Biomedical subjects

D M O'Mullane

Publications and source records attributed to D M O'Mullane.

At least 19 recordsLinked to original sources

PubMed1998

Variation of salivary flow rate in adolescents.

Forty-three children living in North Wales, an area with a temperate climate, were involved in this study from September 1990 until June 1991 inclusive. By standardizing the method and timing of collection the effect of external factors on the salivary flow rate was minimized. Flow rate was assessed once a month. Of the original group of 43, 18 attended at each occasion; these were termed the "regular attendees". Repeated-measures analysis of variance indicated that unstimulated salivary flow rate varied within an individual over time in both the total (43, p < 0.001) and the regular groups (18, p < 0.001). This relation remained when the initial September and October measurements were excluded (p < 0.05, n = 43). When the subgroup, the regular attendees (n = 18), was considered, this relation almost reached statistical significance when September was excluded (p = 0.052) and when both months were omitted the association was no longer evident (p = 0.094). Similar to previously published results from a study of individuals in a subtropical climate, salivary flow-rate variation was inversely associated with ambient temperature in both the total (n = 43) and the subsection of regular attendees (n = 18) (p < 0.05).

Adolescent↗

PubMed1997

A three-year clinical trial of a combination of trimetaphosphate and sodium fluoride in silica toothpastes.

The relative efficacy of NaF silica toothpastes containing 1000 ppm fluoride and 1500 ppm fluoride in the control of dental caries is not clear-cut. Also, it has not been established that incorporation of trimetaphosphate (TMP) improves the anticaries activity of NaF toothpastes. A three-year clinical trial was conducted to test the hypotheses that: (i) the anticaries activity of NaF toothpastes containing 1500 ppm F was greater than that of NaF toothpastes containing 1000 ppm F, and (ii) inclusion of TMP improved the efficacy of NaF silica pastes. Subsidiary aims included determination of whether frequency of toothbrushing and method of rinsing after brushing were correlated with caries increments. The study involved 4196 children aged 11 to 12 years at outset. These participants had been selected from a pool of 7374 potential subjects on the basis of caries experience and dental eruption pattern. They were stratified by sex, examiner, and presence of calculus and caries, and were allocated at random to one of the four toothpastes under study. Using mirror and probe and also FOTI, we carried out clinical examinations at baseline and annually thereafter for 3 yrs. Bitewing radiographs of a subset of children were taken at baseline and at the end of the study. The outcome measure for the study, DMFS increment, was defined as the increase in caries over 3 yrs, taking into account changes occurring on individual tooth surfaces. Data for 3467 subjects were available for analyses at both baseline and year 3 examinations. Radiographs were taken for 1942 subjects at both baseline and year 3 examinations. The mean three-year clinical-only DMFS increment for the subjects using 1500-ppm-NaF pastes was 3.93, which was 6% lower than the corresponding mean of 4.19 for the 1000-ppm-NaF pastes. There was no significant difference between the mean DMFS increment for those using paste with or without TMP. Subjects who claimed to brush more frequently or who claimed not to use a tumbler to rinse after toothbrushing had lower three-year DFMS increments.

Analysis of Variance↗

PubMed1997

Costs in providing facilities for treatment of handicapped patients under general anaesthesia.

The cost of providing dental treatment for severely mentally/physically handicapped patients under general anaesthesia in a specially designed unit are investigated in this study. The costs involved in the provision of such treatment were found to be high at 613 IR Pounds per patient. It is recommended that the full potential of primary care services for handicapped patients be developed in order to reduce the use of these necessary, but expensive secondary care facilities. It is also recommended that such facilities should be shared with other services in order to reduce overall costs.

Anesthesia, Dental↗

PubMed1996

Identification of areas with high levels of untreated dental caries.

In order to examine the geographical variation of dental health within 10 county districts in North Wales, 3538 children were examined. The associations between three demographic indicators, based on the 1981 OPCS census, and dental health outcomes were assessed for electoral wards within the county districts. The Townsend and Jarman indices were the first two indicators employed and the third was based on a mathematical model representing the variation in the mean number of untreated decayed surfaces per person for the wards. This model was developed using the children examined in the five most westerly county districts. Using the data derived from the five most easterly county districts, the three indicators were assessed. All three showed strong correlations (r > or = 0.88) with dental health. These results indicate that measures of dental health based on large administrative units may obscure variation within them. It is concluded that geographical methods of this type may be useful for targeting dental resources at small areas with high levels of need.

Catchment Area, Health↗

PubMed1996

Drinking water fluoride levels, dental fluorosis, and caries experience in Brazil.

OBJECTIVES: The main aim of this study was to consider the association between water fluoride levels and caries prevalence in three Brazilian populations. METHODS: A total of 457 6-12-year-old lifetime residents from three economically deprived groups with 2-3, 0.7, and less than 0.01 ppm F in their water supplies were examined. Dental caries was recorded on permanent upper central incisors and first molars and all primary teeth (dmft). RESULTS: There was a significant trend (P < 01) for the mean dmft to decrease with increasing levels of fluoride in the drinking water. Caries experience in the six permanent teeth was significantly lower (P < 01) in the area with 0.7 ppm F than in the other two groups For the 2-3 ppm F group significantly more caries was found in subjects with higher TF scores (P < 05). CONCLUSION: Optimization of fluoride levels in the drinking water remains a valuable dental public health measure in Brazil.

Brazil↗

PubMed1996

The prevalence of dental caries in Europe 1990-1995. ORCA Saturday afternoon symposium 1995.

Caries prevalence data from recent studies in all European countries showed a general trend towards a further decline for children and adolescents. However, in several countries with already low caries prevalence in primary teeth, there was no further decrease. Regarding the permanent dentition, further reductions were observed in the 12-year age group, these being even more evident at the ages of 15-19 years. In some Central and Eastern European countries, caries prevalence in children and adolescents was still high. Few data were available on young adults, but the benefits of prevention are becoming manifest. The available data on the use of toothbrushes, fluorides and other pertinent items provided few clues as to the causes of the decline in caries prevalence.

Adolescent↗

PubMed1996

Water fluoridation in Ireland.

The basis for the constitutional challenge to the Health (Fluoridation of Water Supplies) Act 1960 in the Republic of Ireland and the judgements of the High Court and Supreme Court are described. Pre-fluoridation baseline surveys and various surveys conducted over the last 30 years in the Republic of Ireland show, that amongst of fluoridated communities, children experience lower levels of dental caries and adults retain more of their natural teeth when compared with residents of non-fluoridated communities.

Adolescent↗

PubMed1996

A photographic study of developmental defects of enamel in Brazilian school children.

The aims of this study were, to record developmental enamel in three areas of Brazil with a range of fluoride concentrations in their drinking water and to consider the association between clinical and photographic methods of recording enamel defects. A total of 457 subjects were examined from areas with less than 0.01, 0.7 and 2-3 ppm F in their drinking water. From the photographs, the prevalences of subjects with TF scores of one or more for the upper permanent central incisors were 7 per cent, 52 per cent and 92 per cent respectively for the three areas. The prevalence of demarcated opacities decreased with increasing fluoride levels in the drinking water (p < 0.008). There was substantial agreement between the Thylstrup Fejerskov (TF) scores using clinical and photographic methods (kappa = 0.63). However, prevalences of TF scores of one or more were higher using the photographic (44.9 percent) than clinical (41.4 percent) method (p < 0.01). The results of this study were compared with one undertaken in the United Kingdom and Ireland which also used the same photographic method. Although the prevalences of TF scores of one or more were similar in the areas with near 'optimal' levels of fluoride in the drinking water, in the groups with levels of fluoride less than 0.1 ppm the prevalence of subjects with TF scores of one or more was higher in the United Kingdom population than in Brazil. This study demonstrates the utility of photographic methods of collecting information on enamel opacities over a wide range of fluoride exposure. Results suggest that for the groups from areas with low levels of fluoride in the drinking water the overall fluoride exposure of the UK children was greater than the Brazilian.

Age Factors↗

PubMed1995

Dental enamel opacities in three groups with varying levels of fluoride in their drinking water.

The aim of this study was to compare the prevalence of enamel defects in three groups with different levels of fluoride in their water supplies. These data, collected using a reproducible method, will form the baseline for ongoing studies on the prevalence of enamel defects. The overall prevalence of enamel defects was similar in all three groups. However, for individual categories of defects differences were found. The prevalence of demarcated opacities was highest in the group with the lowest level of fluoride in the drinking water. The prevalence of hypomineralised enamel defects (TF index) increased with increasing levels of fluoride in the drinking water. However, the number of teeth affected by these enamel defects and their severity did not follow the dose-response relationship expected from the fluoride levels in the drinking water. Associations between both the frequency of tooth brushing and the age tooth brushing was commenced and hypomineralised enamel defects were identified.

Adolescent↗

PubMed1995

Evaluation of a fortnightly school-based sodium fluoride mouthrinse 4 years following its cessation.

The aim of this study was to investigate the effectiveness of a school-based fortnightly 0.2% sodium fluoride mouthrinse programme after children ceased to participate. The programme, which commenced at age 6 and ceased at age 12, was investigated 4 years following its cessation. Three groups of 12-year-olds and three groups of 16-year-olds were examined, i.e. children who had participated in the mouthrinse, those attending non-participating nearby schools and life-time residents of a fluoridated community. Significant differences in mean DMFT in the 12-year-olds between the mouthrinse and the control group were not found in the 16-year-old group. Mean DMFT for the mouthrinse group and those in a fluoridated community (which were the same in 12-year-olds) showed a statistically significant difference in those aged 16. Most caries found, both in 12-year-olds and in 16-year-olds, occurred on molar teeth and was found on pit and fissure surfaces. The cessation of these programmes at age 12 should be reappraised and the combination of school-based fluoride mouthrinse programmes with a fissure sealing programme is recommended.

Adolescent↗

PubMed1995

Reducing the cariogenic effect of sugar by adding fluoride to sugar--project background.

For various reasons, the use of the more widely used fluoride vehicles--such as water, salt, and toothpastes--is not feasible in some communities. There is some theoretical and laboratory evidence to support the view that adding fluoride to sugar and sugar products has potential to reduce their cariogenic effect. However, the clinical evidence is minimal. The minimum concentration of fluoride in sugar which will bring about a caries-preventive effect needs to be determined. Logistical issues requiring investigation include the most efficient method of adding fluoride to sugar and the distribution and consumption patterns of sugar in target populations. The practical application of this knowledge to large populations is the priority focus of this investigation.

Cariostatic Agents↗

PubMed1995

The association between area deprivation and dental caries in groups with and without fluoride in their drinking water.

In order to determine the association between social background and dental caries for subjects living in areas with and without fluoride in the drinking water, lifetime residents from Anglesey (0.7 mg/l F-, n = 196) and Chester/Bala (< 0.1 mg/l F-, n = 267) were examined. The mean age overall was 14.1 (+/- 0.3) years. For the Anglesey group, when differences in material deprivation were controlled, the mean DMFS was 2.9 compared with 4.3 in Chester/Bala, a difference of 33 per cent. Using multiple linear regression it was found that there was no interaction between material deprivation and water fluoridation. This suggested that absolute differences in dental caries between these areas with and without fluoride in the drinking water were similar for different strata of deprivation. It follows that percentage reductions in dental caries resulting from fluoridation of water supplies tended to be less in deprived than non deprived groups.

Adolescent↗

PubMed1994

Accidental damage to incisors amongst Irish adults.

Evidence of accidental damage to permanent incisor teeth was recorded as part of a national survey of adult dental health in Ireland. A total of 746 adults aged between 16 and 34 years were examined. The prevalence of injury was considerably higher in males and the majority of subjects in both sexes had just one tooth affected. There was a continuing increase in prevalence with age which appeared to level out after the age of 24. A high level of untreated injuries was noted in both age groups; of those injuries which were treated, composite restorations were more common in the younger age groups while extraction and replacement by a denture was more common in older subjects.

Adolescent↗

PubMed1994

Association between dental enamel opacities and dental caries in a north Wales population.

This study examined the association between enamel opacities and dental caries in a population from North Wales with low levels of fluoride in the drinking water. Those subjects with only diffuse (n = 317) types of opacity had a mean DMFS of 1.6 (+/- 3.4) compared with those having only demarcated (n = 1,408) opacities of 3.4 (+/- 4.3). The group with both (n = 317) types of defect present had a DMFS of 2.4 (+/- 3.7) and the group with no defects (n = 1,496) had a DMFS of 2.7 (+/- 3.8). These differences were statistically significant (p < 0.001). Possible reasons for these differences are discussed.

Child↗

PubMed1994

Systemic fluorides.

Fluoridation of domestic water supplies has been shown to be effective in reducing the prevalence of dental caries in numerous studies conducted world-wide over the last 50 years. The most widely used systemic alternative to water fluoridation is salt fluoridation, which has been found to be effective against dental caries in programs conducted in Switzerland and Hungary. Currently, fluoridated salt is sold in eight countries. Studies conducted on fluoridated milk in Scotland, Hungary, and Bulgaria have shown it to be effective against dental caries, and a number of fluoridated milk programs are currently at the planning stage. The feasibility of using fluoridated sugar in communities where alternative preventive strategies are not feasible is currently being investigated.

Animals↗

PubMed1994

A 12-month study of the efficacy of a pre-brushing rinse in plaque removal.

A 12-month clinical trial was conducted to compare the effectiveness of a pre-brushing rinse (PBR) in plaque removal with that of water. Four groups participated in the study; group 1 (test group) rinsed with PBR before brushing; group 2 rinsed with plain tap water; group 3 brushed only; and group 4 rinsed with sterile water (same color as the PBR). Pre-brushing and post-brushing plaque scores were recorded at baseline, 3 months, 6 months, 9 months (Ramjford surfaces) and 12 months for groups 1, 2, and 3 and at baseline, 3 months and 6 months for group 4. Pre-brushing minus post-brushing plaque scores (decrements) were significantly higher in the PBR group at baseline, and 6, 9, and 12 months. Using a single criterion (gingival bleeding index) there were no differences between the 4 groups at any of the 5 assessments, hence, the clinical significance of the higher plaque removal scores in the PBR group remains in doubt.

Adolescent↗

PubMed1994

The demographic and social variation in the prevalence of dental enamel opacities in north Wales.

The variation in the prevalence of developmental defects of enamel in areas of North Wales with low levels of fluoride in the drinking water was studied. Significant differences in the prevalence of diffuse opacities were found for the ten county districts in the study area. In addition, there was an association between area deprivation, as measured using the Townsend index, and diffuse opacity prevalence. The prevalence of subjects with one or more diffuse opacities was lower in more deprived electoral wards than those less deprived. For demarcated opacities and hypoplastic defects in the ten county districts, the prevalences were not significantly different and there was no association with area deprivation.

Chi-Square Distribution↗

PubMed1994

Introduction and rationale for the use of fluoride for caries prevention.

Following the original work of Dean et al. showing the link between fluoride levels in the drinking water and the prevalence of dental fluorosis and dental caries, different strategies aimed at maximising the benefits of fluorides for communities and for individuals have been developed during the last 50 years. The effectiveness of fluoridated salt, fluoride mouthrinses, toothpastes, supplements, gels and varnishes has been extensively investigated in laboratory and human clinical studies. The research effort on the different fluoride strategies has not been confined to measuring effectiveness; other areas which have been extensively investigated include the method of action and metabolism of fluorides. As a result of this research effort it is now possible to adopt a more rational approach to the use of fluorides for caries prevention at community level and for individual patients.

Dental Caries↗