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Biomedical subjects

R Bedi

Publications and source records attributed to R Bedi.

At least 19 recordsLinked to original sources

Food and drink consumption, sociodemographic factors and dental caries in 4-5-year-old children in Amman, Jordan.

OBJECTIVE: To investigate the association between type of food and drink consumption, sociodemographic factors and prevalence and severity of caries in 4-5-year-old Jordanian children. METHOD: Two-stage random sampling procedure was used to select children enrolled in kindergartens in Amman. Clinical examinations were carried out by one examiner. Mothers completed a questionnaire relating to sociodemographic factors and food and drink consumption. RESULTS: Snack foods were consumed by a high percentage of children. Amongst the most popular 'high in NME sugar snacks', confectionery was reported to be regularly consumed by 76% and biscuits and cakes by 71% of them. More than 50% had carbonated drinks. Children from a lower social class, attending a kindergarten with lower tuition fees had more dessert, squashes and more teas with sugar. When all variables were considered, consumption of confectionery was independently associated with caries prevalence and consumption of teas with sugar was independently associated with caries severity. CONCLUSION: The types of foods and drinks consumed as snacks by young Jordanian children were similar to those of Western countries. In the absence of more widespread oral health promotion measures and in the presence of high prevalence and severity of caries,the oral health of Jordanian children is a matter of concern.

Beverages↗

Severe tooth loss among UK adults--who goes for oral rehabilitation?

A random probability sample of 2667 United Kingdom (UK) addresses was selected in a multistage sampling process. Participants were interviewed about their oral health status--number of teeth possessed and denture status. In addition information was collected about their socio-demographic characteristics (age, gender, social class and income level) and dental service factors--type of service used and difficulty accessing national health service (NHS) care. The response rate was 70%. Six percent (107) claimed they had less than 20 teeth but did not use a denture. Variations in this practice were apparent in relation to a number of socio-demographic factors: age (P < 0.05), gender (P < 0.01) and social class (P < 0.001) but not service related factors. In regression analysis, social class, gender and age emerged as important predictors of this practice. For example, those from lower social classes were approximately half as likely to use dentures despite experiencing considerable tooth loss (OR=0.53, 95% CI 0.34, 0.83), having controlling for other factors. More than one in 20, in Britain claim they have experienced considerable tooth loss but are without resource to a denture. Socio-demographic factors rather than service related factors are associated with this practice, particularly social class.

Adolescent↗

Caries in preschool children in Amman, Jordan and the relationship to socio-demographic factors.

OBJECTIVE: To determine the prevalence and severity of caries in children attending kindergartens in Amman and the relationship between caries experience and socio-demographic factors including age, social class based on the father's occupation, the level of mother's education and the fee level of the kindergarten attended. DESIGN: Cross sectional survey including a dental examination of the child and a questionnaire completed by the parents. SETTING: Kindergarten schools in Amman. PARTICIPANTS: 1,140 children including 569 4-year-olds and 571 5-year-olds. RESULTS: Prevalence of caries in 4 year olds was 62% and in 5 year olds it was 73%. The dmft values were 3.1 and 4.1 in 4 and 5 year olds respectively. Lower caries prevalence was recorded for children of families where the father had a non-manual occupation, those whose mothers had higher levels of educational attainment and for children attending kindergartens with higher tuition fees. CONCLUSION: Caries prevalence and severity in children attending kindergarten schools in Amman are similar to those seen in studies of children of the same age in Saudi Arabia and higher than those in children in westernised countries such as the UK. As in other countries, caries experience in young children in Amman is clearly related to social factors. Findings illustrate the need for effective oral health promotion accessible to all social groups in this middle eastern capital. Fee scale of the schools appears to be an effective measure to use in designing appropriate strategies.

Age Factors↗

Are single mothers in Britain failing to monitor their oral health?

OBJECTIVES: This study was designed to identify association between self reported dental attendance patterns and family structure in the UK. DESIGN: A national study involving 666 women with dependent children. SETTING: Home interviews were undertaken exploring time and reason for last dental visit. In addition, numerous sociodemographic and service related characteristics were collected. RESULTS: Bivariate analysis identified that family structure was associated with respondents' self reported dental attendance patterns: marital status (p<0.01), number of children (p<0.05), and age of children (p<0.05). When the combined effects of age, family structure, income, educational attainment, working status, and service factors (difficulty obtaining a NHS dentist and time taken to get an appointment) on dental attendance were explored, family structure emerged as a very important predicator of service use. Notably, young (age 16-34) single mothers and those with more than two children were less likely to have attended the dentist within the past year for reasons other than a dental emergency compared with older (age 35 or more), mothers from a two parent family and those with one or two children. CONCLUSION: Family structure is associated with self reported dental attendance patterns. Young single mothers with more than two children may be failing to monitor their oral health appropriately.

Adolescent↗

Caries prevalence and patterns and their relationship to social class, infant feeding and oral hygiene in 4-5-year-old children in Amman, Jordan.

OBJECTIVES: To investigate the relationship between social class, infant feeding, oral hygiene, and prevalence and patterns of caries in 4-5-year-old Jordanian children. METHOD: Two-stage random sampling procedure was used to select children enrolled in kindergartens in Amman, Jordan. Clinical examinations were carried out by one examiner. Mothers completed questionnaires relating to social class, infant feeding and the oral hygiene habits of the children. RESULTS: Sixty-seven per cent of the children had caries; 30% had the more extensive pattern involving molars and incisors. When the significant variables were taken into account, age, social class, sleeping with the mother, use of comforter and confectionery at bed/night time were shown to be independent risk factors for caries experience. Bottle-feeding at nap/bed/night time was associated with caries in incisors and caries in incisors and/or canines. Never being breast-fed, being breast-fed for more than 18 months, being breast-fed at nap/bed/night time showed a negative association with caries confined to molars although this showed a positive association with the more extensive pattern of the disease. CONCLUSIONS: Education for mothers about appropriate breast and bottle-feeding practices should be considered in health promotion strategies.

Bottle Feeding↗

Who has difficulty in registering with an NHS dentist?--A national survey.

AIMS: The aims of this paper are first, to determine the extent of difficulties the public are experiencing in obtaining a dentist undertaking NHS dental care. Second, to describe the personal and socio-demographic details of these groups using data from a national study. METHOD: The vehicle for this study was the Office for National Statistics Omnibus Surveys, undertaken in June and July of 1999. A random probability sample of 5,385 addresses was selected from the British Postcode Address File. Respondents were interviewed in their homes about how difficult they found it to obtain an NHS dentist. RESULT: A total of 3,739 adults took part in this study and the response rate was 69%. Nineteen per cent (705) claimed they found it difficult to get an NHS dentist. Bivariate analysis revealed that difficulty in obtaining an NHS dentist [excluding those who claimed they did not seek NHS dental care (781) and those who refused to answer or did not know (66)] was associated with age group (P < 0.01), gender (P < 0.05), social class (P < 0.01) and area of residency (P < 0.01). Moreover, difficulty in obtaining NHS dental care was also associated with time since last dental visit (P < 0.01), method of payment for last dental visit (P < 0.01) and use of 'out of hours' emergency dental services (P < 0.01). Further analysis revealed that among the socio-demographic variables, area of residency emerged as the most important factor in determining difficulty in obtaining an NHS dentist. Those who lived in the South of England (London, South-East or South West) were more than twice as likely to experience difficulty in obtaining an NHS dentist, OR = 2.40, 95% CI 2.00-2.88 compared with those who lived elsewhere in Great Britain. CONCLUSION: One in five adults in Britain claim that they are experiencing difficulties in finding a dentist who will provide NHS dental care. In particular, those using private dental services and residents of the South of England have experienced such difficulties.

Adolescent↗

Perceptions of vocational trainees on gender and racial disadvantage within the Thames vocational training programme.

BACKGROUND: A recent report has suggested that vocational trainees within London experienced racial or gender disadvantage during their selection. This exploratory study did not investigate the extent or the nature of this disadvantage. AIM: To undertake a survey using a pre-tested questionnaire with dental vocational trainees on the Thames Scheme. The questionnaire explored perceived and experienced aspects of gender and racial disadvantage during their vocational training programme. RESULTS: 127 trainees completed the questionnaire (response rate 92%). Minority ethnic respondents were more than twice as likely to feel their selection was influenced by gender (odds ratio [OR] 2.25, 95% Confidence Interval [CI] 1.02, 5.10) and more than three times likely to feel selection was influenced by their race when compared with their white colleagues (OR 3.05, 95%; CI 1.01,11.45). The majority of trainees did not perceive any disadvantage whilst on the vocational training course. For example, only five respondents (4%) felt that minority ethnic individuals were treated less favourably during the vocational training course. CONCLUSION: In conclusion, this preliminary study has attempted to explore inter-ethnic differences within the profession on perceived racial disadvantage and possible strategies for change. It is clear that the perception of disadvantage is greater than the reality within the experience of most trainees.

Asia, Western↗

Oral submucous fibrosis in a 11-year-old Bangladeshi girl living in the United Kingdom.

A case of oral submucous fibrosis occurring in a 11-year-old Bangladeshi girl is presented. This paper reviews the aetiology, clinical presentation and treatment modalities of oral submucous fibrosis. This case highlights the link between oral submucous fibrosis and the regular use of areca-nut (paan) and the newer transcultural oral tobacco products. This association has been reported among children resident in the Indian sub-continent but is unrecorded for United Kingdom residents. The case report underlines the danger that children face with products which are clearly targeted at them by the tobacco industry.

Areca↗

Can dental attendance improve quality of life?

OBJECTIVE: The aim of this study was to determine the relationship between reported dental attendance patterns and the public's perception of how oral health impacts on quality of life (QoL). METHOD: A national UK study involving a random probability sample of 2,668 adults. Respondents were interviewed in their homes about how oral health affects their QoL and about their dental attendance pattern. Responses were coded as oral health having a negative impact, positive impact or impact in general (either positive and/or negative) on QoL. RESULTS: The response rate was 70% with 1,865 adults participating in the study. 72% (1,340) reported that their oral health affected their QoL in general, 57% (1,065) reported that it had a positive effect, and 48% (902) that it had a negative effect. 61% (1,136) reported to have attended the dentist within the last year- 'regular attenders'. Bivaraite analysis identified association between perception of how oral health impacts on QoL and dental attendance pattern (P < 0.01). When socio-demographic factors (age, gender, and social class) were taken into account in the analysis, 'regular attenders' reported that oral health had greater impact in general on QoL (OR = 1.30, 95% CI = 1.04, 1.63) and, specifically, a greater positive impact (OR = 1.49, 95% CI=1.44, 1.77). CONCLUSION: Dental attendance is associated with perceptions of how oral health impacts on QoL, specifically enhanced life quality. This may have implications for understanding the health gain of regular dental attendance.

Adolescent↗

Can dentures improve the quality of life of those who have experienced considerable tooth loss?

OBJECTIVES: The aim of this study was to identify variations in the impact of oral health on quality of life (OHQOL) among UK residents in relation to self-reported number of teeth possessed and denture status. In addition, to determine whether recourse to a removable prosthesis for those who claimed that they had experienced considerable tooth loss (having <20 teeth) was associated with quality of life. METHODS: The vehicle for this was the Office for National Statistics Omnibus survey in Great Britain. A random probability sample of 2667 addresses was selected in a multistage sampling process. Participants were interviewed about their oral health status. The impact of oral health on quality of life was measured utilising the OHQoL-UK(W) measure. RESULTS: The response rate was 68%. Variations in OHQoL-UK(W) scores were apparent in relation to self-reported number of teeth possessed (P < 0.001) and denture status (P < 0.001). Moreover, disparities in OHQOL were apparent among those who experienced considerable tooth loss who didn't have recourse to a denture (P < 0.001). In regression analysis, those who claimed that they had <20 natural teeth but had no recourse to a denture were less than half as likely to enjoy enhanced oral health related quality of life compared to others in the population (OR = 0.46, 95% Cl 0.30, 0.71), controlling for socio-demographic factors. CONCLUSIONS: Experience of considerable tooth loss without recourse to a removable dental prosthesis is an important predictor of oral health related quality of life, as captured by OHQoL-UK(W), and associated with reduced quality of life.

Adolescent↗

Investigation of an index to measure tooth wear in primary teeth.

UNLABELLED: Tooth wear, in particular erosion, has been reported to be widespread in children in the UK. Wear may affect either dentition, but epidemiological measurement has proved difficult. OBJECTIVES: The objectives of this study were: (a) to investigate use of a simple index of wear in primary teeth; and (b) to compare findings from visual examination and from photographs with those at histological examination of the same teeth. SAMPLE AND METHODS: Forty-one exfoliated or extracted primary anterior teeth were assessed visually and using photographs. Ground sections of the teeth were prepared and examined using polarised light microscopy. RESULTS: On visual examination, 31 of the 41 teeth had evidence of wear. In 14 teeth, tissue loss was confined to enamel and in 17 it extended into dentine. Findings on photographs were very similar to those on visual examination. Of the 10 teeth without erosion visually, two had evidence of loss on histological examination. Of the 14 with visual evidence of erosion confined to enamel, dentine was exposed in 11 cases. Diffuse demineralisation was evident histologically in 11 of the 31 teeth with evidence of erosion. CONCLUSIONS: It was concluded that clinical assessment of erosion may underestimate the extent of the condition. Under the conditions of the study, photographs gave results similar to those on visual examination.

Child↗

Is the current access to health information helping or hindering effective decision-making for dentists and patients? Guidelines for dental practice.

With the introduction of the Internet there has been a growth both in the quantity and accessibility of information to the public concerning health issues. This improved availability of information does not always lead to a more informed public since there is no quality control of information but it can lead to a public that takes a more active role in their own health and thus is involved in shared decision-making. In order to develop a more informed public in the future, systems for quality control of information have been addressed. These systems can range from the present state of uncontrolled information (no quality control) to full-centralised control (censored information). Between these extremes lie two, more appropriate, decentralised filtering approaches--'upstream filtering' (where third parties set quality criteria and evaluate information) and 'downstream filtering' (where data are rated, labelled and weighted according to consumers' criteria). These systems of filtering are discussed along with recommendations for those using the Internet as a source of information. The paper also documents reliable sources of information for the public, highlights the current concepts of shared decision-making, and provides some guidelines for developing an effective decision-making strategy.

Decision Making↗

Oral health status of heroin users in a rehabilitation centre in Hubei province, China.

OBJECTIVE: To report on the oral health of heroin users and to determine risk factors for oral health status. DESIGN: All heroin users at one rehabilitation camp received an interview using a pre-tested questionnaire from one of three trained interviewers and a dental examination using World Health Organization recommended procedures from one of three calibrated dentists. SETTING: Interviews and examinations were carried out at Hubei Province camp. PARTICIPANTS: All 520 resident heroin users at the camp participated in the study. OUTCOME MEASURES: Oral hygiene expressed using the Debris Index; caries status by DMFT; periodontal status by percentage with bleeding, pocketing and calculus; mucosal status using standard World Health Organization criteria. RESULTS: One hundred (19%) of the heroin users were caries free; their mean DMFT was 4.2. The majority (92%) of the DMFT was decay and only a small proportion (8%) was treatment related. The proportion of heroin users with bleeding, calculus, shallow pocketing and deep pocketing was 42%, 95%, 42% and 8% respectively. The mean Debris Index score was 3.2. Mucosal lesions were present in 31 subjects (6%). Using multivariate analysis, duration of heroin use and education were risk factors for DMFT, route of drug administration was a risk factor for calculus and gender was a risk factor for deep pocketing. CONCLUSIONS: There are indications of poorer periodontal health as well as higher caries experience in this group when compared to provincial dental epidemiological data. Mucosal lesions were not widely prevalent. Both social factors and characteristics of drug use were related to oral health in this group.

Administration, Oral↗

An evaluation of a new measure of oral health related quality of life--OHQoL-UK(W).

OBJECTIVE: The aim was to test the reliability and validity of an instrument used to measure the impact of oral health on quality of life. BASIC RESEARCH DESIGN: The instrument tested was the indicator OHQoL-UK(W), which was developed, based on a general UK population's perceptions of how oral health affects life quality. OHQoL-UK(W) consists of a battery of 16 questions, which takes into account both 'effect' and 'impact' of oral health on life quality, incorporating dimensions and an individualised weighting system. A questionnaire containing the indicator was administered to a sample of 500 adults. Determining associations between OHQoL-UK(W) scores, socio-demographic and self-reported oral health status assessed its construct validity. The criterion validity of the indicator was assessed in the absence of a 'gold standard' by correlating OHQoL-UK(W) scores to self-rating of oral health status. The internal reliability of the indicator was assessed using Cronbach's alpha. RESULTS: The response rate was 78%. Associations between OHQoL-UK(W) scores and self-reported number of natural teeth (P<0.01) and denture status (P<0.01) supported the construct validity of the indicator. In addition, OHQoL-UK(W) scores were associated with socio-demographic factors; age (P<0.05), employment status (P<0.01) and ethnicity (P<0.05). The instrument was also associated with self-rating of oral health status (P<0.01), supporting the criterion validity of the indicator. The internal reliability was high with a Cronbach alpha value of 0.94. CONCLUSION: OHQoL-UK (W) appears to be a valid and reliable measure for assessing the impact of oral health on life quality.

Adolescent↗

The relationship between erosion, caries and rampant caries and dietary habits in preschool children in Saudi Arabia.

OBJECTIVES: The aim of this study was to investigate the possible association between dental erosion and caries, and variables including socio-economic status, reported dietary practices and oral hygiene behaviour, in a sample of children in Jeddah, Saudi Arabia. A cross-sectional study including dental examination and questionnaire survey was carried out at a number of kindergartens. SAMPLE AND METHODS: A sample of 987 children (2-5-year-olds) was drawn from 17 kindergartens. Clinical examinations were carried out under standardized conditions by a trained and calibrated examiner (MAM). Information regarding diet and socio-economic factors was drawn from questionnaires distributed to the parents through the schools. These were completed before the dental examination. RESULTS: Of the 987 children, 309 (31%) showed signs of erosion. Caries were diagnosed in 720 (73%) of the children and rampant caries in 336 (34%). Vitamin C supplements, frequent consumption of carbonated drinks and the drinking of fruit syrup from a feeding bottle at bed- or nap-time when the child was a baby, were all related to erosion. Consumption of carbonated drinks and fruit syrups was also related to caries but they were part of a larger number of significant factors including socio-demographic measures and oral hygiene practices. CONCLUSIONS: There was no clear relationship between erosion and social class, or between erosion and oral hygiene practices; the reverse was true for caries. Dietary factors relating to both erosion and caries and/or rampant caries were found in this sample of children.

Age Factors↗

Clinical and photographic assessment of erosion in 2-5-year-old children in Saudi Arabia.

OBJECTIVE: To compare findings from photographs of incisor teeth in pre-school children in Jeddah, Saudi Arabia to those on clinical examination for dental erosion. BASIC RESEARCH DESIGN: Cross sectional study of 2-5-year-old Saudi Arabian children using two methods of examination. MEASUREMENT: of erosion was carried out clinically using a scoring system and criteria based on those used in the United Kingdom national surveys. Photographs of labial and palatal surfaces of maxillary primary incisors were taken for each child and scored in the same way. SETTING: Kindergarten schools in Jeddah, Saudi Arabia. PARTICIPANTS: 987 children from 17 randomly selected schools in Jeddah, Saudi Arabia. RESULTS: Readable photographs were available for 727 children. Two hundred and twenty (30%) had photographic evidence of tooth tissue loss. Prevalence estimates derived from clinical examination were higher than those for photographs (36% compared to 30%). Agreement was seen between the two methods for 93% of the surfaces included. CONCLUSIONS: Photographs have been employed in research in dentistry as well as for documentation and illustration. In epidemiology they have proved to be valuable in measuring enamel defects but have not been used for other conditions. Photographs have potential in measuring erosion, but may benefit from refinement.

Chi-Square Distribution↗