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PubMed1997

A sociodemographic analysis of inpatient oral surgery: 1989-1994.

This retrospective study was designed to assess the socioeconomic status of patients who underwent inpatient oral operations from 1989 to 1994 in the area covered by the West Midlands Regional Health Authority and to compare the distribution with those people treated by other specialties. A total of 4,926,438 hospital inpatient finished consultant episodes within 56 specialties that were recorded on the Hospital Episode Statistics database, of which 61,360 (1.25%) were dental (coded as oral surgery, restorative dentistry, orthodontics, and paediatric dentistry). The main outcome measure was the socioeconomic status of patients as assessed by the Townsend score (a measure of material deprivation that covers car ownership, home ownership, overcrowding, and unemployment). There was a highly significant correlation between the use of all inpatient services and social deprivation (R2 = 0.98, P < 0.001). This observation was consistent across all specialties except oral surgery, in which the correlation was reversed (R2 = 0.69, P < 0.001), indicating that patients who avail themselves of inpatient oral surgery are from a higher socioeconomic group. The application of a deprivation index to hospital episode data will enable purchasers and providers to measure more accurately the impact of their services on groups within the community.

Automobiles↗
PubMed2002

Stress in dental specialists: a comparison of six clinical dental specialties.

OBJECTIVE: To describe and compare the levels of stress reported by dental practitioners working within clinical dental specialties. METHOD: Questionnaire survey of 220 dental practitioners identified from the General Dental Council lists of specialist practitioners in the following clinical specialties: orthodontics, paediatric dentistry, restorative dentistry, endodontics, periodontology, prosthetic dentistry. FINDINGS: The clinical specialties did not differ in their reported levels of stress. Practitioners working in the field of paediatric dentistry reported the highest median levels of reported stress for three of the four scales, though this trend was not significant. CONCLUSIONS: The practitioners surveyed from six clinical specialties did not experience significantly different sources of stress.

Adult↗
PubMed2006

A survey of specialist paediatric dental services in Sweden: results from 2003, and trends since 1983.

UNLABELLED: The child population in Sweden has changed dramatically during the last 20 years. Changes have also occurred within the Public Dental Service (PDS), regarding the provision of dental care to children and adolescents. All these changes may affect the referral pattern and provision of specialist dental care for children and adolescents. OBJECTIVES: The primary aim of this study was to survey the services provided by specialists in paediatric dentistry in Sweden during 2003. A secondary aim was to compare the results with previous surveys. METHODS: A Web-based survey was sent to all 34 specialist paediatric dentistry clinics and was answered by all clinics. Data were compared with results from the surveys performed in 1983, 1989, and 1996. RESULTS: The number of paediatric dentists had been relatively constant over the last 20 years, whereas the number of children referred to paediatric dentists had increased by 28% since 1983. It was estimated that 1.3% of all children in Sweden are treated at a specialist paediatric dental clinic in 2003. Dental treatment need in combination with behaviour management problems (BMP) was the main reason for referral and occurred in 37% of all referrals. The proportion of medically compromised children/children with disabilities had increased from 6% in 1983 to 22% in 2003. The number of patients treated using sedation and general anaesthesia had increased since 1983, and particularly since 1996. CONCLUSIONS: Despite improvements in dental health among children and adolescents in Sweden during the last 20 years, an increasing number of children are referred for specialist paediatric dental treatment. There is an urgent need to increase the number of specialist paediatric dentists in Sweden in order to ensure the continuation of high quality of dental care for children and adolescents.

Adolescent↗
PubMed2004

Restoration materials for primary molars-results from a European survey.

OBJECTIVE: The aim of this study was to obtain an overview of the materials and restorative techniques taught for Class I and Class II restorations in primary molars of different European departments for paediatric dentistry and to compare the results to those for North America. METHODS: The forms were sent to the chairmen of the departments of paediatric dentistry or-when included into the department for operative dentistry-to the director of 200 universities in 32 European Countries. The questions concerned the preferred materials and techniques, as well as the indications or contraindications for the use of the different tooth coloured materials. RESULTS: Forty-three percent of the universities from western European countries (excluding Germany) responded to the survey. A 97% answer rate was obtained from German Schools. Of the other European regions, the response rate varied remarkably (24-54%). Also, opinions on materials used and methods applied were different from country to country. Only in a few regions (Eastern Europe), amalgam remains the filling material of first choice for Class I and II cavities in primary molars, whereas in others, the use has been restricted and tooth coloured materials, especially compomers or resin-modified glass ionomer cements, are being preferred. CONCLUSIONS: Great diversity in teaching was observed not only among the European countries, but also within the countries themselves which makes it difficult to compare the results of our study to the ones obtained from the US.

Compomers↗
PubMed2007

The effect of a community dental service outreach programme on the confidence of undergraduate students to treat children: a pilot study.

OBJECTIVE: To examine the effect of a community dental service (CDS) outreach teaching programme on undergraduates' confidence to undertake a range of paediatric dental procedures. METHOD: Eighteen final year dental students completed a questionnaire prior to, and following participation in an outreach teaching programme. At each time point, the students were asked to identify how confident they felt to carry out a range of procedures commonly encountered in the treatment of children, employing a Likert scale modified to comprise six points where a rating of 1 represented 'not at all confident' and a rating of 6 'very confident'. RESULTS: The distribution of scores at each time point indicated that students were more confident to carry out each of the listed procedures following participation in the outreach teaching programme than they had been on completion of their paediatric dentistry sessions within the School of Dentistry. At the individual student level, 16 of the 18 students indicated that they were, overall, more confident following their placement than previously. CONCLUSIONS: It can be concluded that the long-established CDS outreach teaching programme run by the School of Dentistry, Wales College of Medicine in conjunction with the staff of Cardiff and Vale NHS Trust is a valuable adjunct to undergraduate teaching in paediatric dentistry.

Community Dentistry↗
PubMed1998

[Use of fluorides in children: recommendations of the European Academy for Pediatric Dentistry].

The European Academy of Paediatric Dentistry (EAPD) strongly endorses that fluoride use should be part of any preventive programme for the control of dental caries in children. Each child under the care of a dentist should have a carefully planned programme appropriate to the level of caries risk and age of each child. Such a preventive programme should be reevaluated at least every six or 12 months and changed according to the patient's risk and the improvement or not of his or her's overall health. It is the combination of the use of an appropriate fluoride toothpaste with good oral hygiene that is the key to good dental health. This policy document deals with guidelines for systemic use of fluorides, fluoride supplements, topical methods (varnishes, mouthrinses and gels) and toothpastes. Moreover some recommendations are given to toothpaste manufacturers.

Age Factors↗
PubMed2005

Clinical features of hypodontia and associated dental anomalies: a retrospective study.

OBJECTIVE: Hypodontia is the most commonly known developmental dental anomaly in man. This paper aims to investigate the characteristics of tooth absence and associated dental anomalies among the patients attending our paediatric dentistry clinic. SUBJECTS AND METHODS: For this study, 192 patients aged between 1 and 18 years with congenitally missing teeth were selected among the patients who attended the Department of Paediatric Dentistry of Süleyman Demirel University between January 2000 and December 2003. Clinical and radiographic examinations were performed by two dentists in order to detect the missing teeth. RESULTS: We determined 503 congenitally missing teeth in 192 patients (male = 93, female = 99), excluding third molars. Twelve of these teeth were deciduous and 491 were permanent. A higher incidence of missing teeth was observed in girls than boys, in mandibular arch than maxillary and on the right side than left side. However the differences between arches and sides were not statistically significant in both sexes. CONCLUSION: The diagnosis of the hypodontia should be performed as early as possible, thus alternative treatment modalities can be planned and performed in a multidisciplinary team approach, in order to establish an aesthetic and functional dentition in the future.

Adolescent↗
PubMed1989

[Caridex--conscious sedation association. A new approach in pedodontics].

Psycological approach and analgesia are very important in paediatric dentistry. Sometimes the first is not enough and it is necessary the use of pharmacological methods. They are represented with sure and useful technique like "relative analgesia" with N2O/O2. The use of Caridex method is also very good in operative paediatric dentistry because there is not the necessity of local anesthesia with injection and the use of burns and drills. The AA. have connected together these two methods, and they present some very interesting clinical reports. With Caridex it's possible to remove only decayed dentine saving so the healthy dentine and reducing fear and stress in very young children. The association with relative analgesia permits to do a very early and global therapy in children also very young (24-36 months). The AA. have obtained a reduction of hemotivity, of odontogenous stress, and last but not least with this method there is the opportunity to avoid the general anesthesia.

Aminobutyrates↗
PubMed2005

A prospective study of the use of nitrous oxide inhalation sedation for dental treatment in anxious children.

AIM: To determine baseline data in relation to procedures undertaken during nitrous oxide inhalation sedation sessions within the Hospital Dental Service. STUDY DESIGN: A prospective study. METHODS: Data was collected over a twelve-month period for patients attending the Department of Paediatric Dentistry, Dundee Dental Hospital, Dundee, Scotland, for dental treatment using nitrous oxide inhalation sedation. Overall behaviour and the outcome of treatment were assessed by the dentist providing sedation using the Frankl and Houpt Behaviour Rating Scales respectively. RESULTS: Data was available for 312 patients (F:169; M:143) with a median age of 11.0 (inter-quartile range 8.8, 12.7) years. Overall, 93% of patients successfully completed treatment using sedation. The majority of treatments comprised dental extractions; 19.8% and 41.3% were primary and permanent tooth extractions respectively. Regarding permanent teeth, nearly 50% were first permanent molar extractions compared with just over 30% for first premolars. Nearly three-quarter of cases were treated using a mixture of 30% nitrous oxide and 70% oxygen, with a median sedation time of 35.7 minutes. Only 7% of cases failed to commence or complete treatment and overall, there was a greater failure rate amongst visiting Community Dental Officers, compared with Hospital-based clinicians. CONCLUSION: Extraction of first permanent molar teeth can be successfully achieved using inhalation sedation. There is both a need for further postgraduate training in sedation techniques as well as the necessity to train further Specialists in Paediatric Dentistry to undertake care within the Community Dental Service.

Adolescent↗
PubMed2006

Undergraduate training as preparation for vocational training in England: a survey of vocational dental practitioners' and their trainers' views.

AIMS: To compare the views of new vocational dental practitioners (VDPs) and their trainers regarding how undergraduate dental education has prepared them for their vocational training (VT) in England. This study also aims to identify areas of relative weakness in dental undergraduate education that could influence the future training needs of vocational trainees. METHOD: Structured postal questionnaires were completed by VDPs and trainers from five Deaneries in England. The usable response rate was 71% (n = 186 VDPs and 186 trainers). RESULTS: The vast majority of VDPs and trainers perceived the undergraduate training in history taking, diagnosis and treatment planning for general practice to have been covered 'well' or even 'very well'. Undergraduate training in routine restorative dentistry, oral pathology and paediatric dentistry was also perceived to have been covered well. However, a large proportion of VDPs and trainers reported that they felt that undergraduate training in orthodontics, molar endodontics, surgical endodontics and surgical extraction of teeth had not adequately prepared them for VT. CONCLUSIONS: Newly qualified dentists appear to lack certain competencies recommended by the General Dental Council in The First Five Years. This has implications for dental undergraduate education, but also highlights current training needs during VT.

Attitude of Health Personnel↗
PubMed1993

Analysis of paediatric dental services provided at a regional hospital in Sweden. Dental treatment need in medically compromised children referred for dental consultation.

All inpatients at a regional hospital in Sweden referred for a paediatric dental consultation (n = 269) were studied retrospectively during a two-year period. The children were studied concerning their medical and oral condition and subsequent dental treatment. The most frequent medical condition among the referred children was insulin dependent diabetes mellitus (20%), asthma (9%) and epilepsy (7%). Children with asthma exhibited a significantly increased caries prevalence (p < 0.01) compared to other chronically sick children. Of the children examined 53% were diagnosed with diseases or abnormalities in the oral cavity requiring treatment. Gingivitis, disturbances in occlusal development and dental caries were the most commonly found diagnoses Acute dental or oral problems were diagnosed in 9% of the children. The mean time allocated for each patient was 60 minutes. Thirty percent of the children were subsequently treated at the paediatric dentistry specialist clinic. In conclusion the study emphasises the need of paediatric dental consultation services at regional hospitals.

Adolescent↗
PubMed2004

A prospective comparison between findings from a clinical examination and results of bitewing and panoramic radiographs for dental caries diagnosis in children.

AIM: To compare the findings of a clinical examination with those from bitewing (BW), panoramic (Pan) and panoramic plus bitewing (PanBW) radiographs for dental caries in children. METHOD: A population of 39 children, aged 3.8 to 11.9 years, who required radiographs as part of their initial assessment for care in the Department of Paediatric Dentistry (Leeds), was selected. Each subject was examined clinically for dental caries. Subsequently, a paediatric dentist and a specialist in dental radiography read the radiographs. ANALYSIS: A database in Microsoft Access was used to compare the examiners readings for each radiographic view; agreements were taken to be a consensus. Disagreements were re-viewed by both examiners to arrive at a consensus. Radiographic results were compared with those of the clinical examination. RESULTS: The clinical examination identified 6.0% (95% CI 4.1 to 7.8, p<0.001) more carious surfaces than Pan. Clinical examinations also identified more carious surfaces than BW 1.2% (95% CI -0.7 to 3.2, p<0.247) and PanBW 0.6% (95% CI -1.1 to 2.3, p<0.533) but these differences were not statistically significant. When occlusal surfaces only were compared, the clinical examination identified significantly more carious occlusal surfaces then BW (15.2%, p<0.001), Pan (17.1%, p<0.001) and PanBW (13.5%, p<0.001). Comparing the approximal surfaces only, the BW and PanBW identified significantly more carious surfaces than the clinical examination, 5.1% (p<0.001) and 4.3% (p<0.001) respectively. CONCLUSION: The use of a clinical examination with PanBW provided the maximum information on dental caries in the primary and mixed dentitions, particularly for approximal surfaces. This is important in planning comprehensive dental care for children.

Chi-Square Distribution↗
PubMed2006

[Clinical evaluation of digital imaging].

The rapid progression of digital radiography makes us consider its role in different fields of dentistry. The aim of the present survey was to evaluate the advantages of digital imaging over the use of radiographic films in the diagnosis and therapy of common oral pathologic conditions. The underlying hypothesis was that RadioVisiograph (RVG, Trophy Radiology, Marne-la-Vallée, France)--provided that there is access to this digital network--is easily available. Thus it can provide options for specialists of different dental fields to obtain more detailed information in order to make better decisions. Immediately after the installation of the new system and then, ten months later we analysed the results of digital images and radiographic films in outpatients of different sections at our clinic. The quality of both diagnostic procedures was evaluated using a questionnaire. Digital imaging was used mainly by specialists of endodontics, followed by restorative and prosthetic dentistry in setting up the diagnosis. The application of this new technique in parodontology and paediatric dentistry was negligible. However, it is worth mentioning that the majority of dentists participating in the survey thought that conventional radiographic films gave more detailed imaging than the digital technology. To sum it up, currently, digital imaging systems may represent an efficient device in diagnostic and therapeutic procedures. Nevertheless owing to the technical sensitivity of the above systems, traditional radiographic techniques should also be used as an option due to their advantages.

Dental Caries↗
PubMed1989

Criteria for approval of training programmes for senior registrars in orthodontics in the United Kingdom.

To be appointed as a consultant orthodontist in the British National Health Service requires a period of 3+ years in a higher training post as a senior registrar in orthodontics. Educational approval of these training posts is controlled by the Joint Committee for Higher Training in Dentistry. The detailed monitoring and requirements of senior registrar training posts are controlled by the Specialist Advisory Committee in Orthodontics and Paediatric Dentistry. Revised criteria for the approval of training programmes have recently been issued and are appended for the guidance of aspirant trainees, trainers and for the reader seeking an understanding of the UK title of 'Consultant Orthodontist'.

Consultants↗
PubMed1999

Child protection: a survey of experience and knowledge within the dental profession of New South Wales, Australia.

AIM: To establish the experience and knowledge of dental practitioners in New South Wales, Australia in the area of child abuse and protection. DESIGN: A cross-sectional telephone questionnaire. SAMPLE: One hundred and twenty-two interviews; 67 general dental practitioners randomly selected and 55 members of the Australia and New Zealand Society of Paediatric Dentistry. RESULTS: All of the dentists interviewed could identify physical abuse and most identified emotional abuse, however, none could describe all five forms of abuse. Significantly more (58%) members of the paediatric dental society had at some time suspected abuse, compared with only 24% of the general practitioners. However, only 20 of the paediatric dentists and seven general practitioners had actually reported any cases. The main reason given for not reporting concerned confidentiality. Seventy-two per cent of general practitioners did not know their legal obligations or with whom they could discuss any concerns. While paediatric dentists achieved a better percentage, still over half of them were similarly unsure. CONCLUSIONS: Further education and training is required for both the dental profession and the child protection agencies to improve the inter-agency working relationship and thus provide better protection for children.

Attitude of Health Personnel↗
PubMed1992

The British Dental Journal: a report on its activities 1986-1991.

The contents of 139 issues of the British Dental Journal, published between January 11, 1986 and December 1991, have been analysed. Part I of the Journal contains, on average, one Leader, eleven items of news and notes, 12 letters and eight abstracts/book reviews. One thousand, three hundred and seventeen manuscripts were submitted for publication during the 6-year period. Of these, 403 original articles, 119 case reports and 203 review articles were accepted and published in Part II. Part III of the Journal is devoted to annual and other reports and policy documents, worldwide dentistry, practice management and vocational training, dental electives, trade news, meeting reports and obituaries. Over 40 'strap headings' denoting specialised areas of dentistry were used to describe articles published. Almost one-fifth of the papers were concerned with restorative dentistry. Case reports comprised 14% of the papers published. Oral surgery/oral medicine/oral pathology, and related subjects accounted for nearly 15% of papers published. Articles concerned with community dental health, orthodontics and paediatric dentistry accounted for a similar proportion of the total, as did the section comprising general dental practice, vocational training and practice management. Anaesthesia, analgesia, medical topics, microbiology and therapeutics took up 12% of articles published. The remaining 12% consisted of articles on dental education and research, oral biology, dental history, auxiliaries, dental instruments and diagnostic aids.

Humans↗
PubMed2003

Restoring proximal lesions in the primary dentition: is glass ionomer cement the material of choice?

Adhesive dental materials are now routinely used in paediatric dentistry to restore the proximal lesion. One of these materials, glass ionomer cement (GIC), has a number of advantages including ease of use, the release of fluoride, and acceptable aesthetics. These properties have led to GIC becoming one of the most widely used materials in Australasia in the paediatric population. Although there are a number of advantages for the use of GIC in the primary dentition the drive towards evidence based dentistry requires us to ask the question--is GIC the material of choice for class II restorations in primary molars? This article describes the advantages and disadvantages in the use of the different types of GIC in the primary dentition and compares its success in this group with other dental materials commonly used in class II restorations.

Child↗