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Biomedical subjects

R Bedi

Publications and source records attributed to R Bedi.

At least 73 records · Page 4Linked to original sources
PubMed2000

Gender variations in the social impact of oral health.

BACKGROUND: There is a growing interest in gender related health issues, however, there is little data concerning the relationships between oral health and gender other than on tooth loss. In particular, there is little information on differences in the social impact of oral health between men and women. AIM: The aim of this study was to identify gender variations in the social and psychological impacts of oral health. DESIGN: A random probability sample of 1,865 adults (1,049 women and 816 men) took part in the study to determine how oral health "reduces" and "adds to" quality of life in a nation-wide survey. RESULTS: Women perceived oral health as having a greater impact than men on their quality of life in general, having a greater negative impact (p < 0.01) and a greater positive impact (p < 0.05). Specifically women perceived oral health as causing them more pain (p < 0.05), embarrassment (p < 0.05) and being detrimental to their finances (p < 0.05) compared to men. Women also more frequently perceived oral health as enhancing their life quality (p < 0.05), their moods (p < 0.05), their appearance (p < 0.01) and their general well being (p < 0.01) than men. CONCLUSION: There are gender variations in the social and psychological impacts of oral health. These findings may help in understanding gender differences in oral health needs and behaviour and have implications in assessing oral health needs.

Adolescent↗
PubMed2000

The development of a tactile graphic version of IOTN for visually impaired patients.

The Index of Orthodontic Treatment Need (IOTN) is a visual-based index and has been widely used. This paper describes the development and evaluation of tactile graphics representing the aesthetic component (AC) of IOTN for the use of visually impaired patients (VI). Four tactile graphics were produced corresponding to IOTN photographs 1 (graphic 1, no treatment - mild need), 5 (graphic 2, moderate need), 8 (graphic 3, severe need; increased overjet) and 10 (graphic 4, severe need). Nine (30-50 years) expert consumers from the Royal National Institute for the Blind (RNIB) and 13 VI schoolchildren (11-16 years) evaluated the graphics. The evaluation was in terms of design features, complexity of information and ease of use. Each individual was asked to arrange the graphics in order of severity of malocclusion. The procedure was repeated after 30 min to test individual reliability (http://www.clinorthodres.com/cor-c-084/). The consumer group was able to identify the main features in each graphic and found them easy to use. Six had arranged the graphics correctly at the first attempt and five on their second. The children were able to distinguish the different oral features, except the overjet presentation in graphic 2. Nine children arranged the graphics correctly at the first attempt, but only six at the second. The confusion centred for both groups on presenting an increased overjet with graphic 2. A modification was undertaken to enhance the anterior-posterior nature of the image. Fifteen VI schoolchildren reassessed the modified graphics, 14 arranged them correctly at the first attempt and 13 at the second. The study concluded that IOTN tactile graphics were well accepted and showed a good reliability.

Journal Article↗
PubMed1999

Provision of dental general anaesthesia for extractions in child patients at two centres.

AIM: To two contrasting centres, to describe the provision of dental general anaesthesia (DGA) for simple non-surgical extractions in terms of the type of treatment provided, including the number of primary and permanent teeth extracted, and the characteristics of child patients attending in terms of their age group and gender. DESIGN: Retrospective analysis of hospital records. METHOD: Data were drawn from records of services over a 12-month period in 1996/97 at: a) a London dental hospital (Centre 1), and b) in the community dental services in Rochdale, Lancashire (Centre 2). Information was collated and analysed using the SPSS statistical software package. RESULTS: The majority of patients at both centres were aged less than 9 years. Almost one third (31%) of those seen at Centre 1 were below 5 years of age, but fewer of this age group were treated at Centre 2. Children aged 9 years or less had an average of 5.4 (SD = 3.0) primary teeth extracted at Centre 1 and 3.0 (SD = 2.0) at Centre 2. For permanent teeth, an average of 3.2 (SD = 1.2) and 2.7 (SD = 1.4) were extracted at Centres 1 and 2 respectively. CONCLUSIONS: Both services were used primarily for the extraction of primary teeth although the services differed in the ages of patients who used them and in the numbers of teeth extracted. Numbers of patients attending the service at Centre 1 had declined over time but numbers of teeth extracted per child had increased.

Adolescent↗
PubMed1999

How long do routine dental restorations last? A systematic review.

OBJECTIVE: To conduct a systematic review of the literature on the longevity of routine dental restorations in permanent posterior teeth, and to identify and examine factors influencing its variability. METHOD: Accepted guidelines were followed. An advisory group oversaw the project. Simple Class I and Class II amalgam, composite resin, glass ionomer and cast gold restorations were covered. Comprehensive searching of electronic databases, hand-searching, and location of 'grey' literature, generated 124 research reports. Those considered relevant were assessed for validity and quality according to agreed criteria. The analysis was descriptive. RESULTS: Eight of 58 relevant research reports were categorised, according to agreed criteria, as being of satisfactory validity and quality. They suggested that 50% of all restorations last 10 to 20 years, although both higher and lower median survival times were reported. The findings were supported by the totality of studies reviewed. However, variability was substantial. Restoration type, materials, the patient, the operator, the practice environment and type of care system appeared to influence longevity. CONCLUSIONS: Many studies were imperfect in design. Those considered to be the most appropriate for analysis were too limited to undertake a formal statistical exploration. Therefore there remains a need for definitive randomised controlled trials of restoration longevity, of sound design and adequate power, employing standardised assessments and appropriate methods of analysis.

Bicuspid↗
PubMed1999

A survey of dental practitioners on their use of electronic mail.

OBJECTIVES: To assess the feasibility of using electronic-mail as a tool for surveying dental practitioners; to determine both response rates and response times for this method; and provide baseline information on e-mail usage. METHOD: Self-administered questionnaire distributed by e-mail to 309 practitioners on Monday morning, 1 June 1998. RESULTS: 53.4% response rate within 1 month; 10.2% of replies were sent within 2 hours; and nearly half the replies were sent within 48 hours. Qualified dentists were more likely to respond early than undergraduates. The most popular point of access for e-mail was home (69.1%). The majority of responders (56.8%) use e-mail every day with 1 in 7 (14.2%) using it at least four times a day. 72.4% stated that they found e-mail useful for communicating with professional bodies, while 41.3% used it to communicate with colleagues about patients and patient referrals. 34.0% found e-mail useful for ordering goods, and supplies and 14.6% were using electronic mail to make patient appointments at least some of the time. CONCLUSIONS: Responses can be obtained at much greater speed than conventional postal techniques will allow, but response rates were only 53.4%. E-mail is predominately used at home and for inter-professional communications, only a small proportion of responders use it for direct communication with patients.

Appointments and Schedules↗
PubMed1999

Risk factors for oral epithelial dysplasia--the role of smoking and alcohol.

The present study provides an assessment of the importance of tobacco and alcohol consumption upon the development of oral epithelial dysplasia (OED) in a large group of European patients. Data were collected in a case-control study based upon 630 patients with OED and 643 control subjects selected from UK dental hospital patients with oral disease not caused by tobacco or alcohol. Logistic regression was used to determine the association of several independent factors on the risk of OED. No relationship emerged between patient's gender, age or ethnicity and risk of OED. The regression model demonstrated a combined effect of tobacco smoking and alcohol drinking upon the risk of OED. Non-filter cigarette smoking was a significant predictor of OED, as was alcohol consumption, and the two habits compounded one another in the overall risk of disease. When both factors combined were included in the model through interaction terms, their individual impact was only moderately reduced, illustrating the importance of both factors in their own right. However, more detailed analysis of tobacco smoking habits revealed that the increased risk of OED from smoking was largely attributable to heavy smoking (20 cigarettes per day, OR = 4.38, 95% C.I. = 2.6, 7.2) especially non-filter cigarettes (OR = 1.95, 95% C.I. = 0.9, 4.0) relative to non-smoking. Both heavy smoking and non-filtered tobacco were higher risks for OED than alcohol consumption alone. Tobacco cessation was associated with a significant decline in risk of OED, the reduction being rapid and marked. For alcohol consumption the association with OED was considerably stronger for drinkers of fortified wines and spirits (OR = 3.75, 95% C.I. = 1.40, 10.05 and OR = 1.36, 95% C.I. = 0.76, 2.45, respectively). It is concluded that, while tobacco and alcohol synergistically influence the development of OED, exclusive tobacco consumption is more likely than exclusive alcohol consumption to give rise to OED. The risk of OED may thus be significantly reduced by behavioural changes such as moderation of tobacco and alcohol use.

Adult↗
PubMed1999

Variations in admissions to hospital for head injury and assault to the head. Part 1: Age and gender.

The study retrospectively investigated variations in the use of secondary healthcare for head injury, particularly assault. A total of 25,300 emergency head-related admission were examined over a two-year period, of which 3756 were for assault. More males were admitted during summer and holiday periods, while there were fewer female patients with head injuries and the incidence varied less. The largest number of admissions was among men aged 15-44 and most assaults occurred at weekends. Females were more likely than males to die from all head injuries (OR=1.31) and violent head injuries (OR=2.38). Women (15+) stayed longer in hospital than males. Injuries among males are primarily associated with social occasions. Females experience head injuries all the year round suggesting that these injuries are the result of domestic violence. There are important demographic differences in numbers of patients and duration of hospital care required to treat these avoidable injuries.

Adolescent↗
PubMed1999

Variations in admission to hospital for head injury and assault to the head. Part 2: Ethnic group.

This study retrospectively investigated variations in the use of secondary healthcare for head injury, particularly assault. A total of 25,300 emergency head-related admissions were examined over a two-year period, of which 3756 were assaults. There were seasonal differences according to ethnic group: far more injuries, particularly assault, occurred amongst the black and minority ethnic groups during the summer months and holidays. Black males had two to three times the rate of admission for assault than any other group. Among whites, females stayed longer in hospital after a head injury. White women stayed significantly longer than South Asian women following a head injury and South Asian men stayed significantly longer than white men after an assault. There are substantial seasonal variations and differences in the length of hospital stay after a head injury, particularly assault, depending on ethnic group. These differences require clarification and more detailed studies of head injuries ought to record the patient's ethnic background.

Black or African American↗
PubMed1999

The importance of oral health to older people's quality of life.

OBJECTIVES: This study was designed to determine whether older people perceive oral health as being important to Quality of Life (QoL) and if so, to identify the most important ways in which their lives are affected. In addition, to identify if subgroups of older people perceive its importance differently. DESIGN: Nationwide qualitative face to face interviews with older people were carried out utilising the Office for National Statistics Omnibus survey in Great Britain. SUBJECTS AND METHODS: 454 adults aged 65 or older took part in this study, part of a random probability sample of adults in the UK. SETTING: Respondents were interviewed in their homes. RESULTS: 72% (313) perceived their oral health status as important to their QoL through a variety of physical, social and psychological ways. Most frequently its impact on function: eating (29%, 126) and symptoms: comfort (14%, 59) were considered most important. Gender and social class variations were apparent (P < 0.05). CONCLUSION: Older people perceive oral health as being important to life quality in a variety of different ways. There are significant social class and gender variations which must be taken into consideration when assessing oral health needs of older people.

Age Factors↗
PubMed1999

Factors influencing older people's self reported use of dental services in the UK.

OBJECTIVES: This study was designed to determine the use of dental services and factors associated with their use among the United Kingdoms' older population. DESIGN: A national study involving 1,116 older people (aged 60 or older). SETTING: Home Interviews were undertaken exploring the time and reason for last dental visit. In addition, socio-demographic characteristics and proxy oral health measures (self-reported number of teeth and edentulous status) of the respondents were collected. RESULTS: Forty seven percent (528) claimed they visited the dentist within the past year, 10% (116) claimed that the reason for their last visit was because of a dental emergency, 43% (484) were classified as "regular attenders"--having attended the dentist within the past year for a non dental emergency. Bivariate analysis identified that regular dental attendance was associated with age (P < 0.01), social class (P < 0.01), income level (P < 0.01), educational attainment (P < 0.01), self-reported number of teeth possessed (P < 0.01) and edentulous status (P < 0.01). In regression analysis, self reported edentulous status and number of teeth possessed emerged as the most important factors in determining service utilisation. Possessing a full denture was associated with a 6-fold decrease, having accounted for other factors, in the likelihood of attending the dentist within the past year for a non dental-emergency (OR = 0.15, CI 0.10, 0.21). CONCLUSION: Less than half of the sample population were "regular dental attenders", their attendance was associated with a number of socio-demographic and oral health factors. In particular, edentulous state was a major factor associated with their use of services.

Age Factors↗
PubMed1999

Helicobacter pylori in dental plaque of Pakistanis.

Helicobacter pylori is now generally accepted to play a key role in acid related and neoplastic pathology of gastroduodenal diseases. Recent reports have concluded that dental plaque is not an important reservoir for Helicobacter pylori, however, these studies did not consider the ethnic background of their subjects nor the amounts of dental plaque present. The aim of this study was to explore the association of Helicobacter pylori dental plaque colonisation in 125 males and 53 females (group I) attending a dental clinic in Pakistan. A simultaneous sample of 30 healthy volunteers with good orodental hygiene consisting of 17 males and 13 females was included as a control group (group II). Six dental plaque specimens were obtained from each subject with a sickle scaler; two were inoculated into CLO test gel and the remaining four were used to prepare cytology slides stained with Giemsa's stain. CLO test was positive in all specimens from group I, while cytology for Helicobacter pylori was positive in 173 cases in this group. One hundred and forty two cases had heavy plaque deposits and all of them were positive on cytology. In group II CLO test was positive in 20 and dental plaque cytology was positive in 7 cases. In conclusion, it is important that future studies into the prevalence of Helicobacter pylori in the oral cavity should take into account the levels of oral cleanliness and the ethnic background of the subjects.

Adult↗
PubMed1999

The value and use of 'quality of life' measures in the primary dental care setting.

General dental practitioners are used to taking a dental history and carrying out an examination. The history and examination invariably form the basis of the patient-dentist dialogue with regard to the treatment to be provided and the financial costs involved. The dialogue between patient and dentist is complex, and the importance of 'quality of life' for the patient is now emerging as a central focus of this dialogue. This paper explores the concept of 'quality of life'. In terms of oral health, and considers the potential of 'oral health-related quality of life' measures for general dental practice. Examples of their use in general dental practice are considered, in relation to marketing dental services, improving compliance in treatment plans, assessing the quality of care and improving communications between the patient and the dental team. Quality of life indicators are being used in the healthcare sector for commissioning, planning and evaluating services. In addition, primary care researchers are using these indicators as part of their evidence-based treatment approaches. As general dental practitioners become more involved in planning services and research, it is important they understand the impact of 'quality of life' indicators have on their treatment and practice management.

Communication↗
PubMed1999

Who uses independent dental services? Findings from a national survey.

This study was designed to determine private dental services use in the UK and to determine if those who use an independent dental service attend more regularly, in addition to identifying factors associated with the use of private dental care. A random probability sample of 2668 addresses was selected from the British Postcode Address File (PAF) and 1865 adults aged 16 years or older took part in this study (70%). Respondents were interviewed in their homes about their use of dental services and socio-demographic information was collected. The data were analysed using the statistical package CHAID. A total of 23% (424) reported to be seen on a private basis the last time they visited the dentist. Of those, 54% (230) reported to have attended the dentist within the last six months compared to 46% (629) of those who used NHS services (P < 0.05). Level of income was identified as the most significant factor in determining the use of private services, this being greater for those earning above 30,000 Pounds (P < 0.05). For those on low (< 10,000 Pounds) or middle (10,000 Pounds-< 30,000 Pounds) incomes, area of residence was the next most important factor in determining private service use. Residents of London and the South East in both low- and middle-income groups were more likely to use private services (P < 0.05). Residents of the North of England and the Midlands/East Anglia were less likely to use private services (P < 0.05). In conclusion, income and area of residence appear to be the most important determining factors in the use of private dental services.

Adolescent↗
PubMed1998

The role of alcohol in non-smokers and tobacco in non-drinkers in the aetiology of oral epithelial dysplasia.

Oral epithelial dysplasia (OED) is an important risk factor in predicting subsequent development of invasive carcinoma. Despite the malignant potential of OED, the current state of knowledge regarding aetiological risk factors associated with OED is limited. The aim of our study was to evaluate the aetiological role of alcohol consumption in non-tobacco smokers and smoking behaviour in non-drinkers, in patients presenting with OED. Data from a hospital-based case-control study of OED were used to analyse the risk associated with alcohol in non-smokers and with tobacco in non-drinkers. A total of 140 cases and 236 controls were included. In the non-drinkers, the risks of OED increased with tobacco smoking of more than 20 cigarettes per day, particularly non-filter cigarettes. The risk of OED declined following smoking cessation, with ex-smokers of 10 or more years demonstrating no excess risk relative to non-smokers. In the nonsmokers, consumption of alcohol was not a significant predictor of OED. However, there was a synergistic effect of alcohol when combined with some aspects of tobacco smoking. Our results confirm that tobacco has an independent role in the aetiology of OED. The role of alcohol, however, is principally only important in conjunction with tobacco use.

Adult↗
PubMed1998

Dental negligence: a study of cases assessed at one specialised advisory practice.

AIM: To undertake a review of cases from one dental advisory practice in England over a period of 5.5 years to provide a profile of the type of work undertaken. DESIGN AND SETTING: Compensation claims for dental negligence seen at one dental advisory practice between 1991 and 1996. METHODS: 437 claims were reviewed for: the nature of the complaint; defendant details; plaintiff details; method of funding; duration and outcome of claim. Comparisons were made with previously published data. The relationship between method of funding of a claim and the likelihood of the claim being successful was investigated. RESULTS: 28% of complaints concerned oral surgery and 24%, restorative procedures. In 72% of cases, the compensation claim was made directly against the dentist who had provided treatment for the patient. The majority of claims were gender and age biased; females (63%) and younger people (18-45 years of age) (68%) were more likely to bring actions for dental negligence. Only 3% involved elderly patients (> or = 60 years old). Claims supported by the government legal aid scheme were more likely to be withdrawn or rejected than those privately funded. Nearly all cases were completed in under one year (81%). CONCLUSIONS: Results are similar to previously published studies. A large proportion of claims concerned restorative or oral surgery procedures carried out in general or community practice.

Adolescent↗