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Biomedical subjects

D E Gibbons

Publications and source records attributed to D E Gibbons.

35 records · Page 2Linked to original sources
PubMed1998

Reported dental attendance and perceived barriers to care in frail and functionally dependent older adults.

OBJECTIVES: This study was designed to investigate the reported dental attendance and the perceived barriers to dental care for frail and functionally dependent older adults. DESIGN: A single centre study of a housebound group of more than 60 years of age and their personal carers. SETTING: The study was carried out from a general dental practice in Ware, Hertfordshire, a market town 20 miles north of London. SUBJECTS AND METHODS: A group of 263 housebound adults more than 60 years old were identified. The subjects were living in 5 residential homes, 3 sheltered housing complexes and in private accommodation. The subjects and 115 of their personal carers were interviewed. RESULTS: 93% only attended a dentist when they had problems. The presence of natural teeth, residential status and age were all statistically significant independent explanatory variables for the time since the previous reported dental visit. Lack of perceived need was found to be a barrier to care for 86% of subjects. Cost and lack of suitable transport were also commonly identified. However, the true cost implication to a patient was poorly appreciated especially by those 34% of subjects who cited cost as a barrier. 52% of the whole group, rising with age to 75% of those more than 90 years old, expressed a preference for treatment to be carried out in their own homes. 93% of carers had found difficulty in arranging dental care for their clients but the difficulties were not always the same as the subjects' perceived barriers. Among the carers, younger, regular dental attendees who were paid to care were more likely to see benefit in obtaining dental care for their clients. CONCLUSION: The mechanisms by which these barriers to care may be lowered should be investigated in order to meet the unmet need identified by this study.

Adult↗
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↗
PubMed1998

The relationship between socio-dental indices of handicap, felt need for dental treatment and dental state in a group of frail and functionally dependent older adults.

The present study was designed to investigate the relationship between self-reported oral handicap as measured by socio-dental indicators and both dental state and felt need for dental treatment in a group of frail and functionally dependent older adults. A total of 263 housebound adults over the age of 60 years were investigated with regard to their self-reported dental handicap using the socio-dental indices derived by Locker (Community Dent Health 1992;9:109-24). Of these, 117 were in long-stay residential facilities, 67 in sheltered housing and 79 in private housing. The majority were female (76%) and the largest age group comprised 81-90-year-olds (44%), while only 8% were in the youngest group of 60-70-year-olds. A high level of handicap was recorded. In the previous 4 weeks, 74% of the group experienced difficulty in chewing, 54% some other functional handicap, 22% oral pain, 72% some incident of discomfort and 30% some social problem related to their oral condition. The socio-dental indices related more to the number of teeth than to age or gender. Ability to chew five index foods was related directly to the number of teeth present (P<0.001) but unless there were more than 20 teeth present, subjects with natural teeth were more dissatisfied with their appearance than those with complete dentures (P=0.002). The 57 subjects (29%) who expressed a desire for treatment had significantly higher handicap scores (P<0.001). Thus the results indicate that there are high levels of oral handicap in frail and functionally dependent older adults that are related to both the number of natural teeth retained and desire for treatment.

Age Factors↗
PubMed1998

The purchaser-provider split in NHS care in the United Kingdom and the role of the community dental service in planning.

The former purchaser-provider split underwent an important change during the last years in UK. Especially since the new government came into office in 1997 the approach to equity and equality in dental health care has been characterised by two decisions. Firstly, the level of commissioning services was shifted from the centre to so-called natural communities of about 100,000 people. Secondly, the groups responsible for planning and providing care are constituted from local medical practitioners, community nurses and social services representatives, in line with the Regional Health Authority and the national framework "Our Healthier Nation". The new community dental service is expected to be in a better position to improve the situation in areas of social exclusion.

Community Dentistry↗
PubMed1996

Stress in dental practice: a qualitative comparison of dentists working within the NHS and those working within an independent capitation scheme.

A qualitative research methodology was used to compare the stress experienced by dentists working under two different systems of remuneration. No absolute difference was found in the levels of stress experienced by the two groups, as measured by a questionnaire measure of stress experience. Both groups of dentists identified patient management, time pressures and staff and practice management as sources of stress, though the independent capitation scheme dentists felt that they were under less time pressure and faced considerably less paperwork. Techniques for stress management identified by the dentists were limited and symptom-focused. The results suggest that, for dentists at least, changing from NHS to an independent capitation scheme is of great benefit.

Adaptation, Psychological↗
PubMed1996

Dentaline: an out of hours emergency dental service in Kent.

Following wide consultation in 1991 on how to meet the requirement for out-of-hours emergency service provision, Kent Family Health Services Authority established three emergency dental clinics. The sites chosen were in or adjacent to District General Hospital Accident and Emergency Departments. Local dentists were contracted to provide a service each evening and also weekend and bank holiday mornings. Activity is reported for the three and a quarter year period from October 1991 to December 1994 with 300 dentists operating a rota to attend the clinics to provide 'occasional treatment' for all-comers. Drugs, if required, are dispensed directly and, where appropriate, NHS charges levied. On average, each operator works once every 3 months.

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↗