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At least 253 records · Page 14Linked to original sources
PubMed2006

A controlled trial of the impact of exposure to positive images of dentistry on anticipatory dental fear in children.

OBJECTIVES: Dental anxiety is common in children. This study sought to determine the impact of viewing positive images of dentistry prior to a dental appointment on the anticipatory dental anxiety levels of children attending for dental treatment. METHODS: Controlled trial. Assessment of anxiety and analysis of data were conducted blind to experimental condition. Assessment of anxiety was carried out in the waiting room postintervention but before the patient entered the dental surgery for treatment. PARTICIPANTS: Thirty-eight children and young adults attending a dental clinic in South West England. INTERVENTION: Participants were randomly assigned to one of two conditions. In both conditions the participant was asked to look at photographs for 2 min in the waiting area prior to their appointment. The intervention consisted of viewing positive images of dentistry and dental treatment, the control condition consisted of dentally neutral images. Positive and neutral images were validated independently by four paediatric dentists. The assessment of anticipatory dental anxiety was made blind to experimental condition and statistical analysis was conducted blind to group membership. OUTCOME MEASURE: Anticipatory anxiety assessed by the Venham Picture Test. FINDINGS: A significant difference in anticipatory dental anxiety was found between the two groups (median-positive images = 0, median-neutral images = 3; P < 0.001). Anticipatory anxiety was not correlated to age (rho = 0.04 P > 0.05), there was no difference between male and female participants in their level of anticipatory anxiety (median-males = 0.5, median-females = 1 P > 0.05). CONCLUSIONS: Viewing positive images of dentistry and dentists results in short-term reductions in anticipatory anxiety in children.

Adolescent↗
PubMed1997

[The fight over dentistry 1919-1924].

In the history of many professions there are periods of more or less pronounced borderline fights against other professions and/or charlatans. This article is about such an example from the profession of dentistry in Sweden. From the middle of the second decade of this century, there was an increasing discrepancy between the need for dental care and the too low number of dentists. Furthermore: the majority of the Swedish people could not afford dental care at all. In the public debate the concept "dental misery" was created. In 1919 a famous Swedish paediatric professor, Isak Jundell, presented a debate article in "Allmänna Svenska Läkartidningen" (Journal of the Swedish Medical Association), with a proposal for building up a corps of dental assistants with shorter training than dentists, but still with competence for tooth cleaning, extraction and some operative dentistry. The aim of the proposal was to give people easier available and cheaper dental care. The dental profession had been questioned and threatened and the reaction from the advocates of the dentists was immediate and intense. Now followed an almost five year long struggle, with the Swedish Dental Association on one side and parts of the medical profession, dental technicians, even some dentists and a number of politicians on the other. The controversy ended up in the Swedish Parliament in 1924 where many members in both the chambers had signed motions concerning authorisation of dental technicians. The dentists won the fight thanks to the resolution in the Parliament not to authorise the technicians. But still more important, from a social political point of view, was a statement from the Parliament with a commission to the Government to analyse the prerequisites for building up a Public Dental Health Service organisation in Sweden. After a series of committees this was finally a reality fourteen years later, in 1938, when the Parliament in a resolution initiated "folktandvården".

Dental Assistants↗
PubMed2003

Intravenous conscious sedation in patients under 16 years of age. Fact or fiction?

Recently published guidelines on the use of conscious sedation in dentistry have published varying recommendations on the lower age limit for the use of intravenous conscious sedation. There are a large number of dentists currently providing dental treatment for paediatric patients under intravenous conscious sedation. The 18 cases reported here (age range 11-15 years), were successfully managed with intravenous conscious sedation. The experience in this paper is not sufficient evidence to recommend the wholesale use of intravenous conscious sedation in patients who are under 16 years. The fact that a range of operators can use these techniques on paediatric patients would suggest that further study should be carried out in this population. The guidance should be modified to say there is insufficient evidence to support the use of intravenous conscious sedation in children, rather than arbitrarily selecting a cut off point at age 16 years.

Adolescent↗
PubMed1999

An audit of paediatric audit in Scotland.

We undertook a retrospective review of the Scottish Clinical Audit Project Register (SCAPR). This generated information on audit activities in Scotland relating to children aged 0-15 years over the period 1992 to 1997. All healthcare specialties (including dentistry) in both acute and community sectors were included. Of the 7,073 registered entries, 613 (9%) relating to children were identified. Greater Glasgow contributed a third of entries despite having only 18% of the child population. Over half the projects were conducted in secondary care settings and only 5% in primary care. Medicine and nursing appeared the most audit active professional groups. Our findings suggest that children (who comprise 19% of the Scottish population) are an under-audited group in Scotland. Secondary care (especially surgery) seemed over-represented and primary care under-represented as audit settings. We were unable to use the SCAPR to identify specific service deficiencies or improvements that may have been stimulated in the course of "closing the audit loop." Future refinements to the way data are collected and recorded on the SCAPR will clearly require to address this shortcoming.

Adolescent↗
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↗
PubMed2003

Relative analgesia and general dental practitioners: attitudes and intentions to provide conscious sedation for paediatric dental extractions.

AIM: To examine the attitudes and intentions of general dental practitioners (GDPs) who work within the remit of the National Health Service (NHS) to provide relative analgesia (RA) for paediatric extractions. METHODS: All 45 GDPs working within the boundaries of one Trust were asked to complete a questionnaire to assess demography, etc., intention and attitudes to provide RA for paediatric extractions. RESULTS: Ninety-eight per cent of GDPs took part. All GDPs worked within the NHS. Twenty-nine per cent of GDPs stated that they had RA equipment available in their practices and 68% stated that they discussed RA as treatment alternative. Eighty-seven per cent referred their paediatric extraction cases for dental general anaesthesia. The behavioural intention was predicted by total attitude score and the availability of RA equipment in the practice (R2=0.97, F(37,5)=260.11, P<0.001). Total attitude was predicted by clinical competency, few financial worries or time concerns and the availability of RA equipment (R2=0.91, F(38,4)=106.21, P<0.001). CONCLUSIONS: This study suggests that GDPs' concerns of clinical competence and costs have an inhibiting effect upon their intention to provide RA for paediatric extractions. These concerns must be addressed by planners and policy makers if there is to be a shift from hospital-based DGA to surgery-based RA services for paediatric extractions.

Analgesia↗
PubMed2000

[The prevalence of caries and associated factors in children 2-5 years old from the Almanjáyar and Cartuja Health Centers of the capital Granada].

OBJECTIVE: To estimate caries prevalence and associated factors in children 2-5 years old in a deprived community. DESIGN: Transversal, cross-sectional study. SETTING: Paediatric services. Health centres of Almanjáyar and Cartuja in Granada (Spain). PATIENTS: 173 children attending to a pediatric revision. MEASUREMENTS: Children's odontological examination and revision of clinical records followed by structured interview with the mother or tutor. Target variables were caries, sociodemographic factors, nutritional habits, oral hygiene, medical antecedents, familiar experience of caries and use of dentistry services. RESULTS: Total prevalence of caries was 37%, but 29% among the majority population and 58% in the gipsy group. Statistically significant associated factors with caries were: increasing age (OR = 2.0, 95% CI = 1.2-3.2), father unemployment (OR = 3.1, 95% CI = 1.3-9.9), high consumption of sweets (OR = 3.3, 95% CI = 1.1-8.5), deficient oral hygiene (OR = 9.3, 95% CI = 3.4-24.7), mother's consultation for toothache or tooth extraction (OR = 2.9, 95% CI = 1.1-7.9) and not attendance to dentistry services due to high costs or fear (OR = 4.3, 95% CI = 1.5-12.4). CONCLUSIONS: The prevalence of caries in the gipsy population is very high, and it is probably associated with factors previously reported but not yet controlled. There is a need to initiate therapeutic and preventive measures in this community, and to detect barriers and facilitate the use of public dentistry services.

Analysis of Variance↗
PubMed1998

The management of drooling in children and patients with mental and physical disabilities: a literature review.

Amongst the duties of the paediatric dentist is the provision of oral care to patients with the problem of drooling. Many, but certainly not all, of these patients have physical and/or learning disabilities. Various methods have been advocated for the management of drooling in the paediatric patient and older patients with disabilities, including behavioural programmes, biofeedback techniques, physiotherapy, biofunctional oral appliances, medication and surgery. It is of paramount importance that the patients and/or carers understand the advantages and disadvantages of any treatment method being considered. The paediatric dentist has an important role to play in explaining the different options to the patients and carers, and in implementing some treatment modalities, particularly non-surgical approaches. Referral to surgical specialists should be seen as 'a last resort' and suggested only if other treatment methods have been exhausted. If pharmacological or surgical treatment is carried out, careful monitoring for the development of dental caries and other problems is essential. The aim of this paper is to provide the paediatric dentist with concise overall knowledge of the causes of drooling and treatment options available.

Child↗
PubMed1979

Cost-effectiveness considerations in planning a preventive dental programme for British Columbia.

The Government of British Columbia, Canada, with organized dentistry, in 1974, sponsored research towards the introduction of a comprehensive children's dental programme. Dental care was at that time primarily provided by private practitioners on a personal fee-for-service basis, which system was working close to capacity. Educational and preventive dental programmes in school and health centres were sponsored by governments. Utilization of treatment services by children was estimated at a maximum of 60 per cent per annum. For the improvement of overall dental health, it was adjudged this should be at least 90 per cent. Approximately 45 per cent of children's treatment was related to dental caries. Four possible dental care delivery systems were costed. It was essential that the comprehensive programmed include proven anti-cariogenic measures and that they be the most effective in cost and in the utilization of professional personnel. Techniques for measurement of effectiveness were reviewed. Using a modified Davies cost-benefit ratio, four professionally applied and four self-administered topical fluoride systems were compared. The Knutson-Szwejda technique scored highest when used by community dental health programmes. In a private practice system or in large paediatric clinics the annual application of acidulated phosphate fluoride would be preferable. In British Columbia, experience has indicated problems with continuing school cooperation in mouth rinse programmes. Statistical proof of the effectiveness of "brush-in" programmes was adjudged as inconclusive but hopeful.

Adolescent↗
PubMed1992

The effectiveness of the yellow card warning system for paediatric cardiology patients.

Questionnaires were completed by the parents of 100 children with cardiac problems attending the regional paediatric cardiology clinic in Yorkshire. The parents' possession and knowledge regarding the use of a yellow card (warning parents and dentists of the need for antibiotic cover before certain dental treatment) was assessed. Only 57 per cent of parents reported that they had received a yellow card.

Adolescent↗
PubMed2001

Dental care of autistic children within the non-specialized Public Dental Service.

Children with an autistic disorder may need more dental care and may also be more difficult to treat than healthy children. This study compared oral health in autistic and healthy children. Also explored was the dental management of autistic children within the non-specialized Public Dental Service. The study was designed as a case-control study with all cases of autistic disorders aged 3-19 years identified within a primary care area in southwest Sweden. One dentist did a clinical investigation of cases and one control per case. The patients, or their parents, answered a questionnaire. 28 patients were identified and 20 (71%) agreed to participate in the study. Cases and controls had a similar prevalence of fillings, caries, gingivitis and degree of oral hygiene. However, the need of orthodontic treatment seemed to be greater among the autistic children. According to a standardised assessment, autistic children were less able to cooperate in the dental treatment. Approximately 30% of the cases had occasionally been subjected to specialized dental care. The results of this study indicate that the care provided to autistic children within the non-specialized Public Dental Service is satisfactory, provided that there is access to a paediatric dentist when necessary.

Adolescent↗