Biomedical subjects

L B Messer

Publications and source records attributed to L B Messer.

At least 19 recordsLinked to original sources

PubMed2001

A study of the dental treatment needs of children with disabilities in Melbourne, Australia.

A selected population of children with disabilities in Melbourne, Australia, was studied with reference to their oral disease and treatment needs. A total of 300 children (aged 9-13 years), 150 attending special developmental schools (SDS) and 150 attending special schools (SS), received an oral examination and the parent/guardian completed a questionnaire. Six levels of function were defined, based on the child's independence for five self-care activities (brushing teeth, feeding self, dressing self, walking and performing toilet). The caries experience of children in the SS was lower than in SDS (d + D: 1.3 +/- 1.6 versus 1.5 +/- 2.4; dmft + DMFT: 2.0 +/- 2.3 versus 2.5 +/- 3.1); those attending SDS had higher unmet preventive and restorative needs. Significant associations were seen between the number of decayed teeth, the dmft + DMFT index, and the level of function (p < 0.005). Periodontal disease was prevalent; significant associations were seen between periodontal status, the need for periodontal therapy, and the level of function (p < 0.005). Assessment of the level of function by staff could assist in triaging individuals for urgent dental examination. Despite 41 per cent of children requiring simple treatment, the preventive and treatment needs of many remained unmet. Following examination, diagnosis and treatment planning by a dentist, much of the preventive, simple treatment and oral health promotion could be performed by trained dental auxiliaries. An epidemiological survey followed by the implementation and evaluation of a long-range public dental health care plan for children and adolescents with disabilities is needed urgently.

Adolescent↗

PubMed2001

Oral hygiene measures and promotion: review and considerations.

Current mechanical and chemotherapeutic approaches to oral hygiene aim to modify the oral microflora to promote healthy periodontal and dental tissues. Current oral hygiene measures, appropriately used and in conjunction with regular professional care, are capable of virtually preventing caries and most periodontal disease and maintaining oral health. Toothbrushing and flossing are most commonly used, although interdental brushes and wooden sticks can offer advantages in periodontally involved dentitions. Chewing sugar-free gums as a salivary stimulant is a promising caries-preventive measure. Despite new products and design modifications, mechanical measures require manual dexterity and cognitive ability. Chemotherapeutic supplementation of mechanical measures using dentifrices, mouthrinses, gels and chewing gums as delivery vehicles can improve oral hygiene. The list includes anticalculus, antibacterial and cariostatic agents. For the population at large to make effective use of these oral hygiene measures, oral hygiene promotion needs to be implemented. Considerations include the role of parents, school and the media for children and the workplace, social environments. nursing homes and trained carers for adults and the elderly. Community oral hygiene promotion must attempt to maximise opportunities for oral health for all and reduce inequalities by removing financial and other barriers. Oral health approaches should be tailored to lifestyles and abilities of children, adults and the elderly in order to enable them to make decisions to improve personal oral hygiene and oral health.

Adult↗

PubMed2001

Professional development for dentists: patterns and their implications.

BACKGROUND: Approaches to models of professional development for dentists continue to evolve. This study examined the participation and attitudes of dentists in non-formal and informal professional development and continuing dental education. METHODS: Two methodologies were utilised: a self-administered cross-sectional survey of dentists in Victoria, Australia (conducted October to December, 1994), and a review of the records of the Continuing Education Unit of the School of Dental Science at The University of Melbourne for 1995 to 1999. For the cross-sectional survey, the sampling frame was the register of dentists of the Dental Board of Victoria in 1994. RESULTS: From a sample of 616 dentists invited to participate, 396 usable questionnaires were returned (response rate, 66.8 per cent). The valid data indicated that 52.5 per cent of dentists belonged to a study group, 66.5 per cent subscribed to at least one dental journal (other than the Australian Dental Journal), 88.9 per cent discussed dental matters with colleagues regularly, 98.6 per cent personally assessed their own work, 13.3 per cent did not attend continuing education courses and 18.1 per cent did not complete any courses in the year preceding the survey. Participation patterns in continuing education courses were related to socio-demographic characteristics of dentists. Some support was apparent for flexible delivery options for professional development. CONCLUSIONS: Involvement of dentists in Victoria, Australia in professional development activities is high, with complex participation patterns. Whether these patterns adequately address their own and the community's needs for such activities is debatable. Such issues should impact on any regulatory models for professional development for dentists and the development and use of alternative continuing education modalities.

Analysis of Variance↗

PubMed2000

Fourier analysis of facial profiles of young twins.

Twins studies provide a powerful approach to determining the relative contribution of genetics and environment to observed variation. Such studies assume trait differences in monozygous (MZ) twins are due to environmental factors and those in dizygous (DZ) twins are due to both genetic and environmental factors. This study quantitated facial profiles of twins using Fourier equations, determining their value in profile analysis and the assessment of the genetic contribution to facial shape. Standardized profile slide photographs of 79 pairs of 4-6 year-old twins (37 MZ pairs, 42 DZ pairs) were scanned and x and y coordinates were extracted from each profile using sellion and Camper's plane as references. The coordinates were subjected to Fourier analysis and the normalised vertex projection coefficients were studied. The means of the differences between coefficients for MZ co-twins did not differ significantly from that of DZ co-twins, although the DZ group showed higher mean differences in the higher harmonics. Subjective examination of superimposed reconstructions showed wider variation between DZ co-twins than MZ co-twins. Correct classification of twins by discriminant function analysis using Fourier coefficients was similar for both groups (MZ: 70.3%; DZ: 73.8%). Fourier analysis could quantitate facial profiles of young children and differentiate some details, but was unable to discriminate between genetic and environmental influences, and any possible interactions between these influences, on their overall facial profiles at this developmental stage.

Child↗

PubMed2000

Assessing caries risk in children.

With the dramatic improvements in the oral health of children in Australia that have occurred over the past two decades, the option of, and the need for, targeted prevention of dental caries for those at high risk has become apparent. Since caries is of multifactorial aetiology, the clinical outcome varies depending on which factor, or combination of factors, is prominent in a particular individual; this may be related to both age and stage of life. Tests for caries risk can assist in prediction, but clinical signs and history are as important in assessing the main cause(s) of caries in an individual. In studies involving several factors, past caries experience (especially of the first permanent molar) continues to be the best predictor of future caries in children. Despite their ready availability, tests in the form of commercial kits are still expensive; no one test is an adequate predictor of caries risk, and the specificity and sensitivity of the tests are not reliably diagnostic for an individual. There is a need for regional longitudinal risk assessment studies in which potential risk factors are identified before the onset of caries in order to maximize predictive power and then validated against subsequent caries. Caries activity may not be able to be predicted in a population with low disease prevalence. Any risk assessment strategy must be followed by appropriate preventive interventions.

Adolescent↗

PubMed1999

Child abuse and dentistry: a study of knowledge and attitudes among dentists in Victoria, Australia.

Child abuse is a disturbingly common finding in society today. In view of the high proportion of orofacial injuries seen in victims of child abuse, dentists are in a strategic position to recognize and report suspected cases. The present study of 347 dentists in Victoria, Australia, assessed the level of knowledge and attitudes among dental professionals on the important issue of child abuse. While a high level of interest was shown by the participants towards this issue, a need for further information and training in the recognition and reporting of child abuse was seen in the survey findings. While dentists at present are not legally mandated in all states of Australia to report suspected cases of child abuse, the dental profession is in a key position to play an active role in the identification and reporting of this substantial community problem.

Adolescent↗

PubMed1998

Clinical simulation in teaching preclinical dentistry.

Current and projected approaches to dental education have created a wide interest in clinical simulation, and recently there has been a considerable expansion in the availability of experiential learning tools which imitate "real life" clinical conditions in dentistry. These include patient simulation devices such as heads, jaws, teeth and clinical environments, standardized patients, interactive video-discs and computer-based instruction. This paper reviews some of the equipment currently available for simulation of clinical procedures, and assesses the initial experiences and responses of 2nd, 3rd and 4th year undergraduate dental students at The University of Melbourne to case-based simulations in a patient simulator in comparison with preclinical exercises in a traditional bench and manikin laboratory. Student response to teaching and learning in the simulator over a 3-year evaluation period, collected via a student questionnaire was uniformly positive. Students were very enthusiastic about the learning environment and educational approach, preferring it to traditional preclinical laboratory instruction.

Adolescent↗

PubMed1997

The retention of pit and fissure sealants placed in primary school children by Dental Health Services, Victoria.

The benefit of a public sector sealant programme for children in Australia is yet to be established. This study evaluated sealants placed by therapists of the School Dental Service in Victoria, between 1989 and 1994, on permanent teeth of children in 15 primary schools in Melbourne. Seven hundred and seventy four children aged 6-12 years were examined in school dental clinics by six calibrated examiners. A total of 5363 sealants placed on 2875 permanent teeth (including 2616 first molars, 91 per cent of sample) up to four and a half years previously was examined. Values for complete and partial sealant retention were highest for premolars (86 per cent, 9 per cent respectively, total 95 per cent); similar for occlusal surfaces of maxillary and mandibular first molars (63 per cent, 30 per cent; 62 per cent, 32 per cent respectively) and buccal pits of mandibular molars (66 per cent); and low for pits/fissures of Carabelli's cusps of maxillary molars (44 per cent). Cross-sectional examination up to 24 months for both maxillary and mandibular first molars indicated average values of 67 per cent complete retention, 27 per cent partial retention, 6 per cent missing; thereafter complete retention decreased and partial retention increased. Sealant failures in the six months post-placement were attributed to technique failure. Regardless of sealant retention, caries experience was low under partially retained or missing sealants (4.5 per cent) and completely retained sealants (0.4 per cent). It is concluded that the SDS sealant programme is a sound preventive dental public health approach.

Bicuspid↗

PubMed1997

Variability in cytotoxicity and fluoride release of resin-modified glass-ionomer cements.

New-generation glass-ionomer cements contain resin to improve their restorative properties. These resin-modified glass-ionomer cements vary considerably in their chemistry, which could result in corresponding variability in their physical and biological properties. This study investigated the cytotoxicity and the fluoride release of two resin-modified glass ionomers, a conventional glass-ionomer cement, and a resin composite. Samples were prepared and extracted in distilled water for 1, 4, and 7 days; eluates were filtered and tested by means of 3T3 mouse fibroblasts. Cytotoxicity (MTT assay) values were low for all materials and extraction times, indicating minimal cytotoxicity of all materials (less than 30% inhibition). Cytotoxicity of one resin-modified glass ionomer was significantly higher than for the other materials (p < 0.001). One resin-modified glass ionomer and the conventional glass-ionomer cement released significantly more fluoride at each time interval (p < 0.001) than the other resin-modified glass-ionomer cement and the resin composite. Fluoride release and cytotoxicity were correlated (r2 = 0.60; p < 0.001), although the fluoride release does not account for the cytotoxicity observed. Cytotoxicity and fluoride release suggest that one hybrid behaved more like a conventional glass ionomer, and the other like a resin composite. These differences may have implications for material selection in specific clinical situations.

3T3 Cells↗

PubMed1996

Promotion of mouthguards among amateur football players in Victoria.

Wearing mouthguards while playing contact sports reduces the prevalence and severity of orofacial injuries. We report on a 1991-92 promotion of mouthguard use among amateur football players in Melbourne. Four questionnaires were completed by players (1991 season: middle: n = 638, 49 per cent response: late: n = 770, 51 per cent: 1992: early: n = 505, 26 per cent: late: n = 698, 54 per cent), in four age groups (16-19, 20-23, 24-29, 30-44 years), about perceived mouthguard value and usage, injury experience, and awareness of a promotional message. Over the two seasons, mouthguard ownership and consistent wear increased and dental injuries decreased. Ownership of mouthguards increased among: 20-23 year olds and 30-44 year olds (13 and 16 per cent); managers, tradespersons, salespersons, labourers and the unemployed (14-19 per cent); residents of northern and western regions (12 and 13 per cent); those with 6 to 10 years of education (29 per cent); players in old boys' networks (13 per cent); and those with English as a first language (8 per cent). Consistent wear was high at matches (89 per cent) but low at training (13 per cent), owing to perceived lack of physical contact. Of dental injuries reported by 25-31 per cent, fractures predominated over luxations and avulsions. Fractures and avulsions were more common at matches than training; luxations predominated at training. When a mouthguard was not worn, the likelihood of a fractured or avulsed tooth was at least twice that when a mouthguard was worn. Some injuries occurred despite the wearing of mouthguards. The promotional message appeared effective in increasing mouthguard use; newspapers and football journals provided effective message locations for players, and ground signs and the electronic scoreboard for spectators.

Adolescent↗

PubMed1996

An in vitro study of the efficacy of mouthguard protection for dentoalveolar injuries in deciduous and mixed dentitions.

Sports-related dental trauma remains a risk for children and adolescents. Although mouthguards provide protection, up to 25% of dentoalveolar injuries can occur with a mouthguard in place. This study examined the effect of mouthguard protection in an in vitro model. A total of 97 sheep mandibular segments with incisors at four developmental stages (early deciduous, ED, n = 37; middle deciduous, MD, n = 20; late deciduous, LD, n = 18; mixed dentition, PD, n = 22) was used. Customised pressure formed mouthguards (MG) provided protection from trauma produced by a servohydraulic materials testing machine to test incisors. Injuries were examined clinically, radiographically and by dissection. Mean forces required to produce dentoalveolar injury were significantly greater in test (with MG) teeth than control (no MG) teeth. Mean forces to produce injury in test teeth decreased with resorbing root lengths. Deciduous incisors differed in injury type: subluxations and horizontal root fractures predominated in test teeth; lateral luxations and horizontal root fractures in control teeth. Predominant injuries in test and control permanent incisors were enamel infractions and subluxations. The magnitude of lateral luxation measurements of individual teeth was reduced significantly by mouthguard protection in both deciduous and permanent dentitions. The mouthguard tended to increase the mobility of the teeth it encompassed and, in some instances, promoted dentoalveolar injury of adjacent teeth.

Alveolar Process↗

PubMed1995

Pit and fissure sealants: another major cornerstone in preventive dentistry.

Despite dramatic reductions in caries in fluoridated communities, the disease continues to occur during childhood and adolescence and there is a sustained caries susceptibility of pits and fissures. Pit and fissure sealants have been available to the dental profession for the past two decades. Closely following community water fluoridation, this use of adhesive technology is now recognized as a major cornerstone of modern preventive dentistry. However, the technique appears to have been slow in implementation by the dental profession. Recent expanded utilization of sealants in the public sector, particularly in Victoria, has increased the awareness of the procedure amongst the public and is heightening demand. A review of the pertinent literature and current trends in utilization of sealants is presented. The case is made for expanded utilization of sealants in both the public and private sectors of dental health care delivery in Australia.

Adolescent↗

PubMed1994

Parental knowledge and attitudes towards pit and fissure sealants.

No survey of public knowledge and attitudes towards pit and fissure sealants has been carried out in Australia. This study assessed the knowledge and attitudes of parents of Melbourne school children attending five dental treatment centres, regarding sealants. Of 554 parents surveyed by questionnaire, 487 (88 per cent) provided codable responses which were analysed by the log-likelihood ratio statistic and three-way hierarchical log-linear regression models. A total of 57.5 per cent respondents had heard of sealants; 46.4 per cent knew sealants prevent dental caries, and 45 per cent rated sealants important in caries prevention. Respondents attending private dentists or the Dental Therapy School were more knowledgeable about sealants than those attending other centres. Sealant awareness was related significantly to gender (p < 0.05), country of origin (p < 0.05), family income (p < 0.05), and frequency of dental visits of children (p < 0.001); the apparent association with country of origin, and annual family income, was explained by interactions between these variables and treatment centres. Dentists were the main source of dental health information including sealant awareness (p < 0.001). The most significant factors in sealant awareness were previous discussion of caries prevention by respondents with dentists; dentists as the main source of dental health information; and frequency of dental visits by the child(ren). These three factors confirm the importance of dentist-patient interactions in disseminating oral health information.

Adolescent↗

PubMed1994

Nursing caries: literature review and report of a case managed under local anaesthesia.

Although the prevalence of dental caries in children has fallen in recent years, significant numbers of children are still treated for nursing caries. This form of rampant caries affects the primary dentition and causes rapid destruction of normally resistant surfaces. The treatment of nursing caries is multifactorial, involving the child, parents, dental team and other health care providers to ensure the restorative dental treatment is supported by parental education in caries prevention, oral hygiene and infant nutrition. This paper presents a literature review on the condition, followed by a case report of a child with nursing caries treated in the clinic under local anaesthesia.

Anesthesia, Dental↗

PubMed1994

Ectopic eruption of transposed mandibular permanent lateral incisors beneath primary first molars. Case report.

Mandibular permanent lateral incisors showing bilateral transposition and ectopic eruption were seen beneath primary first molars on bitewing radiographs in a female aged 9 years. This report chronicles management of the case during the mixed dentition period. Appropriate space maintenance after extraction of mandibular primary first molars, cuspids and lateral incisors on both sides facilitated eruption and repositioning of the permanent lateral incisors without the need to sever supracrestal gingival fibres.

Child↗

PubMed1993

Dental caries and treatment characteristics in human twins reared apart.

The 'reared apart' model, eliminating the effect of common environmental factors, is used extensively in twins research. In this study, teeth present (TP), teeth present excluding third molars (TPX3), teeth restored (TR), teeth restored index (TRI), surfaces restored (SR), surfaces restored index (SRI) and surfaces restored or carious (SRCI), were compared in 46 monozygotic (MZ) twin pairs and 22 dizygotic (DZ) twin pairs separated during infancy and raised apart. The dental examination included charting, panoral and bitewing radiographs, study models and a questionnaire. Data were analysed using intraclass correlations (ICC) and analysis of variance (corrected for age and sex). For all characteristics, the MZ pairs showed greater within-pair similarity than DZ pairs. For MZ pairs, the ICC values for the dental characteristics were all statistically significant (p < 0.005): TP, 0.45; TPX3, 0.49; TR, 0.57; TRI, 0.61; SR, 0.46; SRI, 0.67; SRCI, 0.58. For DZ pairs, none of the ICC values reached statistical significance: TP, 0.04; TPX3, 0.11; TR, 0.30; TRI, 0.31; SR, 0.20; SRI, 0.17; SRCI, 0.26. Despite subjects being reared in different environments, receiving different diets and different dental professional care, the MZ findings demonstrated significant genetic variance (45-67%) for the number of teeth present, number of teeth and surfaces restored, and caries present; the DZ data supported this conclusion. These findings provide new evidence for a genetic contribution to dental caries.

Adult↗

PubMed1990

Temporomandibular joint dysfunction and selected health parameters in the elderly.

Little research has focused on temporomandibular joint dysfunction (TMJD) in the elderly. The present study describes relationships between TMJD and selected health parameters in a population of 75- to 94-year-old Roman Catholic sisters (nuns). Mental, physical, and oral assessments made on 117 sisters identified 26 with TMJD. Among all sisters, TMJD was not associated with age, education, mental impairments, hand coordination, handgrip strength, mobility, or use of walking aids. In 75- to 84-year-old sisters, TMJD was positively associated with self-reported arthritis (p = 0.12), edentulism (p = 0.09), and the presence of complete dentures (p = 0.05), and negatively associated with the number of teeth present (p = 0.05), especially the posterior teeth. These associations were weaker in 85- to 94-year-old sisters. This study suggests that TMJD is associated with the presence of complete dentures and a low number of teeth, especially the posterior teeth.

Aged↗

PubMed1988

Cariogenicity of frequent aspartame and sorbitol rinsing in laboratory rats.

The cariogenicity of frequent rinsings with aspartame and sorbitol was studied in the rat caries model with animals randomly assigned to four oral rinse groups (16 rats/group): 0.05% aspartame, 20% sorbitol, deionized distilled water, and 20% sucrose; all solutions at pH 3.0. After rinsing five times daily for 21 days, mandibular molars were scored for caries. Smooth surface, proximal and morsal caries scores did not differ significantly between groups. Moderate dentinal sulcal caries for the sucrose group was significantly greater than in the aspartame, sorbitol, and water groups (p less than 0.05). Rinsing with 0.05% aspartame (similar in pH and concentration to that found in carbonated beverages) or sorbitol did not potentiate caries activity.

Administration, Oral↗