudes to possible orthodontic treatment for their child. It consisted of an analytical survey using a self-administered questionnaire, taken in South East England of six-hundred parents of children aged 9 years. The questionnaires were delivered to the parent with the help of their child's school. Four-hundred-and-thirty-seven questionnaires were returned (73 per cent). Significant associations were found between desire by the parents for orthodontic treatment for themselves and perception of need in their child, parental satisfaction with own dental appearance and perception of need in their child, a parental history of orthodontic treatment and a determination to insist on their child's co-operation with orthodontic treatment. Logistic regression models show the odds of parents who desire orthodontic treatment themselves, perceiving need in their children are three times greater than for other parents. 1. There is some evidence that parents who desire orthodontic treatment for themselves, or who are former orthodontic patients are more likely to approve of orthodontic care in principle and to perceive a need for it in their child. 2. Further research is required to establish to what extent genetic factors are involved.

Attitude to Health↗
PubMed1997

Dental attendance patterns and oral hygiene habits of 5-year-old children in Athens and in south London.

This study compared the dental attendance patterns and oral hygiene habits of 5-year-old children in the London boroughs of Lambeth, Lewisham and Southwark with those in the municipality of Athens in the light of differing provision of oral health education. Questionnaires were sent to the parents of 384 children in London and 318 children in Athens who took part in a survey of dental health. Response rates of 51% and 53% respectively were obtained. More children visit the dentist in South London than in Athens, the difference being highly significant. In South London the majority of children visit every 6 months, whereas in Athens they only visit when they have toothache. More London children brush their teeth than Athens children, the difference being significant. Of those brushing in London, most brush twice daily. The above findings indicate marked differences in dental attendance patterns and oral hygiene habits, and this may be partly attributable to differences in the delivery of dental care and oral health education in the two countries.

Chi-Square Distribution↗
PubMed1997

Accessing primary dental care in three London boroughs.

OBJECTIVE: To investigate and identify factors that may influence individuals' ability to access primary health care services. DESIGN: Cross-sectional study SETTING: Lambeth, Southwark and Lewisham. SUBJECTS: A 0.1 per cent random sample of people aged 18 years and over in the population of 626,621 people in the three boroughs. MAIN OUTCOME MEASURES: Demographic as well as psychosocial profile of the sample, perceptions of their dental health needs, accessed dental care. RESULTS: The results indicated that people believed that their oral health was good. The majority of the sample had attended for dental care within the previous year and were registered with a general dental practitioner. Accessing dental care was related to age, social class, borough of residence, dentate status and dental phobia status. In addition subjects experiencing problems with their teeth gained access to care more readily than others. This was related to social class. Accessing dental care was predicted by dental care being provided by a general dental practitioner, experiencing problems with teeth and not being dentally phobic. CONCLUSIONS: The findings suggest that psychosocial factors together with dental health status can act as determinants when accessing primary dental services. It is considered that family health services authorities should be aware of these influences when developing and monitoring dental health services, in order to make them responsive and sensitive to the needs of the people whom they serve.

Adolescent↗
PubMed1997

Oral and dental health in alcohol misusing patients.

Dental and oral health and their relationship to nutritional status among a group of alcohol misusers (n = 107) from south London is reported. The Alcohol Use Disorders Identification Test (AUDIT) questionnaire was validated as an accurate and reliable screening questionnaire for use in alcohol misuse detection by a dentist. Half of the study population consumed >200 units of alcohol/week, and 80% were heavy smokers. A high incidence of tooth wear and trauma to the dentition was recorded. Eight subjects had oral mucosal lesions, including two previously treated carcinomas. The dental health in alcoholics overall was not compromised, but nutritional impairment (body mass index and reduced midarm muscle circumference) was associated with periodontal lesions. Oral mucosal health of alcoholics is of concern, particularly in heavy smokers. The interrelationships between dental-oral health and alcohol-tobacco usage have implications for preventative counseling in this patient group.

Adult↗
PubMed1996

Dental caries and caries-associated micro-organisms in the saliva and plaque of 3- and 4-year-old Afro-Caribbean and Caucasian children in south London.

Three and four-year-old Caucasian and Afro-Caribbean children (n = 641) attending childcare facilities in the London boroughs of Lambeth, Lewisham and Southwark were studied in order to determine the prevalence of caries and caries-associated micro-organisms and the interactions between these for each of the racial groups; dmft (decayed, missing or filled teeth) scores were recorded using British Association for the Study of Community Dentistry criteria. Saliva and plaque samples were taken from each child and the numbers of mutans streptococci, lactobacilli and yeasts per sample were determined. The mean dmft scores of the 3- and 4-year-old Afro-Caribbean children were 0.36 +/- 0.10 and 0.51 +/- 0.13, respectively, compared to 0.80 +/- 0.17 and 1.48 +/- 0.24 for the equivalent Caucasian children (p < 0.001). Mutans streptococci and lactobacilli were recovered less frequently from the Afro-Caribbean children than from the Caucasian, but in both groups there were significant correlations between the plaque and salivary levels of mutants streptococci and caries experience. In both groups, children from whom both mutans streptococci and lactobacilli were isolated had the greatest mean dmft scores and these were not significantly different. Multiple regression analyses demonstrated that, after controlling for age and dmft, there were still significant associations between race and salivary levels of mutans streptococci and lactobacilli, p = 0.0013 and p = 0.0167, respectively. These data indicate that Afro-Caribbean children had lower levels of dental caries than Caucasian children living in the same London boroughs and attending the same preschool care facilities and, after controlling for age and caries experience, they also had lower salivary levels of mutans streptococci and lactobacilli.

Africa↗
PubMed1996

Caries prevalence of 5-year-old children in Athens and in South London.

This study compared the dental health of 5-year-old children in the London boroughs of Lambeth, Lewisham and Southwark with that in the municipality of Athens, Greece. Three hundred and eighty-four children were examined in London, and 318 in Athens; both samples had a mean age of 5 years 6 months. The proportion of London children who were caries free was 56%, and of Athens children 57.5%, and the mean dmft was 1.63 and 1.48, respectively; these differences were not statistically significant. However, excluding caries-free children from the analysis, the London children had significantly fewer decayed teeth (mean 2.35 compared with 2.93 in Athens) and significantly more missing teeth (mean 0.63 compared with 0.02), indicating marked differences in treatment patterns.

Child, Preschool↗
PubMed1996

An education and training initiative on dental care for the HIV-positive patient.

Workshops were established on the theme of 'HIV and the General Dental Team' to meet the expressed needs of dentists working in one family health services authority (FHSA). The workshop's effect with regard to knowledge, attitudes and working practices was assessed. A questionnaire, completed at the beginning of the day by the 29 participants, explored areas of staff knowledge, attitudes, concerns and reported practices regarding treatment of people with HIV. A second questionnaire was completed at the end of the day to enable comparisons to be made before and after the course. After the workshop, there were general improvements in the levels of knowledge about clinical signs and symptoms, oral manifestations of HIV and AIDS and modes of the transmission of HIV. A change of attitude towards the provision of dental care for people with HIV was reported by 39%, 59% were more likely to provide this care and 72% of participants said they would change their working practices, principally with respect to infection control. A follow-up survey one year later reported long term behaviour changes and requests for further support in the form of a newsletter, video or telephone helpline and a confidentiality policy for use in general practice.

Acquired Immunodeficiency Syndrome↗
PubMed1996

Oral health in alcohol misusers.

One hundred and seven chronic alcohol misusers (mean age 42.9 years; range 21-65 years; 80 males) attending four centres in South East London were interviewed on their current and past alcohol consumption. Their nutritional status (body mass index (BMI) and mid arm muscle circumference) was also recorded. Each subject completed a dental and oral mucosal examination. Ninety four per cent of the sample consumed greater than 50 units of alcohol per week and 80 per cent greater than 100 units of alcohol per week. Smoking and alcohol misuse were found to be related, 81 per cent reporting both habits. Neither plaque index scores or mean subject pocket depths were correlated with alcohol consumption but both were positively correlated with the frequency and duration of smoking. Overall mean DMFT was 15.4; age specific mean DMFT and tooth loss of the sample were closely similar to the 1988 United Kingdom adult dental health survey data. The prevalence and severity of tooth wear and attrition were greater in the sample than levels described in the literature and these dental features may prove useful markers to the practitioner. Trauma to teeth and oral mucosae was noted in 25 per cent of the sample. Seven oral mucosal lesions (including one treated carcinoma) were detected; mucosal trauma could have acted as a co-factor. Furthermore, 21 per cent of the alcoholics were malnourished (BMI < 20). It is concluded that, unlike several reports from the United States, dental health in this sample of alcoholics is not compromised; however mucosal health is a cause for concern.

Adult↗
PubMed1996

Lack of knowledge among parents, of the implications of receiving orthodontic treatment.

In a survey of parental knowledge of the complications of orthodontic treatment it was surprising to find how few 'experienced' parents knew that dental decay could occur beneath an appliance or that, after treatment ceased, there might be some relapse. Experienced parents were defined as those who had children who had received or were receiving treatment, or who had been patients themselves. Self-administered questionnaires were delivered to 600 parents of 9-year-old children randomly selected from school rolls in two areas of South East England. Among the 430 replies received, 123 were from parents with experience of orthodontic treatment. Only 41 per cent of them knew that decay could occur beneath a fixed appliance and less than a third that relapse could occur after treatment ceased.

Attitude to Health↗
PubMed1996

Margaret McMillan: 'mother' of child health.

This paper discusses the work of Margaret McMillan. In particular, it highlights her efforts to improve the dental health of children in Deptford, London. Among her achievements was the opening of a health centre which included one of the earliest school dental clinics in London.

Child↗