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Biomedical subjects

R A C Chate

Publications and source records attributed to R A C Chate.

8 recordsLinked to original sources
PubMed2006

The impact of clinical audit on antibiotic prescribing in general dental practice.

OBJECTIVE: To reduce the number of antibiotics inappropriately prescribed by general dental practitioners, and to increase overall prescription accuracy. DESIGN: A prospective clinical audit carried out between September and March of 2002-3 and 2003-4. SETTING: General dental practices in Eastern England. SUBJECTS AND METHODS: The pre-audit antibiotic prescribing practices of 212 general dental practitioners were recorded over an initial six week period. On each occasion this included which antibiotic had been chosen, together with its dose, frequency and duration, as well as the clinical condition and reason for which the prescription had been raised. When related to prophylaxis, the patient's medical history was also noted. Following education on contemporary prescribing guidelines, presentations which illustrated the practitioners' previous errors, and the agreement of standards to be achieved, the process was repeated for another six weeks, and the results compared. RESULTS: In the pre-audit period, 2,951 antibiotic prescriptions were issued, and during the audit this was reduced by 43.6% to 1,665. The majority were for therapeutic reasons, with only 10.5% and 13.6% for medical prophylaxis during the pre-audit and audit periods respectively. Over both periods, amoxicillin and metronidazole were the two most commonly prescribed antimicrobials (63.4% and 21.2% respectively). In the pre-audit period, only 43% of all prescriptions were error free in dose, frequency, and/or duration of use, but this rose significantly to 78% during the audit. Equally, using contemporary published guidelines, out of all the prescriptions made in the pre-audit period, only 29.2% were deemed to be justified, as compared to 48.5% during the audit. CONCLUSIONS: Clinical audit, in conjunction with education, and prescribing guidelines can favourably change antibiotic prescribing patterns among general dental practitioners.

Anti-Bacterial Agents↗
PubMed2006

An audit improves the quality of water within the dental unit water lines of three separate facilities of a United Kingdom NHS Trust.

OBJECTIVE: To improve the quality of water emanating from dental unit waterlines (DUWLs). DESIGN: A prospective clinical audit. SETTING: Three geographically separate district dental facilities of a United Kingdom NHS Trust, involving two community clinics and one hospital orthodontic department, which were evaluated between 2002 and 2004. METHODS: Samples of water discharged from the DUWLs were collected prior to the start and midway through a morning session. These were tested microbiologically at a United Kingdom Accreditation Service testing laboratory within six hours of sampling. INTERVENTIONS: One of the clinics followed the contemporaneous BDA advice of flushing water through its DUWLs while the other two clinics used separate intermittent disinfection purging regimes instead. One of them used a two stage protocol of Ethylene Diamine Tetra-Acetic acid followed by hydrogen peroxide, while the other used Bio 2000 as a single agent, which was subsequently superseded by the continuous use of super-oxidised water (Sterilox). MAIN OUTCOME MEASURE: To assess whether the samples either met the American Dental Association's guideline on the quality of DUWL water, or the more stringent European Union standards for potable (drinking) water. RESULTS: The two units which used a disinfection regime both complied with the ADA guideline and the EU potable water standard. However, the unit which only flushed through its DUWLs without using a disinfectant failed to comply with either of them. After all three dental facilities subsequently standardised their DUWL disinfection regimes by using Bio 2000, the colony counts from all of the water samples thereafter remained well below the EU recommended level. The unit which progressed to using Sterilox as a continuous disinfectant achieved and maintained zero readings from its water samples. CONCLUSIONS: Clinical audit can result in the improvement of the quality of water that is discharged through DUWLs, thereby minimising both the risk of cross infection to vulnerable patients, as well as to dental staff chronically exposed to contaminated aerosols.

American Dental Association↗
PubMed2004

Facial scoliosis due to sternocleidomastoid torticollis: a cephalometric analysis.

Facial scoliosis can be caused by either the plagiocephaly which arises from unilateral coronal suture synostosis, or by the effects of sternocleidomastoid torticollis. Despite publications which have presented the key clinical and radiographic craniofacial differentiating features, confusion between the two still persists. This report presents the essential cephalometric features found in sternocleidomastoid torticollis, which may be applied to confirm the diagnosis in those cases which present late, and which do not exhibit the characteristic features of synostosis.

Adolescent↗
PubMed2004

Maxillary canine impaction; a final twist in the tale?

A case is presented with a displaced maxillary canine, where one year subsequent to the radiographic diagnosis, a bend in the apical one third of the adjacent premolar root had developed. This finding lends further support to a recent hypothesis, that in such circumstances, the canine impaction results in the deviation of the developing premolar root, rather than the obverse.

Bicuspid↗
PubMed2003

Maxillary canine displacement; further twists in the tale.

This report describes two cases seen over a 5-year period, each with a labially impacted maxillary canine found in close proximity to the adjacent first permanent premolar, which had a deviated palatal root. The issue as to whether the premolar root deviation either produced the canine impaction or vice versa is discussed, both with reference to the processes considered to be involved in normal tooth eruption, and to three previously published similar cases.

Adolescent↗