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Biomedical subjects

A Sheiham

Publications and source records attributed to A Sheiham.

At least 145 records · Page 8Linked to original sources
PubMed1983

Delivery programmes for elderly and isolated populations.

The provision of dental care for the elderly and for other isolated population groups cannot be ignored. In particular, special provision must be made for the housebound and institutionalized elderly as well as for those who are isolated for social or medical reasons. Continuous liason with social service personnel and health service workers, as well as with voluntary agencies, is essential for identifying and treating these populations. The assessment of dental treatment needs must take account of the clinical dental status of the subjects, their demands for treatment and their oral handicaps. The aims should be to treat overt oral and dental pathology and to relieve oral handicaps. Treatment should be readily available and must not be an added burden for those who are already medically or socially disadvantaged. Careful consideration must be given to treatment and manpower requirements. The dental team should consist of people who are particularly skilled at treating elderly and/or handicapped people. Schemes for domiciliary visits should be devised and facilities such as mobile dental units and dental surgeries within long-stay hospitals should be made available. Most importantly, in order to provide an appropriate ongoing dental service, dental personnel and other health workers must be totally committed to making quality dental health care available to all.

Adult↗
PubMed1982

Medical theories and professional development. The theory of focal sepsis and dentistry in early twentieth century Britain.

This paper traces the history of the theory of focal infection--which related a number of general conditions to septic foci from which toxic products spread to different parts of the body--and its application to dental diseases in early 20th century Britain. Bad teeth were said to be one of the major sources of infection and a cause of many diseases. The paper focuses on the social and professional context in which the theory emerged and flourished. It shows that in spite of its lack of scientific foundation, the theory of focal sepsis was readily accepted by the dental profession and used to advance its claims for professional recognition. Thus the paper attempts to illustrate the point that the acceptance of a medical theory by health practitioners is as much determined by social and economic factors as by its therapeutic potential or its scientific validity.

Focal Infection, Dental↗
PubMed1982

The concept of need in dental care.

The most commonly used methods of assessing need for treatment are based solely on clinical criteria. Recently, it has been recognized that a wider interpretation than that provided by clinically assessed need is required. Measures of need should include the impact of ill health upon individuals, the degrees of dysfunction and the perceptions and attitudes of patients. Although there is no generally agreed definition of need, the taxonomy suggested by Bradshaw (1972) is recommended. He divides need into normative, felt, expressed and comparative types. One of the major shortcomings of all methods of assessing need is that they do not assess the need and propensity for preventive care and health education. A more realistic assessment of treatment needs should include the functional and social dimensions of dental disease and an assessment of the social and motivational factors which predispose people towards dental ill health and influence the effectiveness of treatment and health education. Some dental needs are not very well assessed. In particular, the assessment of the need for treatment of malocclusion, whilst claiming to be objective, does not incorporate measures of lay perception or impact of the condition. Instead of relying only upon purely clinical methods of assessing needs, the development of sociodental indicators is required. This will encourage a shift in emphasis away from the mechanical to the behavioural aspects of treatment and the development of a health-orientated model of care in preference to the sickness model that dominates current dental services.

Dental Care↗
PubMed1981

Retrospective longitudinal study of the rate of alveolar bone loss in humans using bite-wing radiographs.

This study investigates the possible use of unstandardized bite-wing radiographs to determine the rate of alveolar bone loss over long periods of time. A total of 100 pairs of bite-wing radiographs obtained from patients of two general dental practitioners were read on a 3M Reader, normally used for reading microfilm. For the purpose of measurement, two reference points were selected on the teeth; the highest point on the occlusal surface of the crown, the mesial and distal points of the cemento-enamel junction. Both vertical and horizontal bone loss was measured. Initially bone levels on 20 full mouth bite-wing radiographs on all posterior teeth were measured, then in the next 80 cases, an abbreviated index was used. The bone heights were first examined at the beginning and then at the end of a 10-year time span. The percentages of measurable distances were 28% and 57%. From the Occlusal measurement point and the C E J measurement points, reasons for unreadability were also recorded. The annual rate of horizontal bone loss was 0.06 mm and 0.04 mm from the Occlusal reference point and the CEJ reference point. The rates for the vertical bone loss was 0.05 and 0.03 mm. In order to study whether there was a constant loss over a period of time, bone levels were measured in 10 successive years. The findings suggest that the bone loss rat per year fluctuated. The study suggests that the bite-wing radiographs can be used in longitudinal studies of periodontal disease and can provide important information on the natural history of the disease.

Adolescent↗
PubMed1980

An analysis of factors affecting compliance with tooth-cleaning recommendations.

A study was undertaken on a group of patients who have had periodontal treatment in an attempt to test some of the predictions of the "Health Belief Model" (Rosenstock et al. 1966). This present study set out to test whether (1) persons who knew they had periodontal disease (hence considered themselves susceptible) (2) thought the condition serious and (3) had a knowledge of how to prevent the disease (4) were effectively complying with a previously prescribed oral hygiene regimen. The study was conducted at a school of dental hygiene, providing a source of patients attending specifically for periodontal care and where the format of hygiene instruction and treatment is largely standardized. A questionnaire was designed to assess (1) attitudes and beliefs (2) knowledge of the disease (3) reported behavior. Gingival health was measured using Gingival Index (Löe & Silness 1963) and patients actual behavior was measured using the Plaque Index (Silness & Löe 1964). The majority of the highly motivated patients in the study were concerned with their susceptibility to, the seriousness of, and the benefits of treatment for periodontal disease. They were stimulated to take action by a cue, bleeding gums. These findings confirm the predictions made in the Health Belief Model. However, none of the factors in the Health Belief Model were significantly associated with the gingival health status of the patients, indicating that other factors were important for patients to clean their teeth effectively. It was also shown that information is not necessary followed by a change in behavior.

Adult↗
PubMed1980

Dental treatment needs and demands of an elderly population in England.

A sociodental investigation was conducted among 254 elderly people living at home in Nottingham. A clinical assessment was made of the subjects' dental treatment needs and this was compared with the subjects' felt and expressed needs. Seventy-eight percent of the sample were clinically judged as needing dental treatment, mainly some form of prosthetic treatment. There was, however, a wide discrepancy between the normative and perceived needs of this elderly population. Only 42% of those who were clinically assessed as needing treatment felt that they required it and only 19% had actually tried to obtain it. Many of the elderly mentioned a number of barriers to obtaining dental care; these included the cost of treatment, fear of the dentist, immobility and the feeling that they should not "bother" the dentist

Aged↗