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Biomedical subjects

J G Whittle

Publications and source records attributed to J G Whittle.

At least 19 recordsLinked to original sources
PubMed2000

Maintaining good dental practice: the East Lancashire approach to dentists whose performance gives cause for concern.

The Consultant in Dental Public Health and the Local Dental Committee in East Lancashire have developed a local system, similar to that being set up for general medical practitioners, to help general dental practitioners whose performance is causing concern. GDPs approved it at an open meeting of practitioners. A Dental Performance and Assessment Group has been set up and one problem has already been resolved to everyone's satisfaction. The model is recommended to dentists in other areas.

Clinical Competence↗
PubMed1999

A model framework comparing resources required for activities in the Community Dental Service validated using the Delphi technique.

OBJECTIVE: To validate a model framework comparing resources required for activities in the Community Dental Service. The framework consisted of five levels of care of increasing complexity for six groups of patients. The patient groups were: children with behavioural problems, mentally disabled patients, anxious adults, paedodontic patients, medically compromised and physically disabled patients. DESIGN: Delphi study using two sequential questionnaires. Participants were asked to rate the difficulty of 29 different treatments on a scale from 1 to 100. PARTICIPANTS: Six clinical directors and eleven senior dental officers working in the Community Dental Service in the North West of England. RESULTS: Seventeen of the 29 treatments were rated at the level of care predicted by the model. Nine were rated lower and three higher. Within the patient groups the order of increasing complexity, predicted by the model, was verified with only one exception. CONCLUSIONS: The research confirmed that it is possible to measure CDS activity in a rational way. Consensus was reached on a suitable framework which was simpler than the original model in having only four levels of care. The use of the modified model is now being tested in the Community Dental Service.

Adult↗
PubMed1998

Dental caries in 12-year-old children and the effectiveness of dental services in Salford, UK in 1960, 1988 and 1997.

OBJECTIVE: To investigate the dental health of 12-year-old children and the effectiveness of dental services in 1997 and compare the results with studies carried out in 1960 and 1988. BASIC RESEARCH DESIGN: Analytical survey using a one in five random sample of children in all seven secondary schools in Salford UK. Standard clinical criteria were used. SETTING: Clinical examinations were carried out in school. PARTICIPANTS: 65 boys and 49 girls were examined. OUTCOME MEASURES: Caries experience expressed as DMFT, Restorative Index and Care Index. RESULTS: The boys and girls both had a mean DMFT of 1.65. (95% confidence intervals were 1.18-2.12 for the boys and 1.16-2.14 for the girls.) This compared with means of 2.34 (1.85-2.83) for boys and 3.40 (2.63-4.17) for girls in 1988, and 6.04 (5.65-6.43) and 6.54 (6.09-7.00), respectively in 1960. The prevalence of caries fell least in first permanent molar teeth. The Care Index for the boys was 22.0 in 1960, 51.4 in 1988 and 31.5 in 1997. The pattern was similar for the girls for whom the values were 19.5, 48.6 and 32.2 respectively. The boys' Restorative Index scores (modified to include fissure sealants) were 25.7 in 1960, 58.5 in 1988 and 57.1 in 1997. The girls' scores were 23.9, 53.7 and 58.0. CONCLUSIONS: Caries has declined considerably in Salford since 1960. More of the total disease was concentrated in first permanent molar teeth in 1997. Indices, which measure the effectiveness of dental services, show that a greater proportion of overall disease was being treated in 1988 than in 1960 or 1997.

Child↗
PubMed1998

Trends in the provision of primary care dental general anaesthesia in the north of England, 1991/92 to 1994/95.

AIM: To investigate trends in the provision of primary care dental general anaesthesia (PCDGA) and any association with dental caries. DESIGN: Cross-sectional analysis of data about the provision of PCDGA in the general dental service and community dental service from 1991/92 to 1994/95. SETTING: The former North Western, Mersey, Northern and Yorkshire regions. METHOD: The combined rates of PCDGAs in the general dental service and community dental service, from 1991/92 to 1994/95 were calculated and compared with the levels of caries from the NHS dental epidemiology programme. RESULTS: All regions except the North Western had a lower rate at the end of the 1991 study but only the Northern region had a lower rate in 1994/95 than in 1993/94. Only weak correlations were found between the PCDGA rate in a health authority and the level of dental caries. CONCLUSIONS: PCDGA rates did not continue to decline during the period of this study. One of the principal recommendations of the Poswillo report was that the use of general anaesthesia should be avoided wherever possible. Other initiatives, perhaps the development of criteria for selection of patients, may be necessary if further reductions in PCDGA rates are to be achieved.

Anesthesia, Dental↗
PubMed1998

Household income in relation to dental health and dental health behaviours: the use of Super Profiles.

OBJECTIVE: To investigate the relationship between household income defined by Super Profiles, a socio-economic indicator, and dental health and dental health behaviours. BASIC RESEARCH DESIGN: Analytical survey involving a clinical examination and a questionnaire to parents. SETTING: Primary schools in Salford, UK. PARTICIPANTS: Two thousand five hundred and seventy eight 5-year-old children were examined; 1938 (75%) returned questionnaires. MAIN OUTCOME MEASURES: Mean caries experience and ages at first visit to dentist and when toothbrushing commenced. RESULTS: Children in the highest income group had a mean dmft of 1.83 compared with 2.56 in the middle group and 3.43 in the lowest income group. The proportions who had visited a dentist by their second birthday were 71%, 64% and 62% respectively. The corresponding proportions having their teeth brushed by their first birthday were 69%, 58% and 57%. CONCLUSIONS: The study showed a relationship between Super Profiles, and the dental health and dental health behaviours of 5-year-old children.

Age Factors↗
PubMed1997

Water fluoridation, tooth decay in 5 year olds, and social deprivation measured by the Jarman score: analysis of data from British dental surveys.

OBJECTIVE: To examine the effect of water fluoridation, both artificial and natural, on dental decay, after socioeconomic deprivation was controlled for. DESIGN: Ecological study based on results from the NHS dental surveys in 5 year olds in 1991-2 and 1993-4 and Jarman underprivileged area scores from the 1991 census. SETTING: Electoral wards in three areas: Hartlepool (naturally fluoridated), Newcastle and North Tyneside (fluoridated), and Salford and Trafford (non-fluoridated). SUBJECTS: 5 year old children (n = 10,004). INTERVENTION: Water fluoridation (artificial and occurring naturally). MAIN OUTCOME MEASURE: Ward tooth decay score (score on the "decayed, missing, and filled tooth index" for each electoral ward). RESULTS: Multiple linear regression showed a significant interaction between Jarman score for ward, mean number of teeth affected by decay, and both types of water fluoridation. This confirms that the more deprived an area, the greater benefit derived from fluoridation, whether natural or artificial (R2 = 0.84, P < 0.001). At a Jarman score of zero (national mean score) there was a predicted 44% reduction in decay in fluoridated areas, increasing to a 54% reduction in wards with a Jarman score of 40 (very deprived). The area with natural fluoridation (at a level of 1.2 parts per million-higher than levels in artificially fluoridated areas) had a 66% reduction in decay, with a 74% reduction in wards with a Jarman score of 40. CONCLUSION: Tooth decay is confirmed as a disease associated with social deprivation, and the more socially deprived areas benefit more from fluoridation. Widespread water fluoridation is urgently needed to reduce the "dental health divide" by improving the dental health of the poorer people in Britain.

Child, Preschool↗
PubMed1995

Five-year-old children: changes in their decay experience and dental health related behaviours over four years.

At the time of the 1989-90 survey of 5-year-old children, co-ordinated by the British Association for the Study of Community Dentistry, a questionnaire about dental health behaviour was sent home to 2,390 parents in Salford and 2,098 in Trafford. The response rates were 78 per cent and 81 per cent respectively. The questionnaire was repeated for the 5-year-old survey in 1993-94 with the aim of finding out if there had been any changes: 2,794 parents were contacted in Salford and 2,343 in Trafford. The response rates were 75 per cent and 73 per cent. The percentage of children who were having their teeth brushed before they were aged one and who had visited a dentist by their second birthday rose in both districts. Campaigns at regional and district levels are thought to have influenced these improvements. The percentage of children who had experienced toothache and the proportion who had received a general anaesthetic for tooth extraction were similar in both years.

Beverages↗
PubMed1994

The views and expectations regarding dental care of the parents of children with special dental needs: a survey in the County of Cheshire, England.

A postal questionnaire of multiple-choice design was sent to 122 parents of children with special dental needs in the county of Cheshire, England, with the aim of determining parents' views and expectations of dental care. Replies were received from 85 (70%). Eighty respondents (94%) were in favour of preventive dental advice being given to their children and 83 (98%) felt that an explanation should be given of the risk to general health posed by dental disease or its treatment. A high proportion of parents felt that simple dietary and oral hygiene advice was necessary, that the benefits of fluoride supplementation should be explained and that free fluoride supplements should be issued. The 'family dentist' was most favoured as the source of advice, closely followed by a community dental officer. Likewise the dental surgery was the most popular location for receiving advice, and doctors' surgeries were the least favoured. Parental support for regular school dental screening examinations of all children was extremely high and parents thought that special-needs children should be examined more frequently.

Attitude to Health↗
PubMed1993

An open-access dental practice.

The DoH funded a drop-in dental practice in inner-city Salford for 12 months. Its aim was to increase accessibility and availability of dental services to people not registered with a dentist. It operated on a no-appointment basis and priority was given to those in pain and/or on their initial visit.

Adult↗
PubMed1993

Attendance patterns and dental health of parents and children.

Questionnaires were posted to the parents of 293 5-year-old children who had been dentally examined at school in Stretford, Manchester, UK. Replies were received from 195 addresses and consisted of 182 mothers and 149 fathers. The mothers who replied were divided into three groups; 99 who reported that they attended the dentist for regular check-ups, 38 who went for occasional check-ups and 45 who only went when having trouble. The mean numbers of decayed teeth of their children were 0.92, 1.50 and 2.00 respectively (p < 0.05) and the mean dmft scores were 1.36, 2.05 and 2.69 (p < 0.05). Fifty children whose mothers reported having 25 teeth or less had a mean of 2.12 decayed teeth compared with 1.06 for 125 children whose mothers had 26 teeth or more (p < 0.01). The mean dmft scores for the two groups were 2.68 and 1.59 respectively (p < 0.05). In contrast, dividing the children into groups based on reported attendance patterns and numbers of natural teeth of their fathers did not show any significant differences in decayed teeth or dmft scores. It is concluded that the dental attendance pattern and dental health of the mother, but not of the father, are important influences on the dental health of 5-year-old children.

Adult↗
PubMed1992

Dental caries in 12-year-old children in Salford, UK: changes over 28 years.

A sample of 111 12-year-old children in Salford, UK was examined in 1988, and the findings compared with those of a survey carried out in 1960 of 12-year-old children in the same city. Between 1960 and 1988, the mean DMFT of the boys fell from 6.04 to 2.34 and that of the girls from 6.54 to 3.40. All types of teeth were affected by caries in 1960 but in 1988 none of the canines and mandibular lateral incisors were affected. In 1960 the permanent first molars contributed 57% of the boys' and 54% of the girls' total DMFT while in 1988 they contributed 87% of the boys' and 73% of the girls' DMFT. Jackson's Treatment Index showed that the dental services were making a greater impact in 1988; for the boys it rose from 29.5 to 63.2 and for the girls from 27.8 to 62.3.

Child↗
PubMed1992

A classification of residential neighbourhoods (ACORN) in relation to dental health and dental health behaviours.

Five-year-old children in two district health authorities in the North Western Region of England were examined during 1989-90. Questionnaires were issued to parents to determine whether dental health and related behaviours were associated with socio-economic status. Parents of 1858 children in Salford (response rate = 78 per cent) and 1691 in Trafford (response rate = 81 per cent) returned the questionnaires. Their replies were analysed by dividing the children into a hierarchy according to a classification of residential neighbourhood (ACORN). Significantly fewer in the highest of three Divisions in both districts had suffered from toothache and had undergone a general anaesthetic to have teeth extracted. They were also more likely to have had their teeth brushed with toothpaste by their first birthday and to have visited the dentist by their second. Because ACORN had detected these differences in dental health related behaviour it was possible to identify localities towards which dental health promotion activities can be directed.

Carbonated Beverages↗
PubMed1990

Some parental views on the Community Dental Service.

A sample of 220 adults accompanying children to Community Dental Service (CDS) clinics in two adjacent health districts in the North Western Health Region of England were questioned to gain insight into their views about the service. Seventy-five per cent reported that they had a dentist of their own; 82% of these claimed to have visited him/her in the previous 12 months. They had chosen the CDS for four broad reasons: 51% saw it as providing a specialised service, 27% came as a result of a school inspection, 15% used it because it was convenient, and 7% had been unhappy with the care provided by a general dental practitioner. Seventy-six per cent thought that the CDS should be allowed to treat adults. There were no significant differences between those with dentists of their own and those without, or between those who gave the specialised nature of the CDS as the reason for attending and those who did not. Those who came by car were significantly less likely to believe that the CDS should treat adults; nevertheless, 69% of these were in favour.

Adult↗
PubMed1990

Dental health education: training of homecarers of mentally handicapped adults.

A seven week induction course for homecarers of mentally handicapped adults, organised by the Social Services Department in Salford, UK, includes a dental health education session of one and a half hours. The session is divided into three parts; an illustrated discussion, a demonstration of tooth-brushing and a practical component session where carers are divided into pairs and carry out oral hygiene measures for each other. The effectiveness of the session has been assessed using a questionnaire. This was completed by 33 carers who attended the session and 31 carers who had not. Many members of both groups knew about the shape and colour of healthy gums and what plaque was. However significantly fewer of the control group knew that gum disease resulted from a lack of toothbrushing, what to do with bleeding gums and the amount of toothpaste to use on the toothbrush.

Female↗