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At least 775 records · Page 43Linked to original sources
PubMed2003

Promoting sugar-free medicines: evaluation of a multi-faceted intervention.

OBJECTIVE: To evaluate an intervention to increase the proportion of medicines prescribed as sugar-free formulations by general practitioners. BASIC RESEARCH DESIGN: Natural experiment. SETTING: Interventions were set in Camden and Islington Health Authority with comparator data within that and adjacent health authorities. PARTICIPANTS: General medical practices. INTERVENTIONS: Two interventions were employed. A prescribing incentive scheme that used the proportion of medicines prescribed as sugar-free formulations as a quality marker for general practitioners and a publicity campaign for health care workers and members of the public. MAIN OUTCOME MEASURES: The proportions of amoxycillin mixture and all paracetamol liquid preparations that were prescribed in sugar-free formulations. RESULTS: Sugar-free prescribing in the practices participating in the incentive scheme increased from 27% to 45% whereas non-participating practices showed a decrease from 20% to 14%. The proportion of prescriptions for sugar-free formulations increased by approximately one half across the entire health authority so that after two years Camden and Islington had the highest level of prescribing of sugar-free paracetamol and amoxycillin in London. CONCLUSION: These data provide compelling evidence of the effectiveness of the prescribing incentive scheme whereas the publicity campaign did not change prescribing behaviour.

Acetaminophen↗
PubMed2004

Evaluation of a fissure sealant program as part of community-based teaching and training.

Since 1995 the Department of Community Dentistry of the University of Pretoria has been involved in the rendering of mobile primary oral health care services to children in the Hammanskraal area of Gauteng, South Africa, as part of their students' community-based training. Mokonyama Primary School was identified as the first school where a primary oral health care service could be rendered. The objective of this study was to evaluate the impact (outcomes) of a fissure sealant program on the dentition status of the school children. Seven years after the implementation of the program, the dentition status of children at Mokonyama was compared with that of a comparable group of children from the same area who were not exposed to the program. The results showed that the decayed, missing, and filled teeth in the primary dentition (dmft) in the six-year-old group in Mokonyama (1.74) did not differ significantly from the dmft (1.43) of the control group (p = 0.49). The decayed, missing, and filled teeth in the permanent dentition (DMFT) of 0.59 for the fifteen-year-old group in Mokonyama, however, differed significantly (p = 0.0001) from the DMFT of the control group (2.38). Fifteen-year-old children in Mokonyama had 75.2 percent fewer caries than their counterparts in the control group.

Adolescent↗
PubMed2004

Why not gold? Contemporary esthetics and restorative practice.

In today's dental world, there are many more options of materials and equipment than there was years ago. It can be very confusing for anyone to sift through the marketing and lectures and determine which of the new materials are best suited for our patients. Classic gold techniques have been around for over 100 years and have an obvious track record. Leinfelder (7) has stated, "Gold alloys are certainly the best materials by far in terms of maintaining a functional occlusion and longevity." Underutilized in the recent past, gold is undergoing a comeback in many areas. A major dental company recently introduced a new casting gold and recent advertisements for gold-related products have reappeared in dental magazines. It is incumbent upon the modern dental professional to be aware of all the restorative options available, learn how to perform them, and then choose the technique that will be the most appropriate for each situation. Longevity should always be a factor in the decision making process and gold is the answer in many applications.

Crowns↗
PubMed2004

Examiner agreement in the replacement decision of Class I amalgam restorations.

The aim of this study was to investigate interexaminer and intraexaminer agreement in the replacement decision for Class I amalgam restorations. Three examiners evaluated the restorations clinically and with bitewing radiographs. One hundred and twelve restorations were evaluated for secondary caries, body fracture, deficient anatomic form (contour), ditched margins, and marginal overhangs. After one month, the assessments were repeated by the same examiners under the same conditions. Cohen's Kappa analysis was used to analyze the data. The number of replacement decisions varied from 12 to 27 and from 6 to 14 at the first and second evaluations, respectively. The Kappa statistics indicated "moderate" to "substantial" consistency for interexaminer and intraexaminer agreement in the replacement decisions based on clinical and radiographical examinations. Restorations with deficient anatomic form and marginal overhangs presented the most frequent diagnostic difficulties and lead to disagreement among examiners. The most frequently mentioned reasons for replacement were the restorations had ditched margins at both clinical evaluation periods and secondary caries was detected during radiographical evaluations. In the absence of agreement among examiners, clinical and radiographic guidelines are necessary for replacing Class I amalgam restorations.

Adolescent↗
PubMedDate not supplied

Repair or replacement of amalgam restorations: decisions at a USA and a UK dental school.

Whereas replacement of failed restorations is the major treatment for adults in dental practice, repair is an important alternative with the potential to save tooth structure and increase the longevity of restorations at a lower cost. This in vitro study recorded the choices of treatment for the same set of teeth with defective Class II amalgam restorations by students and faculty at two dental schools (University of Manchester, UK and University of Florida, USA). Treatment options (monitor, refurbish, repair and replace) and reason(s) for the choice of treatment for 24 marked amalgam restorations were selected. Overall, participants more frequently chose replacement of restorations; whereas, repair was the least favored option. The reasons cited the most to replace restorations were secondary caries including unsightly appearance, partially lost restoration and tooth fracture; for repair, the major reasons included loss of part of the restoration and marginal ditching; and for refurbishment, the major reasons included poor anatomic form and marginal ditching. There was a significant difference between the students and faculties at the two sites in their choice of treatment (p<0.0001; Chi-square test). The treatment decision to "monitor" the restorations was more frequent for the Manchester site than the Florida site. Conversely, the combined treatment decisions to "refurbish, repair and replace" were more frequently chosen in Florida than in Manchester.

Adult↗
PubMed2004

Will dentistry be left behind at the healthcare station?

The emerging opportunities for biological approaches to managing oral health were clearly apparent fifteen years ago. Responses in this direction have been tardy because of the economic prosperity of dental practice and the financial constraints on dental education. Representative existing and promising biology based technology is described. It is argued that education must be changed to teach the context and understanding of this technology. The alternative will be to concede important aspects of oral health care to physicians and others trained in their use.

Biological Therapy↗
PubMed2005

The relationship between children's dental caries experience and the prescription of general anaesthetics. an evaluation of the effectiveness of a Personal Dental Service Pilot.

OBJECTIVES: To determine if there was a high correlation between the prescription of a general anaesthetic for dental treatment in young children by a Personal Dental Services (PDS) general anaesthetic pilot and the dental health of children at a ward level. BASIC RESEARCH DESIGN: Postcode data from an audit of the single dental general anaesthetic provider in an area was extracted and mapped to individual wards. A proxy for the oral health population was obtained by using the results of a large-scale dental prevalence study of five-year-olds. The wards were ranked into quintiles by dmft and a mean dmft calculated for each. There were 1,406 patients who had a general anaesthetic, 74% were aged 11 years or less. SETTING: A personal dental service dental general anaesthetic pilot in the north of England providing services for a population of approximately 300,000 residents in a non-fluoridated area. RESULTS There was a positive correlation between increasing levels of dental decay in the population and increasing intervention ratios for dental treatment under general anaesthesia (r2 = 0.90). CONCLUSIONS: The PDS pilot provided dental care under general anaesthesia for more patients from wards with poor dental health than from wards with better dental health.

Anesthesia, Dental↗