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Biomedical subjects

Sudeshni Naidoo

Publications and source records attributed to Sudeshni Naidoo.

16 recordsLinked to original sources
PubMed2006

Foetal alcohol syndrome: a cephalometric analysis of patients and controls.

Foetal alcohol syndrome (FAS) consists of multi-system abnormalities and is caused by the excessive intake of alcohol during pregnancy. The teratogenic effect of alcohol on the human foetus has now been established beyond reasonable doubt and FAS is the most important human teratogenic condition known today. The purpose of this study was to analyse the craniofacial parameters of children with FAS and compare them with matched controls. Ninety children diagnosed with FAS (45 males, 45 females) and 90 controls were matched for age, gender, and social class. The mean age of the FAS children was 8.9 years with the controls slightly older at 9.1 years. This age difference was not significant (P = 0.34). A standard lateral cephalometric radiograph of each subject was taken. The radiographs were digitized for 20 linear and 17 angular measurements. These 37 variables were formulated to assess the size, shape, and relative position of three craniofacial complexes: (1) the cranial base, (2) midface, and (3) mandible. In addition, nine variables were computed to compare the soft tissue profiles. The study showed that measurements related to face height and mandibular size appear to be the most important features when distinguishing FAS children. Overall, the FAS children in the present study presented with vertically and horizontally underdeveloped maxillae, together with features of long face syndrome with large gonial angles and a short ramus in relation to total face height. There was also a tendency for the development of an anterior open bite, which appears to be compensated for by an increase in the vertical dimension of the anterior alveolar process to bring the incisor teeth into occlusion. The latter adaptation occurred mainly in the mandible.

Age Factors↗
PubMed2006

Foetal alcohol syndrome: a dental and skeletal age analysis of patients and controls.

Foetal alcohol syndrome (FAS) consists of multisystem abnormalities and is caused by the excessive intake of alcohol during pregnancy. The teratogenic effect of alcohol on the human foetus has now been established beyond reasonable doubt and FAS is one of the most important human teratogenic conditions known today. The purpose of this study was to assess the dental age (DA) and skeletal age (SA) of children with FAS and compare them with matched controls. The samples of 90 children diagnosed with FAS and 90 controls were matched for age, gender, and social class. The mean chronological age (CA) of the FAS subjects was 8.95 years, with the controls slightly older at 9.04 years. This difference was not significant. Dental maturity was determined by assessing the stage of tooth formation and SA assessment was made from hand-wrist radiographs for the patients and controls by assigning a SA and comparing it with standard plates. The means and standard deviations of CA and DA for the stages of calcification were calculated and the Pearson ranked order correlation coefficient was applied to measure the associations between skeletal maturity indicators and DA. t-tests were used to test for group differences between independent groups, and paired t-tests to determine paired group differences. This study provided evidence of a positive association between DA and SA in both the FAS children and the controls. The data suggest that both DA and SA may be a reflection of general somatic growth. It must be acknowledged that growth of individuals is often irregular, when any norms of development based on central tendencies and variabilities of healthy children are applied. Some aspects of growth and development for healthy children may show a variable pattern of growth. Therefore, correlation of these aspects of growth and development will often not show the degree of correlation that theoretically exists between different areas of growth and development. A more complete appraisal of the entire skeleton and an evaluation of the entire dentition, rather than just the mandibular teeth, might improve the correlation between the variables.

Age Determination by Skeleton↗
PubMed2005

Fetal alcohol syndrome: anthropometric and oral health status.

The purpose of this study was to analyze the anthropometric measures and oral health status of children with fetal alcohol syndrome (FAS) and compare them to matched controls. The sample of 90 cases (children diagnosed with FAS) and 90 controls were matched for age, gender, and social class. The mean age of the cases was 8.9 years with the controls slightly older at 9.1 years. The results of the anthropometric measurements in respect of weight, height, and head circumference showed significantly lower values for the FAS children when compared to the controls. Several physical abnormalities described in children with FAS were seen in this study. Some of these abnormalities seen in the FAS children included deformities in the small joints of the hand, altered palmar creases, and malformation of the ears. The prevalence of enamel opacities between FAS and controls was not significantly different and averaged around 15% for both groups. More than three quarters of both the cases and the controls demonstrated the presence of plaque and almost two-thirds demonstrated gingival bleeding on probing. FAS patients had statistically significantly (p<0.001) more dentofacial anomalies than the controls. The mean decayed, missing, and filled teeth (dmft) score for the FAS sample was slightly higher, though not significantly different from that of the controls, and the decayed component (d) made up the largest part of the index in both groups.

Anthropometry↗
PubMed2005

A baseline survey: oral health status of prisoners--Western Cape.

South African prison populations continue to grow because of the escalating crime and an overstretched judicial system. The aim of this study was to assess the oral health status of prison inmates in the Western Cape (Pollsmoor, Goodwood, Paarl and Worcester). A cross-sectional epidemiological survey involving a clinical oral examination and face-to-face interviews was used to collect information on DMFT, periodontal health, perceived needs and the knowledge, attitudes and behaviour of inmates to oral health. Clinical examinations were carried out using WHO criteria. Of the 340 study participants, 264 were male and 76 were female. The prevalence of oral disease was high. The mean DMFT was 15.45 and the total DMFT increased with age. There was a reported impact on oral health quality of life, with many citing problems with eating, drinking and pain. Self-reported dental needs indicated a perceived need for dentures, scaling and fillings. Over two thirds of the sample (72%) reported that the dental services that they presently receive are poor. This study found a high prevalence of dental caries and periodontal disease among the correctional service populations. There is an urgent need for the development of a basic oral health care package that should be offered to all inmates as eventually many of them will be returning to the community.

Adolescent↗
PubMed2004

Developing explanatory models of health inequalities in childhood dental caries.

OBJECTIVE: Long-term aim is to determine optimum interventions to reduce dental caries in children in disadvantaged communities and minimise the effects of exclusion from health care systems, of ethnic diversity, and health inequalities. DESIGN: Generation of initial explanatory models, study protocol and development of two standardised measures. First, to investigate how parental attitudes may impact on their children's oral health-related behaviours and second, to assess how dentists' attitudes may impact on the provision of dental care. SUBJECTS: Core research team, lead methodologists, 44 consortium members from 18 countries. To complete the development of the questionnaire, the initial set of items was administered to parents (n = 23) with children in nursery schools in Dundee, Scotland and sent to the same parents one week later. A standardised measure examining barriers to providing dental care for children aged 3 to 6 years was developed. 20 dentists working in primary dental care in Scotland completed the measure on two different occasions separated by one week. RESULTS: Explanatory models were developed. Family questionnaire: test-retest reliability excellent (r = 0.93 p < or = 0.001) with very good internal reliability (alpha = 0.89). Dentists questionnaire: excellent test-re-test reliability r = 0.88, (alpha = 0.90). CONCLUSIONS: Interaction between consortium members enhanced the validity of the questionnaires and protocols for different cultural locations. There were challenges in developing and delivering this multi-centre study. Experience gained will support the development of substantive trials and longitudinal studies to address the considerable international health disparity of childhood dental caries.

Attitude of Health Personnel↗
PubMed2004

A multi-country comparison of caries-associated microflora in demographically diverse children.

OBJECTIVE: The aim of this formative international collaborative research on childhood dental caries was to undertake an initial investigation comparing the dental plaque of young children from diverse ethnic and socioeconomic backgrounds with and without dental caries. BASIC RESEARCH DESIGN: The following four null hypotheses were investigated. There were no differences in numbers of individual taxa when comparing plaque samples from: 1) caries-free children from deprived and non-deprived backgrounds; 2) children from deprived and non-deprived backgrounds with at least 3 decayed teeth; 3) children from non-deprived backgrounds who are caries free with those from similar backgrounds with at least 3 decayed teeth; and, 4) children from deprived backgrounds who are caries free with those from similar backgrounds with at least 3 decayed teeth. PARTICIPANTS: 277 children aged 3-4 years from 5 countries. MAIN OUTCOME MEASURES: A sample of interproximal plaque from anterior teeth was collected using sterile dental floss, and cultured according to accepted international standards. RESULTS: Analysis of the data found that the first null hypothesis was accepted and that the fourth was rejected. Unexpectedly, the second null hypothesis was rejected as the children with caries from deprived and non-deprived backgrounds had a different caries-associated flora. In particular, children living in deprivation harbored more caries-associated bacteria [mutans streptococci and lactobacilli]. This greater microbial challenge was associated with a higher level of cavitated carious lesions and with more frequent consumption of confectionery. Conclusions Children from deprived backgrounds with caries may be further disadvantaged by having higher levels of caries-associated microflora.

Candy↗
PubMed2004

Familial and cultural perceptions and beliefs of oral hygiene and dietary practices among ethnically and socio-economicall diverse groups.

UNLABELLED: OBJECTIVE; The aim of this international study was to develop a valid and reliable psychometric measure to examine the extent to which parents' attitudes about engaging in twice-daily tooth brushing and controlling sugar snacking predict these respective behaviours in their children. A supplementary objective was to assess whether ethnic group, culture, level of deprivation or children's caries experience impact upon the relationships between oral health related behaviours, attitudes to these respective behaviours and to dental caries. CLINICAL SETTING: Nurseries, health centres and dental clinics in 17 countries. PARTICIPANTS: 2822 children aged 3 to 4 years and their parents. MAIN OUTCOME MEASURES: Dental examination of children and questionnaire to parents. RESULTS: Factor analysis identified 8 coherent attitudes towards toothbrushing, sugar snacking and childhood caries. Attitudes were significantly different in families from deprived and non-deprived backgrounds and in families of children with and without caries. Parents perception of their ability to control their children's toothbrushing and sugar snacking habits were the most significant predictor of whether or not favourable habits were reported. Some differences were found by site and ethnic group. CONCLUSIONS: This study supports the hypothesis that parental attitudes significantly impact on the establishment of habits favourable to oral health. An appreciation of the impact of cultural and ethnic diversity is important in understanding how parental attitudes to oral health vary. Further research should examine in a prospective intervention whether enhancing parenting skills is an effective route to preventing childhood caries.

Adult↗
PubMed2004

Barriers to the treatment of childhood caries perceived by dentists working in different countries.

OBJECTIVE: To explore whether dentists' beliefs and attitudes to providing preventive and restorative dental care for young children can form a barrier to the provision of care. BASIC RESEARCH DESIGN: The Barriers to Childhood Caries Treatment (BaCCT) Questionnaire, a standardised international measure was developed and applied. PARTICIPANTS: Through a research consortium, each site was asked to recruit 100 dentists. The sample participating was not intended to be nationally representative. Dentists were mainly randomly selected and contacted by mail with one or more mailings depending on site. RESULTS: 2,333 dentists in 14 countries and 17 sites participated. Factor analysis identified four factors as potential barriers. Two factors were found to be barriers in many sites. First, in most countries, dentists agreed that young children's coping skills limit their ability to accept dental care. Secondly, dentists with negative personal feelings, for example, that providing care can be stressful and troublesome and that they feel time constrained. Differences in dentists' beliefs can be partly explained by their work profile, with those treating children often, and those working under systems where they feel they can provide quality care being least likely to identify barriers to providing care for children. CONCLUSIONS: The BaCCT Questionnaire was determined to be a valid psychometric measure. Separately, it was found that health systems do impact on dentists' ability to deliver preventive and restorative care for children but that these effects vary across countries and further work is needed to determine how best these should be examined.

Attitude of Health Personnel↗
PubMed2004

International comparisons of health inequalities in childhood dental caries.

OBJECTIVE: To undertake formative studies investigating how the experience of dental caries in young children living in diverse settings relates to familial and cultural perceptions and beliefs, oral health-related behaviour and oral microflora. PARTICIPANTS: The scientific consortium came from 27 sites in 17 countries, each site followed a common protocol. Each aimed to recruit 100 families with children aged 3 or 4 years, half from deprived backgrounds, and within deprived and non-deprived groups, half to be "caries-free" and half to have at least 3 decayed teeth. OUTCOME MEASURES: Parents completed a questionnaire, developed using psychological models, on their beliefs, attitudes and behaviours related to their child's oral health. 10% of children had plaque sampled. RESULTS: 2,822 children and families were recruited. In multivariate analyses, reported toothbrushing behaviours that doubled the odds of being caries-free were a combination of brushing before age 1, brushing twice a day and adult involvement in brushing. Analyses combining beliefs, attitudes and behaviours found that parents' perceived ability to implement regular toothbrushing into their child's daily routine was the most important predictor of whether children had caries and this factor persisted in children from disadvantaged communities. 90% of children with lactobacillus had caries. CONCLUSIONS: Parental beliefs and attitudes play a key role in moderating oral health related behaviour in young children and in determining whether they develop caries. Further research is indicated to determine whether supporting the development of parenting skills would reduce dental caries in children from disadvantaged communities independent of ethnic origin.

Adult↗
PubMed2004

A review of foetal alcohol syndrome and the role of the oral health care worker.

Foetal Alcohol Syndrome (FAS) consists of multi-system abnormalities and is caused by the excessive intake of alcohol during pregnancy. The teratogenic effect of alcohol on humans has now been established beyond reasonable doubt and FAS is one of the most important human teratogenic conditions known today. Many investigators have catalogued, quantified and refined these hallmarks of FAS over the years and have established that the most consistent consequences of heavy maternal drinking during pregnancy are prenatal and postnatal growth deficiency, and brain and craniofacial abnormalities. Many practitioners are unable to recognise the often subtle features associated with FAS and fail to diagnose it. The purpose of this article is to review the epidemiology, pathophysiology, clinical presentation and discuss the relevance of FAS to clinical dental practice.

Abnormalities, Multiple↗
PubMed2002

Community dental service--the first year.

In July 2000, the first group of graduates entered compulsory community dental service. The aim of this study was to document the experiences of the community dentists in their first year of placement. A cross-sectional, descriptive study was carried out among 171 community dentists. A structured questionnaire divided into nine sections: demography, the allocation process, accommodation and living conditions, dental clinic facilities--equipment and materials, work environment, income, sense of achievement, intellectual fulfillment. Thirty five per cent of the sample responded. Of the respondents 54% could speak the local language; almost half (45%) felt that the allocation process was not handled efficiently and 40% said that they needed more information; 60% were placed within 20 km of the nearest town; 26% did not have access to telephone or fax and only 52% were provided with accommodation. Twenty six per cent described the condition of the clinics as poor. Almost a quarter of the respondents indicated that they did not have full sets of instruments. Ten per cent did not have an autoclave nor a high-speed handpiece. Fifty seven per cent did not have oxygen and half the clinics did not have any emergency equipment. Fifty per cent reported that equipment broke down often and an equal number that it was not fixed promptly. More than 90% indicated that they needed a short course to help with repairs. Almost two-thirds said that they enjoyed their work environment. Fifty three per cent had supervision, but 30% felt that they did not need supervision. Although 75% felt that their professional competence had been enhanced, more than three-quarters indicated that they had lost some of their clinical competence in one or other area. While 58% felt that there were many opportunities to improve clinical skills, almost two thirds felt that they were over-skilled for the job. Three-quarters of the respondents indicated that the year had been fulfilling and worthwhile. Problem areas centred around the adequacy of the information provided, accommodation and breakdown of equipment. With the next community service placement, it would be useful if the experiences and lessons of the first year could be taken into account.

Achievement↗