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N B Pitts

Publications and source records attributed to N B Pitts.

At least 37 records · Page 2Linked to original sources
PubMed2002

The dental caries experience of 12-year-old children in England and Wales. Surveys coordinated by the British Association for the Study of Community Dentistry in 2000/2001.

DESIGN: This paper reports the results of standardised clinical caries examinations of 106,694 twelve-year-old children from England, Wales, the Isle of Man and Jersey. These 2000/01 coordinated surveys are the latest in a series which seek to monitor the dental health of children and to assess the delivery of dental services. METHOD: The criteria and conventions of the British Association for the Study of Community Dentistry were used. Representative samples were drawn from participating health authorities and boards, and caries was diagnosed at the caries into dentine (D3) threshold using a visual method without radiography or fibre-optic transillumination. RESULTS: Once again a wide variation in caries prevalence across the United Kingdom was demonstrated, with mean values for D3MFT for the English 'regions' (of the National Health Service) and Wales ranging from 0.63 in the West Midlands to 1.31 in Wales. The mean value for DMFT across England Wales was 0.89 (D3T=0.39, MT=0.07, FT=0.43). Overall, 38% of children had evidence of caries experience at the dentinal level of detection (D3MFT>0), although the means ranged between 30% (West Midlands) and 51% (Wales). The mean D3MFT for those with disease at this threshold was 2.35. Trends over time demonstrate an improvement of 11% in overall D3MFT since 1996/97, compared to the 15% seen over the previous four year period. FT and care index fell. The number of fillings provided in 2000/01 and thus the care index, remained low. On average across England and Wales, only 48% of the dentinal caries experience identified by survey examinations of permanent teeth was seen as fillings (range in individual districts: 30% to 78%). The use of the SiC index highlights dental health inequalities. CONCLUSION: Taken together, these findings demonstrate the continuing need for more effective preventive strategies and treatment services for this important age group.

Child↗
PubMed2001

The impact of oral health on people in the UK in 1998.

Knowledge of the extent of dental disease gives a clinical indication of the experience of dental problems but it does not necessarily reflect the problems that people experience as a result of their dentition. It is becoming increasingly appreciated that the way a disease affects people's lives is just as important as epidemiological measures of its prevalence or incidence. The 1998 Adult Dental Health survey is the first of the decennial series of UK adult dental health surveys to use and report a measure of the self-perceived impact on people of the dental and periodontal diseases and other oral conditions. Over half (51%) of dentate adults said they had been affected in some way by their oral health, and in 8% of cases the impact was sufficient to have reduced their quality of life.

Adult↗
PubMed2001

Dental restorations in adults in the UK in 1998 and implications for the future.

People in their late fifties in the UK today can expect to live another 20 years and most want to maintain a functional and aesthetically acceptable dentition. However, 50% of the teeth of dentate adults aged 45 years and over are filled and crowned. The challenges for the dental profession in addressing these aspirations are discussed.

Adolescent↗
PubMed2001

Does social deprivation in 1, 2, 3 and 4-year-old Scottish infants influence the frequency isolation of caries-associated micro-organisms?

OBJECTIVES: The aim of this study was to determine if there are associations between the level of social deprivation/affluence and the frequency isolation of caries-associated micro-organisms (Streptococcus mutans, Streptococcus sobrinus, lactobacilli and yeasts) in a large cohort of infants examined annually from 1 to 4 years of age. METHODS: DEPCAT was used to measure the socio-economic status of all consented infants (n=1099--1392) born in Dundee during a 1 year period (total n=1974). Caries-associated micro-organisms were cultured from saliva when the infants were 1, 2, 3 and 4 years of age. Standardised dental examinations were also carried out annually. Log linear analysis, which controlled for caries, was used to look for associations between DEPCAT and the isolation frequency of caries-associated micro-organisms. RESULTS: When controlling for caries, there was an association between DEPCAT and the isolation frequency of yeasts when the infants were 1 and 2 but not when 3 and 4 years old, whereas lactobacilli were associated only when the infants were 3 and 4 years old. Correlations between S. mutans and social deprivation were usually dependent on the caries status of the infants. CONCLUSIONS: The relationship between social deprivation and the isolation frequencies of caries-associated micro-organisms is complex with lactobacilli developing an association when the infants were 3 and 4 years old in contrast to yeasts which were only associated when the infants were 1 and 2 years old. Streptococcus mutans was associated with social deprivation when the infants were 2 years old and older, but dependent on caries status in the 3 and 4 year olds.

Age Factors↗
PubMed2001

A proposed method for assessing the quality of sealants--the CCC Sealant Evaluation System.

OBJECTIVES: The aim of this paper is to introduce the C (colour) C (coverage) C (caries) Sealant Evaluation System and to present results of its use on a sample of adolescent patients in Scotland. METHODS: Baseline data are presented from a 3-year prospective study in general dental practices across Scotland. Subjects were examined under standardised conditions by one trained and calibrated examiner. RESULTS: 78.6% of the subjects had one or more sealed teeth, over half of these sealants being judged inadequate. There was a low prevalence of dentine caries associated with the sealed teeth (2.8%). The CCC sealant Evaluation System proved practical as demonstrated by its use during the project and had substantial intra-examiner reproducibility. CONCLUSIONS: There was a high level of sealant provision; however, this provision may not be optimal in terms of both targeting of provision and sealant maintenance. The CCC sealant Evaluation System appeared to be a useful assessment tool for assessing sealed surfaces.

Adolescent↗
PubMed2001

Restoration removal with and without the aid of magnification.

This study aims to quantify any cavity size change following removal of tooth-coloured restorations in vitro using unaided vision and 2.6 x magnification. Occlusal composite restorations were removed under simulated clinical conditions and changes in cavity size were measured, blind to method, using standardized photographs. The outline of the cavity was digitized and its area was used as a surrogate for cavity size. The change in cavity size was determined for unaided vision and 2.6 x magnification, with any differences between the techniques investigated. There were significant increases in cavity size using both techniques and although the increase in size was less when magnification was used, the difference was not statistically significant. Cavity size changes significantly during re-restoration and the use of magnification may be of benefit for some clinicians in reducing the size of the change.

Adult↗
PubMed2001

Visual standards in a sample of dentists working within Scotland.

INTRODUCTION: This study aims to measure the visual acuity of practising dentists and to establish the average time elapsed since their last routine eye examination. MATERIALS AND METHODS: Distance visual acuity, near visual acuity, convergence, accommodation, contrast sensitivity, heterophorias and stereoscopic vision were measured in a diverse group of 46 dentists practising in Scotland. RESULTS: The results indicated that distance visual acuity was at least 6/6 for all but one of the subjects. All had acceptable near visual acuity. Accommodation followed the expected age-related trend of decreasing with age. No subjects had a definitely abnormal contrast sensitivity score although four were in the borderline zone. No subjects had a horizontal squint but two had a significant vertical phoria. Three subjects had no stereoscopic vision and one subject had a very high threshold level. All other subjects were able to see stereoscopically. Of the subjects 57% had been for an eye examination within the previous two years, with the range being from less than one month to 17 years. CONCLUSION: The eyesight of this group of clinicians exceeds generally accepted normal population values. Although the majority of the clinicians had attended for an eye examination within two years, the large range of time since last attendance is of concern and regular eye examinations are to be encouraged.

Accommodation, Ocular↗
PubMed2001

The dental caries experience of 5-year-old children in Great Britain. Surveys coordinated by the British Association for the Study of Community Dentistry in 1999/2000.

OBJECTIVE: This paper reports the results of standardised clinical caries examinations of 199,440 5-year-old children from across Great Britain. These 1999/2000 coordinated surveys are the latest in a series which seek to monitor the dental health of children and to assess the delivery of dental services. METHOD: The criteria and conventions of the British Association for the Study of Community Dentistry were used. Representative samples were drawn from participating health authorities and boards and caries was diagnosed at the caries into dentine threshold using a visual method without radiography or fibre-optic transillumination. RESULTS: The results again demonstrated a wide variation in prevalence across Britain, with mean values for d3mft for the current English regions (of the National Health Service) and for Wales and Scotland ranging from 0.94 in the West Midlands to 2.55 in Scotland. Mean d3mft across Great Britain was 1.57 (d3t=1.14. mt=0.22, ft=0.21). Overall, 40% of children had evidence of dentinal caries experience (d3mft>0), although the means ranged between 30% (West Midlands) and 55% (Scotland). The distribution of caries was highly skewed. Thus the British mean caries experience for those with the disease was 3.88, as opposed to the overall mean of 1.57. Trends over time demonstrate a modest improvement of 4% in overall d3mft for Britain since 1997/98, compared with the 8.6% improvement seen for the two previous years. All three components with dmft have also fallen. The care index has remained virtually unchanged in Britain as a whole (13.6% in 1999/2000, compared to 13.9% in 1997/8). Regional/country means for 1999/2000 ranged from 8-20%. This indicator has not, however, regained the levels seen in the past. CONCLUSION: There has been some improvement in the dental health of 5-year-old children. Overall, the provision of operative care for those with dental decay has not changed; significant groups remain within the population of 5-year-old children who have dental disease and who are in need of dental care.

Child, Preschool↗
PubMed2001

Clinical diagnosis of dental caries: a European perspective.

The aim of this paper is to provide a broad international perspective on aspects of the RTI/UNC systematic review, to introduce relevant literature not cited, and to make recommendations for clinical practice education and research suggested by the evidence. Clinical caries diagnosis represents the foundation on which the answers to most of the consensus questions will be based. This paper highlights needs for being clear about definitions and nomenclature; understanding the importance of the concepts underlying the D1 and D3 diagnostic thresholds used widely within the RTI/UNC Review; and appreciating that the diagnostic challenge now faced by clinicians is significant and is becoming more complex as the presentation and distribution of the disease changes over time and the range of preventive and operative treatment options expands. A series of recommendations informed by the evidence are made, including a rather contentious issue for many clinicians concerning the lack of evidence supporting the continued use of a sharp explorer as a diagnostic tool for primary caries diagnosis. This practice should be discontinued as it may cause some harm to the patient and yet fails to provide a significant balancing diagnostic benefit. Finally, it is suggested that dentistry should learn from the developing evidence base in medicine on how best to disseminate the findings of reviews and promote appropriate changes in clinical practice.

Decision Making↗
PubMed2000

The condition of teeth in the UK in 1998 and implications for the future.

The latest of the decennial surveys of the United Kingdom was undertaken in 1998 by the Office of National Statistics in collaboration with the dental schools of the Universities of Birmingham, Dundee, Newcastle and Wales. Dentate adults in 1998 have fewer missing teeth and more sound and untreated teeth on average than in 1978. The average number of decayed teeth has dropped significantly from 1.9 in 1978 to 1.1 in 1998. The average number of filled teeth has remained fairly constant over the same time but its distribution has changed quite markedly towards older adults having more filled teeth than people of a similar age in the past whilst the reverse is true for younger adults. The overall trends are encouraging, but there is a need to review the way disease is managed in adults in the United Kingdom.

Adolescent↗
PubMed2000

Total tooth loss in the United Kingdom in 1998 and implications for the future.

The 1998 Adult Dental Health Survey, published this year, showed that the number of people without teeth should fall over the next three decades, to only 4% of the UK population. Patterns of tooth loss and retention are also changing. This article, the first of a series on the interpretation of the Adult Dental Health Survey, discusses the implications of these trends for dentistry.

Adolescent↗
PubMed2000

Scottish consortium for development and education in dental primary care.

A national consortium for dental primary care in Scotland has been formed as a result of integrated planning by groups involved in managing and delivering postgraduate dental education in Scotland. In 1998 a partnership was formed with representatives from the Scottish Council for Postgraduate Medical and Dental Education (SCPMDE) and the three Scottish dental institutions at Dundee, Edinburgh and Glasgow Universities. The principal aim of the Consortium is to promote evidence-based dental care through postgraduate education and research. The activities of the Consortium will provide a broadly based adjunct to current postgraduate provision with partner institutions contributing in different ways. Since its inception the Consortium has focused on two main areas: 'Higher Training' for Primary Care. Scottish Dental Practice Based Research Network.

Dental Research↗
PubMed2000

A clinical evaluation of an Erbium:YAG laser for dental cavity preparation.

OBJECTIVE: A randomised controlled trial to determine the acceptability to dentists and patients of cavity preparation with an Erbium:YAG laser as compared with conventional handpieces. METHODS: Fifteen dentists (9 GDPs, 1 community dentist and 5 hospital dentists) treated 77 patients (age range 3.5-68 years old) who had two matched cavities, in a split mouth, randomised trial. One cavity was prepared conventionally, the other with the laser, with dentist and patient preference determined by questionnaire. RESULTS: In the majority of cases, where dentists expressed a preference, it was for conventional cavity preparation, and this was significant (P < 0.001). In more than half of the laser appointments, dentists had to use conventional handpieces to complete the cavity. Principle difficulties reported with the laser were access (25 cases) and slow speed of cutting (11 cases). Patients aged > or = 10 years who expressed a preference, preferred laser treatment, and this was significant (P < 0.001). Patients aged < 10 years, assessed using a simplified pictorial questionnaire, did not show a significant preference for either technique. CONCLUSIONS: Dentists preferred conventional handpieces for cavity preparation while patients aged > or = 10 years old preferred laser treatment. Patients < 10 years old did not express a preference.

Adolescent↗
PubMed2000

General dental practitioners diagnostic and treatment decisions related to fissure sealed surfaces.

OBJECTIVES: The purpose of this in-vitro study was to assess the validity and reproducibility of the diagnosis and treatment planned for occlusal surfaces prior to and following the placement of a clear sealant by a sample of general dental practitioners (GDPs). METHODS: 160 permanent posterior teeth were examined by 25 GDPs. The GDPs were not given any criteria and were therefore free to diagnose and plan care, as they felt appropriate. Each GDP conducted four examinations, two prior to and two after sealing. The teeth were serially sectioned to provide the validating criterion. RESULTS: After sealant placement, there was a statistically significant increase in specificity and decrease in sensitivity of both diagnostic and treatment decisions. The reproducibility expressed by the kappa-statistic was of the order of 0.5 prior to and after sealing with regard to diagnostic decisions. There was a general tendency to diagnose less disease after placement of a sealant (P<0. 001). There was also significantly less care (preventive or restorative) planned after sealant placement (P<0.001). CONCLUSIONS: The placement of a sealant resulted in the diagnosis of less disease and less restorative treatment. This may be appropriate as evidence exists to support the use of sealants as caries therapeutic agents.

Bicuspid↗
PubMed2000

Caries-associated micro-organisms in infants from different socio-economic backgrounds in Scotland.

OBJECTIVES: The aims of this study were: (1) to compare the frequency of isolation of mutans streptococci, (Streptococcus mutans, Steptococcus sobrinus), lactobacilli and yeasts (caries-associated micro-organisms) in the saliva of 1-year-old infants with and without dental caries; and (2) to determine if socio-economic background influenced the frequency isolation of bacteria and caries status. METHODS: 1393 1-year-old consented infants, who comprised 70. 3% of children born in Dundee during a 1year period, had saliva samples taken (tongue-loop method) for microbiological culture and were examined for dental caries (d(1)-threshold: enamel and dentine diagnostic threshold). Thirty-nine infants were diagnosed with caries and the frequencies of isolation of caries-associated micro-organisms (and absolute microbial counts) were compared with infants who were caries-free. In addition, associations were sought between the infants' socio-economic background, the frequency of isolation of caries-associated micro-organisms and caries status. RESULTS: Streptococcus mutans, lactobacilli and yeasts were isolated more frequently from those infants with caries compared to those who were caries-free (S. mutans: 29.7 vs 9.8%, P=0.0008; lactobacilli: 15.4 vs 4.3%, P=0.0073; yeasts: 23.7 vs 10.4%, P=0.0016-Fisher's exact test). There were no significant differences between the isolation frequencies of S. sobrinus (2.7 vs 1.3%, P=0.39) from those with and without caries. Significantly, more infants living in areas of high deprivation had caries compared to those from more affluent areas (DEPCAT 6 and 7 vs 1-5: 3.6 vs 1.9%, P=0.049), but, apart from yeasts, socio-economic background was not significantly associated with the isolation frequencies of any of the caries-associated micro-organisms. CONCLUSIONS: In infants as young as 1year of age, salivary S. mutans, lactobacilli and yeasts but not S. sobrinus were isolated significantly more frequently from those with caries compared to those who were caries-free. Apart from yeasts, socio-economic background did not influence the frequency of isolation of caries-associated micro-organisms. However, infants living in areas of highest deprivation had significantly higher frequencies of caries compared to those from more affluent areas.

Colony Count, Microbial↗
PubMed2000

Effect of diagnostic threshold on the validity and reliability of epidemiological caries diagnosis using the Dundee Selectable Threshold Method for caries diagnosis (DSTM).

OBJECTIVES: To develop a method for recording dental caries at the D1 (enamel and dentine) diagnostic threshold (without loss of D3 information) and assess its reliability, 'benchmark' validity and potential effects on reported caries prevalence and needs assessment. METHODS: Multi-examiner training, calibration and validation trial. Two groups of 10 dental examiners were trained to diagnose dental caries at the D1 (enamel and dentine) diagnostic threshold under the conditions of a caries prevalence survey, prior to a calibration trial being undertaken. RESULTS: Where 'experienced examiners' were trained to examine at the D1 (enamel and dentine) diagnostic threshold, under the conditions of a cross-sectional epidemiological survey, there was no significant deterioration in inter-examiner agreement on the assessment of teeth and a significant difference in one of two comparisons on the assessment of surfaces using the kappa statistic. Assessed against a benchmark examiner, there was no significant loss of sensitivity at the D1 diagnostic threshold compared with the D3 threshold and, although there was a significant loss of specificity at the D1 threshold, all specificity values could be considered to be high. CONCLUSIONS: Modifying the diagnostic criteria typically used in surveys of caries prevalence (to allow assessment of the levels of enamel caries which could benefit from preventive care as well as dentinal caries requiring restorative care) in adolescents does not adversely affect the reliability or benchmark validity of experienced examiners to a significant degree.

Adolescent↗
PubMed2000

In vitro validity of the Dundee Selectable Threshold Method for caries diagnosis (DSTM).

OBJECTIVES: It is not generally possible to assess diagnostic accuracy in dental surveys as no histological 'gold standards' are available, therefore examiner agreement tends to be used as a proxy for accuracy. The aim of this study was to investigate, using extracted teeth in arch models, the in vitro validity of a diagnostic system to assess caries at the D1 (enamel and dentine) and D3 (dentine) diagnostic thresholds, for epidemiological purposes. METHOD: Two groups of 10 dental examiners trained in the use of the Dundee Selectable Threshold Method for caries diagnosis (DSTM) each examined (on two occasions) 160 extracted permanent molar and premolar teeth set in arch models in phantom heads according to the codes and criteria of the DSTM. The teeth were subsequently radiographed and sectioned to provide validation of the diagnoses. RESULTS: Intra-examiner agreement according to the kappa statistic was substantial. In general terms the results of the in vitro validation exercise demonstrated significantly higher sensitivity values at the D1 diagnostic threshold than were found at the D3 diagnostic threshold with a consequent loss of specificity. CONCLUSIONS: The results of this in vitro validation exercise demonstrate that at the D1 diagnostic threshold the sensitivity of the DSTM was greater than at the D3 threshold indicating no loss of diagnostic accuracy at the D1 threshold.

Bicuspid↗