Biomedical subjects

I G Chestnutt

Publications and source records attributed to I G Chestnutt.

35 records · Page 2Linked to original sources

PubMed2000

Prioritisation of research recommendations from a national needs assessment programme.

OBJECTIVE: To gain consensus on and rank research and development recommendations from a series of Scottish Needs Assessment Programme (SNAP) reports. DESIGN: A two stage Delphi questionnaire was used and participants were asked to rank the recommendations in terms of potential health gain, practicality and priority. SUBJECTS: Views were sought from all consultants in dental public health in Scotland and from non-consultant members of the SNAP oral health steering group. RESULTS: Of the 17 individuals eligible, 16 participated in the study. Fifty four recommendations for research and development were identified in seven SNAP reports. Recommendations relating to the prevention of dental caries in young children, the organisation and delivery of dental care to disadvantaged groups and increased understanding of the aetiology and pathogenesis of oral cancer in younger people were seen as of highest priority. CONCLUSIONS: This study has drawn together and prioritised a series of recommendations, and will help inform future oral health research needs in Scotland.

Delphi Technique↗

PubMed1999

Factors influencing the diagnosis and management of teeth with pulpal and periradicular disease by general dental practitioners. Part 2.

OBJECTIVE: To identify techniques commonly used in the management of periradicular disease by general dental practitioners and to ascertain views on continuing professional education in endodontics. DESIGN: Data was collected via a postal questionnaire distributed to 617 general dental practitioners in Scotland (33% of practitioners registered with the Dental Practice Board). RESULTS: 417 (69%) questionnaires were completed and returned. Only 24.9% of respondents used rubber dam routinely. The majority of respondents used hand instruments for preparation with either sodium hypochlorite or local anaesthetic being used most frequently for irrigation. The mean time for treatment of a single rooted tooth was 71 minutes. The demand for continuing education courses was high with 340 and 197 respondents requesting endodontic and rubber dam courses, respectively. CONCLUSIONS: Traditional methods for preparing the root canal using hand instruments were favoured by most dentists. The major disincentive to the use of rotary instruments and new techniques for obturating with thermally softened gutta-percha was expense. The importance of rubber dam isolation requires reiteration and more continuing education courses are required to update clinical skills.

Dental Pulp Diseases↗

PubMed1999

Factors influencing the diagnosis and management of teeth with pulpal and periradicular disease by general dental practitioners. Part 1.

OBJECTIVE: To identify factors influencing the diagnosis and management of periradicular disease by general dental practitioners. DESIGN: The study was conducted in two stages. 1. Analysis of recent returns to the Scottish Dental Practice Board. 2. Data collection via a postal questionnaire distributed to 617 general dental practitioners in Scotland (33% of practitioners registered with the Dental Practice Board). RESULTS: 417 (69%) questionnaires were completed and returned. The majority of respondents undertook root canal treatment and the number of cases treated had increased in the last five years. The vast majority of the respondents (89.3%) were confident in their diagnosis of periradicular disease and 77.1% were confident of their treatment of the disease. A referral system for treatment was used by 31% of respondents of whom the majority used a specialist in a hospital. Over 50% of the respondents undertook surgical root canal treatment. Only 40% of respondents followed up their completed cases for longer than six months. Constraints on the provision of treatment included the time available and the low level of fees. CONCLUSIONS: Current arrangements for the treatment of periradicular disease in general dental practice are less than optimal. The fiscal arrangements for the provision of these treatments must be developed to encourage a high standard of treatment to be performed thereby maximising the likelihood of success. In addition, efforts to inform patients of the benefits of the treatment of periradicular disease should be increased.

Dental Pulp Diseases↗

PubMed1998

The provision of dental and oral health advice by community pharmacists.

A common theme of recently published strategies for improving oral health has been the need to involve healthcare professionals so as to influence a wider section of the population, many of whom do not routinely attend a dentist. The purpose of this paper is to review changes that have affected pharmacy practice in the community, to identify opportunities and barriers to the provision of dental and oral health advice in that setting, and to propose increased collaboration between the dental team and pharmacy staff.

Community Pharmacy Services↗

PubMed1998

The influence of toothbrushing frequency and post-brushing rinsing on caries experience in a caries clinical trial.

OBJECTIVE: To examine the effect of reported toothbrushing frequency and method of rinsing after brushing on caries experience and increment. METHODS: Data are presented from 2621 adolescents (mean age 12.5 years at outset) participating in a 3-year double-blind caries clinical trial. At baseline, examiners questioned each participant about their toothbrushing habits, and at subsequent examinations, this information was obtained using a self-administered computer-based questionnaire. Participants used a fluoride-containing dentifrice throughout and clinical examinations were conducted using a mirror, CPITN probe and fibre-optic transillumination. RESULTS: The reported brushing frequency increased throughout the trial. Caries experience at baseline was inversely related to toothbrushing frequency with mean DMFS=9.66, 8.12 and 7.63 respectively for <1/day, 1/day and >1/day brushers (P<0.001). Mean 3-year DMFS increments of 8.90, 6.63 and 5.48 (P<0.01) were observed in those reporting to brush <1/day, 1/day or >1/day, on not less than two of the three clinical examinations during the trial. Caries increment was also significantly related to the claimed method used to rinse post-brushing. Overall frequency of brushing and rinsing method accounted for over 50% of the explained variance in the ANOVA model used to analyse the DMFS increments. CONCLUSIONS: Stated toothbrushing frequency and rinsing method after brushing were found to be strongly correlated with caries experience and caries increment. These factors should be reflected in the design of oral health education material and taken into account in the design and analysis of caries clinical trials.

Adolescent↗

PubMed1997

Factors influencing the diagnosis and management of periodontal disease by general dental practitioners.

OBJECTIVE: To identify factors influencing the diagnosis and management of periodontal disease by general dental practitioners. DESIGN: The study was conducted in two stages. 1. Analysis of returns to the Scottish Dental Practice Board. 2. Data collection via a postal questionnaire distributed to 500 general dental practitioners (27% of Scottish practitioners). RESULTS: 374 (75%) questionnaires were completed and returned. Analysis revealed the majority of treatment provided was in the form of simple scale and polishes, with multi-visit periodontal therapy comprising less than 0.2% of all non-surgical periodontal treatment. While the majority of respondents were confident in their ability to diagnose periodontal disease, only 40% were confident in treating it. Patient related factors were seen as the major hindrance to disease management, although time factors and the low level of fees were viewed by at least one half of respondents as major constraints. CONCLUSIONS: Greater efforts are required to motivate and inform patients of the necessity for and benefits of periodontal treatment, as is emphasis on appropriate treatment of early to moderate forms of disease. There is also a need for the development of appropriate, evidence-based clinical guidelines and fiscal arrangements to facilitate such provision.

Adolescent↗

PubMed1997

Prevalence of dental caries in Omani 6-year-old children.

OBJECTIVE: To determine the prevalence of dental caries in Omani 6-year-old children. DESIGN: Clinical caries cross-sectional survey, conducted by 16 trained and calibrated dentists. SETTING: Omani primary schools in December 1994. SUBJECTS: 3,114 subjects, randomly selected to achieve an overall 6.6 per cent sample of Omani 6-year-old children. OUTCOME MEASURES: Caries diagnosis based solely on clinical examination in accordance with criteria of British Association for the Study of Community Dentistry. RESULTS: Only 484 subjects (15.5 per cent) were caries-free; regional variations ranging from 4.4 per cent to 31 per cent. Overall, the national dmft averaged 4.61; the majority of caries experienced being in the form of untreated decay, with occlusal surfaces of first primary molars being the most commonly involved site. CONCLUSIONS: Compared with results from a survey of Omani 12-year-old children in 1993, a much smaller proportion of this 6-year-old sample were caries free, emphasising the need for continuance of existing, and the development of further, preventive programmes.

Child↗

PubMed1997

Relationship of diabetes to periodontitis.

Although the relationship between diabetes and periodontal disease has been the subject of much debate, the consensus of recent studies is that diabetic patients have an increased risk of periodontal disease, particularly when metabolic control is poor. This paper reviews recently published studies in this area and concludes that not only is metabolic control a risk factor in disease susceptibility but that it may also influence the outcome of periodontal therapy.

Diabetes Complications↗

PubMed1996

Incremental susceptibility of individual tooth surfaces to dental caries in Scottish adolescents.

This study reports on the caries susceptibility of tooth surfaces in 4294 adolescents (mean age 12.5 yr) during a 3-yr, double-blind clinical caries trial, conducted in Lanarkshire, Scotland, between 1988 and 1992. Children were selected on the grounds of dental maturity and past caries experience. Clinical examinations with mirror, CPITN probe and fibre optic trans-illumination were carried out on the permanent dentition, with the buccal pits of mandibular molars and palatal pits of maxillary molars being recorded as separate sites. At baseline 6061 surfaces were decayed (1.0% of 601 160 surfaces examined), 20 160 (3.4%) filled, and 10 909 (1.8%) missing due to caries. The number of surfaces recorded as sound at baseline in subjects completing the study was 454 663. Of these 8176 (1.8%) new surfaces were decayed, 14 832 (3.3%) filled and 4000 (0.9%) missing at the final examination. Molar occlusal surfaces showed greatest susceptibility to attack, 35.8%) of those at risk becoming carious in the course of the study. All buccal and lingual smooth surfaces showed a low susceptibility, but 8.8% of buccal and palatal pits developed caries. At the final clinical-only examination, pit and fissure caries accounted for 48%, interproximal surfaces for 39%, and smooth surfaces for 13% of caries prevalence. However, overall the contribution of these surfaces to 3-yr increments was, 40%, 47% and 13%, respectively.

Adolescent↗

PubMed1996

The oral health status of Omani 12-year-olds--a national survey.

This study reports the first ever national oral health survey of Omani 12-year-olds. Conducted in October 1993, of the 3,435 children examined, 1,438 (41.9%) were caries-free, although regional variations ranged from 24.8% to 61.9%. Overall, the national DMFT averaged 1.53, the majority of caries experienced being in the form of untreated decay, with occlusal surfaces of first permanent molars being the most commonly involved site. Oral hygiene was poor, only 11% of those examined being scored as plaque-free.

Child↗

PubMed1995

Evaluation of the in vitro cariogenic potential of Streptococcus mutans strains isolated from 12-year-old children with differing caries experience.

The limited usefulness of caries activity tests based solely on counts of mutans streptococci has been recognised increasingly. Such tests do not account for potential differences in cariogenicity of Streptococcus mutans strains harboured by individual patients. Hence, this study describes the evaluation of a simple and inexpensive method involving the dissolution of powdered hydroxyapatite as a means of determining the cariogenic potential of 64 freshly isolated strains of S. mutans from 24 children. Whilst it is apparent that differences between strains isolated from individuals could be demonstrated using this test, the variability observed was such that it was not possible to relate in vitro cariogenicity to actual clinical caries experience.

Anions↗

PubMed1994

The prevalence and effectiveness of fissure sealants in Scottish adolescents.

The presence of fissure sealants was recorded in 4294 adolescents during a 3-year, double-blind clinical caries trial, conducted in Lanarkshire, Scotland, between 1988 and 1992. Of 68,704 occlusal surfaces examined at baseline, sealants were detected on 7011 (10.2%) surfaces, in 1596 subjects. Of these, 17.4% were judged as incompletely sealed. At the final examination 24.3% of sealants originally recorded as complete were missing, with partial loss observed on a further 18.2% of surfaces. At that time, 21.4% of surfaces 'unsealed but sound' at baseline were recorded as decayed, filled or extracted due to caries, compared with 14.4% of surfaces on which an intact sealant had been recorded (P < 0.001). In contrast, of those surfaces on which the sealant was noted as deficient at the outset, 22.9% were judged to have been affected by caries. This study shows that sealants should be repaired when deficient if they are to be effective.

Adolescent↗

PubMed1994

An in vitro investigation of the cariogenic potential of oral streptococci.

Whilst the importance of the mutans streptococci in the aetiology of dental caries is clear, a number of studies have described caries development in their absence. This investigation aimed to assess the cariogenic potential of Streptococcus gordonii, Strep. sanguis, Strep. vestibularis and Enterococcus faecalis in comparison with Strep. mutans and Strep. sobrinus, using a recently described in vitro model. In the presence of a 146 mM sucrose solution and powdered hydroxyapatite, each species was incubated for 5 h, after which acid anion production, calcium release and change in pH were measured. It was possible to assign each species to one of three groups, with E. faecalis, Strep. gordonii, Strep. sanguis exhibiting low, Strep. vestibularis intermediate, and Strep. mutans and Strep. sobrinus high in vitro cariogenic potential. This assay could be used as a screening test to assess the potential cariogenicity of a range of bacterial species.

Acetates↗

PubMed1994

Studies on plaque fluoride after use of F-containing dentifrices.

Increased fluoride levels in plaque and saliva have been associated with improved protection against dental caries for dentifrices which contained sodium monofluorophosphate (Duckworth et al., 1992). The main aim of the present work was to test whether oral fluoride retention depended on F source after use of dentifrices containing either NaF or Na2FPO3. In study 1, plaque samples were collected from 474 subjects who had been using one of six test dentifrices for two years, and analyzed by F extraction with water. The dentifrices contained 1000 or 1500 micrograms F/g as either NaF or Na2FPO3. Significantly more fluoride was found in plaque from subjects who were using the NaF dentifrices than in plaque from subjects who were using Na2FPO3 dentifrices of the same F content. Subsets of plaque samples were large enough to divide into two parts for extraction by both acid and water. No significant difference was found between mean fluoride contents, indicating that the majority of fluoride retained in plaque from these conventional dentifrices appears to be relatively labile. The results of two small-scale human enamel studies showed that NaF dentifrices gave elevated F concentrations in plaque and saliva, respectively, compared with Na2FPO3 dentifrices of equivalent F content, consistent with the main plaque study 1. These findings demonstrate that oral F retention from dentifrices is dependent on the source of ionic fluoride and support the view that NaF dentifrices may be more clinically effective than dentifrices which contain the same amount of F as Na2FPO3.

Adolescent↗

PubMed1994

The effect of NaF and SMFP toothpastes on three-year caries increments in adolescents.

A three-year double blind clinical caries trial was undertaken to compare the anticaries efficacy of three types of active agent, namely sodium fluoride (NaF), sodium monofluorophosphate (SMFP) and the combination of NaF plus sodium trimetaphosphate (TMP), using two fluoride levels (1000 ppm F and 1500 ppm F). The prime objective of the study was to determine whether there was any difference in the anticaries efficacy between NaF and SMFP. The second objective was to assess the effect on caries protection of the incorporation of TMP into a NaF dentifrice formulation. The study was carried out to FDI protocol and involved 4,294 children aged 11-12 years at outset. These participants had been selected from a pool of 6,212 potential subjects on the basis of caries experience and dental eruption pattern. They were stratified by sex, examiner, presence of calculus and caries, and allocated at random to one of the six toothpastes under study. Clinical examinations were carried out at baseline and thereafter annually for 3 years. 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 three years, taking into account changes occurring on individual tooth surfaces. After three years, clinical-only data for 3,517 children were available for the calculation of caries indices. The mean three-year DMFS increment for subjects using a dentifrice containing NaF alone was 6.4 per cent lower than for those using a dentifrice containing SMFP. The difference between the NaF+TMP users and the SMFP users was 8.1 percent.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMedDate not supplied

Smoking cessation counselling--a role for the dental profession?

Whilst several studies have investigated the views of North American dentists on providing advice to patients on stopping smoking, the role of their UK counterparts in this area is uncertain. Thus this study aimed: 1. to examine dentists' awareness of the effect of smoking on general and oral health, 2. to determine their views on counselling patients to give up smoking, 3. to investigate the extent to which they currently engage in this activity, and 4. to survey barriers to providing such advice. Data were collected via a postal questionnaire mailed to 587 Scottish dental practitioners, of which 448 (76.3%) were completed and returned. The importance of smoking as a cause of ill health and death was acknowledged universally, and most were aware of the adverse consequences of smoking on the oral tissues. Over half the respondents (245 or 54.7%) thought dentists had a role in counselling patients to give up smoking and whilst 107 (23.8%) were uncertain, the remaining 95 (21.2%) felt this was outside their remit. Nonetheless, 384 (85.6%) reported that, at least occasionally, they advised patients to quit. Lack of time was seen as an important barrier to tobacco counselling, as was lack of training. Further studies are required to determine the most useful strategies or approaches, and to determine their effectiveness.

Adult↗

PubMedDate not supplied

What should we do about patients who smoke?

The adverse consequences of smoking on both general and oral health are well recognized. It is now accepted that brief advice from a healthcare professional is an effective aid to stopping smoking and recently interest has focused on the role of the dental team in this area. This paper provides an update on current concepts of how smokers give up and makes practical suggestions as to how smoking may be discussed in the dental clinic.

Health Education, Dental↗