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Biomedical subjects

M E J Curzon

Publications and source records attributed to M E J Curzon.

18 recordsLinked to original sources
PubMed2006

Cost-effectiveness of a long-term dental health education program for the prevention of early childhood caries.

AIM: To evaluate the benefit-cost (B/C) and cost-effectiveness (C/E) of a long-term dental health education program to prevention early childhood caries (ECC) through home visits. METHODS: The data collected over a three year period in a dental health education programme (DHE), previously reported [Kowash et al., 2000] for infants aged 8 months at start were analysed for B/C and C/E. Dental caries indices (BASCD) for dmft and dmfs were used. Costs were based on British National Health Service (UK) fees for treating children by general dental practitioners and salaries for community dental officers in the Community Dental Services in the UK. Comparisons were made for B/C and C/E with results from a clinical trial of a slow releasing fluoride device (SRFD), community water fluoridation (CMF) and a school based fissure sealant program (FSP) using the hypothetical community of Niessen and Douglass, [1984]. RESULTS: The cavities, as ECC, saved over the three year period indicated a B/C ratio for the DHE of 5.21 compared with SRFD of 4.17; CWF of 1.15 and FSP of 0.42. The C/E results were 1.92, 2.40, 8.66 and 23.74 respectively. CONCLUSION: A dental health education program of home visits with mothers of young infants to prevent early childhood caries and starting at 8 months of age, gave better benefit-costs and costs effectiveness ratios than other preventive programs.

Child, Preschool↗
PubMed2006

Slow-release fluoride glass devices: in vivo fluoride release and retention of the devices in children.

AIMS: To study the fluoride release and retention of new-shaped glass slow-release F devices (SRFD) in vivo in children. METHODS: A group of 15 children had a SRFD with 17.4% or 14.8 mgm F with a relative solubility of 294, attached intra-orally on the buccal surface of one of their maxillary permanent molars. The devices were monitored for six months. RESULTS: The retention rate of the devices was 93% and the mean salivary F levels in the child volunteers was 01.17+/-0.1 ppm F compared with 0.025 ppm F baseline levels. The difference was statistically significant (p<0.01). There were no systemic or local side effects. CONCLUSIONS: The devices were well tolerated by children and released fluoride intra-orally for the whole period of six months to a level consistent with inhibition of demineralisation.

Adolescent↗
PubMed2006

Restoration of primary teeth: clinical criteria for assessment of the literature.

AIM: This is was to establish a system of clinically based criteria for the assessment of papers published in peer reviewed journals concerning the use of restorative techniques in primary teeth. BACKGROUND: Various publications that consider the approaches to be taken to setting up assessment criteria with the dental/medical literature were reviewed. These included the so called 'Cochrane criteria'. On the basis of this review a set of clinically based criteria were drawn up that were then used to produce a list of criteria to be used in a series of systematic reviews of the literature concerning the various restorative techniques, materials and medicaments for pulp therapy and the restoration of primary teeth. RESULTS: There were 23 criteria that were felt to be appropriate. The list of 23 criteria were deemed to be appropriate for pulp therapy and 21 for restorative techniques and materials. Conclusion.A set of clinically based criteria is suggested for the systematic review of publications on restorative techniques for primary teeth.

Child↗
PubMed2005

Soft drinks and dental health: a review of the current literature.

In recent years there has been increased interest in the role of commercial soft drinks in dental diseases namely as dental caries and erosion. The objective of this paper has been to review the past and current literature to determine the present knowledge on this subject. The literature related to dental caries, erosion, drinks, soft drinks and fruit juices was reviewed. The literature shows efforts have been taken to modify soft drinks by either adding or deleting certain components so as to reduce their harmful effects on teeth. A rational protocol to encourage the sensible use of drinks and the modification of drinks to render them less harmful would be advisable.

Age Factors↗
PubMed2005

Potential toxicity.

Explore the source record for details and available documents.

Aluminum Compounds↗
PubMed2004

In vitro and in vivo assessment of a glass slow fluoride releasing device: a pilot study.

AIMS: The aims were to evaluate a) whether a slow release fluoride-glass pellet (SFG) would be retained in the mouth and release fluoride (F) over a long period of time, b) what concentrations of F in the glass would provide ideal intra-oral saliva F concentrations and c) whether an SFG would affect blood plasma concentrations of F after swallowing compared with ingestion of a commercial NaF tablet. METHODS: a) A prototype SFG was attached to a maxillary molar of a volunteer. Baseline saliva F concentrations were measured prior to glass placement, daily in week one; one day a week for weeks two to three and then one day a month up to 18 months. Four subjects had the SFG for six months with saliva F concentration assessments at periodic intervals. b) SFGs containing F at 13.3%, 18.3% and 21.9%, and an improved solubility, were tested using three volunteers and saliva F concentrations measured. c) Five volunteers each swallowed either a SFG or a NaF tablet. Blood plasma samples were taken at baseline and F measured at time intervals of 2.5, 5, 10, 20, 30, 45, 60, 90 and 120 mins post-ingestion. RESULTS: a) The prototype SFG were successfully retained and released F into saliva; mean concentrations of 0.035 mg L(-1) were achieved lasting for over 18 months. Overall saliva F concentrations were approximately doubled. Analysis of the pellet at the end of use showed it still contained some F possibly indicating a recharging effect. b) The 13.3% F concentration SFG produced significantly higher saliva F levels than the two other concentrations tested. The two higher concentration F glasses contained aluminium as part of the formulation of the glass structure, which is known to bind F whereas the 13.3% glass contained F alone. c) While blood plasma F levels increased after ingestion of the NaF tablet there was no increase in F when the SFG was swallowed. CONCLUSION: A slow release F containing glass device showed promise as a means to enhance intra-oral F saliva concentration.

Adult↗
PubMed2004

Anxiety related to dental general anaesthesia: changes in anxiety in children and their parents.

AIM: To examine the anxiety levels of children referred for dental general anaesthesia and their parents at various key points of the referral and anaesthetic procedure. METHODS: Structured interviews and anxiety measures were conducted with 50 children attending the Department of Paediatric Dentistry, Leeds Dental Institute, and progressing to general anaesthetic (GA) and their parents. Interviews were conducted with parents and children prior to initial assessment, following assessment and prior to a GA. Anxiety was measured at each interview, using the Visual Analogue Scale for parents and the Venham's Picture test for children. A fourth telephone interview was conducted with parents one week after the GA when the degree of upset caused to parents and children by the procedure was evaluated. RESULTS: Anxiety of children remained constant at each interview. Parent and child anxiety were not related. There was a rise in parent anxiety following initial assessment in those families attending in response to a routine referral and progressing to GA (p<0.05). There was a further rise in parent anxiety in these families immediately prior to the GA itself (p<0.001). Parent upset was strongly related to their anxiety at each of the three interviews prior to the GA (p<0.01, 0.05 and 0.001 respectively) and to the distress of their child (p<0.02). Child distress was strongly related to anxiety at each of the three interviews prior to the GA. CONCLUSION: The anxiety levels of children did not appear to change throughout the whole GA assessment and treatment process. Parent anxiety rose significantly following assessment and again just prior to the GA. Factors contributing to parent upset post treatment were child upset and pre treatment parent anxiety levels. Children who were most anxious prior to GA found the procedure most distressing.

Adolescent↗
PubMed2004

A prospective comparison between findings from a clinical examination and results of bitewing and panoramic radiographs for dental caries diagnosis in children.

AIM: To compare the findings of a clinical examination with those from bitewing (BW), panoramic (Pan) and panoramic plus bitewing (PanBW) radiographs for dental caries in children. METHOD: A population of 39 children, aged 3.8 to 11.9 years, who required radiographs as part of their initial assessment for care in the Department of Paediatric Dentistry (Leeds), was selected. Each subject was examined clinically for dental caries. Subsequently, a paediatric dentist and a specialist in dental radiography read the radiographs. ANALYSIS: A database in Microsoft Access was used to compare the examiners readings for each radiographic view; agreements were taken to be a consensus. Disagreements were re-viewed by both examiners to arrive at a consensus. Radiographic results were compared with those of the clinical examination. RESULTS: The clinical examination identified 6.0% (95% CI 4.1 to 7.8, p<0.001) more carious surfaces than Pan. Clinical examinations also identified more carious surfaces than BW 1.2% (95% CI -0.7 to 3.2, p<0.247) and PanBW 0.6% (95% CI -1.1 to 2.3, p<0.533) but these differences were not statistically significant. When occlusal surfaces only were compared, the clinical examination identified significantly more carious occlusal surfaces then BW (15.2%, p<0.001), Pan (17.1%, p<0.001) and PanBW (13.5%, p<0.001). Comparing the approximal surfaces only, the BW and PanBW identified significantly more carious surfaces than the clinical examination, 5.1% (p<0.001) and 4.3% (p<0.001) respectively. CONCLUSION: The use of a clinical examination with PanBW provided the maximum information on dental caries in the primary and mixed dentitions, particularly for approximal surfaces. This is important in planning comprehensive dental care for children.

Chi-Square Distribution↗
PubMed2003

Prevalence of drooling in children with cerebral palsy attending special schools.

Prevalence of drooling in children with cerebral palsy (CP) and its severity across dental age (i.e. children with primary, mixed, and permanent dentitions) was investigated. One hundred and sixty children and adolescents (91 males, 69 females; mean age 10 years 10 months, SD 4 years 2 months; range 4 to 18 years) with CP who attended special schools were involved in this study. Sixty eight per cent of participants had spastic CP with the majority (45%) diagnosed as having quadriplegia. Presence or absence of drooling was determined by direct observation of the participants. Other data, such as age, sex, learning disability, and type of CP were collected using questionnaires. Results showed 93 of 160 children (58%) with CP had a drooling condition and of these 53 (33%) had severe drooling. It was found that the degree of drooling decreased as the child's dental age increased. Prevalence of drooling in children with primary dentition was found to be 75% as compared with 43% of those with permanent dentition, although this difference was not statistically significant. It was concluded that any invasive treatment to reduce drooling should, perhaps, be postponed until the child's oromusculature has matured.

Adolescent↗
PubMed2003

The cause of drooling in children with cerebral palsy -- hypersalivation or swallowing defect?

OBJECTIVE: To determine whether or not drooling in children with cerebral palsy is due to hypersalivation. POPULATION AND METHODS: The study population consisted of 10 children with cerebral palsy who were identified as having severe drooling, and a matched control group composed of 10 unaffected children who had no known physical or mental disabilities. Salivary flow rate was compared between the cerebral palsied children and the control group using the chin-cup collection drool quantification method described by Sochanjwskyj. Components of the system included a cup-like collection device, a vacuum pump, plastic tubing, an airtight collection chamber, and calibrated test tubes held against the subject's chin with elastic straps attached to an orthodontic head bonnet. Statistical analysis was completed using the Student's t-test and Fisher's Exact Probability test. RESULTS: The ages of the population ranged from 5.2 to 15.6 years, mean age (+/- SE) of 10.56 +/- 1.13 years. There was no statistically significant difference in the rate of salivary flow rate between the two groups' mean +/- SE: cerebral palsy group 0.220 +/- 0.018; control group 0.334 +/- 0.052 (P = 0.053). The results were further confirmed by comparing the buffering capacity (P = 1.00) and concentrations of the sodium (P = 0.065) and potassium ions (P = 0.058) in the saliva of the study groups. CONCLUSIONS: Children with cerebral palsy who drool do not appear to produce excess saliva. Their salivation is similar to the control children.

Adolescent↗
PubMed2003

Changes in dentists' attitudes and practice in paediatric dentistry.

AIM: The purpose of the study was to determine if there had been any changes in the clinical practice and attitudes to the care of children by general dental practitioners over a ten year period from 1986 to 1996, following the introduction of a system of capitation payments in the United Kingdom. METHODS: A questionnaire was mailed to 1,290 general dental practitioners practicing in Yorkshire (UK) in an identical way to a previous survey ten years before. Practitioners were asked questions concerning their practice of dental caries prevention, behaviour management, restoration of primary teeth and pulp therapy. Responses were compared with the results of the 1986 survey. RESULTS: Of the total of 687 replies (53.2% response) 61% practiced, or said they practiced, diet evaluation and gave dietary advice. Oral hygiene instruction was reported by 87% and 57% used fissure sealants. The routine use of amalgam, previously 80%, had declined to 35% in favour of glass ionomer cements (57%). There had been a significant improvement in the use of pulp therapy for primary teeth at 35% compared with previous 3%. The use of rubber dam also increased, but only from 0% before to 9% in the present study. The usage of stainless steel crowns had changed from 2% over ten years to 8% and strip crowns from 1% to 5%. CONCLUSION: The use of paediatric dental techniques by general dental practitioners had generally increased, particularly in preventive measures and pulp treatment. Restorative techniques had marginally changed, but a dramatic shift away from amalgam had occurred. There was still a very low usage of stainless steel crowns and rubber dam was also not used to the extent that it should be.

Adolescent↗
PubMed2002

The use of the local analgesia syringe in children. Should it be kept out of sight? A clinical trial of two methods of presentation.

AIM: The study was carried out to determine whether showing a local analgesia (LA) syringe to a child would influence behaviour during subsequent administration of LA, as opposed to concealing it. MATERIALS AND METHODS: 25 children were randomly assigned to either a show (13) or no-show (12) group. The children were aged 4 years and 3 months to 8 years and 9 months, mean age 7 years and 9 months. One operator carried out all LA administrations. The procedure and dialogue were strictly standardised. Each child was filmed during LA administration. Three paediatric dentists scored the video recorded behaviours, using the Frankl Behaviour Rating Scale. The raters were blind as to which group the child belonged to. RESULTS: No statistical difference was found between the behaviour ratings of the no-show and the show groups during LA administration (p>0.05). CONCLUSION: Overall, the behaviour of the children in the show group did not differ from the behaviour of children in the no-show group. Whether to show or not to show the LA syringe is probably dependent on the behavioural skills of the operator.

Clinical Trial↗
PubMed2002

The prevalence of developmental enamel defects in permanent molars in a group of English school children.

AIM: An epidemiological study was designed to determine the prevalence of enamel defects in first permanent molars in English children of ethnic backgrounds. MATERIALS AND METHODS: A population of school children aged seven years, living in the low water fluoride City of Leeds (UK) were examined for the presence of developmental enamel defects in first permanent molars. The examination criteria were based on the DDE index for screening surveys. The ethnic background to the children examined was determined by school records, name and visual assessment. RESULTS: The results for 307 children (154 females) showed an overall prevalence of defective enamel in first permanent molars of 14.5% and tooth prevalence of 7.2%. There were effects of gender or tooth site. There was no significant difference in prevalence between White-Caucasian (17%) or Asian-Caucasian (10%) children. The demarcated opacity was the most frequent type of defect seen, followed by diffuse opacities and hypoplasia. The occlusal and buccal surfaces were the most commonly affected. CONCLUSION: As there were no significant differences in prevalence between children of different ethnic groups it was concluded that the aetiology of enamel defects in permanent molars was most likely affecting all children.

Journal Article↗
PubMedDate not supplied

A clinical trial of a slow-releasing fluoride device in children.

The objective was to test a fluoride-containing slow-release device in preventing dental caries in children. Accordingly a population of 174 children aged 8 years living in a high-caries, low socio-economic area of Leeds (UK) was assembled. Two slow-release/dissolving glass (SFG) pellets, one with fluoride (F) and one without, were randomly attached to the maxillary molars of the children. Baseline caries as dmft/s, DMFT/S, periodontal disease, plaque and calculus were recorded using standard indices. Unstimulated saliva samples were collected 2 h postprandial for F analysis. All parameters were measured at 6-month intervals for 2 years. There were 132 children completing the trial of whom 63 (test n = 31, control n = 32) still retained the glass devices at the end. Comparison of mean values for gingival health and calculus showed no differences between groups throughout the trial. Mean caries as dmfs at the end of the trial (2.26) was significantly lower for the test (SFG, 2.26) compared with that for the control children (8.41; p < or = 0.001). DMFS was significantly lower at 0.84 and 2.34, respectively (p < or = 0.05). Mean salivary fluoride concentrations were 0.11 and 0.03 mg/l for test and control groups. It was concluded that placement of a glass slow-releasing fluoride device significantly reduced caries incidence in a group of low socio-economic schoolchildren over 2 years.

Cariostatic Agents↗