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Biomedical subjects

W M Thomson

Publications and source records attributed to W M Thomson.

At least 55 records · Page 3Linked to original sources
PubMed2000

Dental neglect and dental health among 26-year-olds in the Dunedin Multidisciplinary Health and Development Study.

OBJECTIVES: To test a modification of a previously-reported six-item dental neglect scale and examine its association with dental health and service-use among young adults. METHODS: Of the 980 26-year-old participants in the Dunedin Multidisciplinary Health and Development Study, 973 completed the scale and 930 underwent dental examination. Sociodemographic and dental service-use data were collected using a self-report questionnaire. RESULTS: Factor analysis showed that five of the original six items loaded on the scale, and responses to those items were summed to give a dental neglect scale score for each participant. Scale scores were normally distributed (mean=13.0; SD=3.6; range 5 to 25), and a median split created higher and lower dental neglect groups. A higher proportion of the higher neglect group group: (i) were male; (ii) rated their dental health and dental appearance as below average; (iii) brushed their teeth infrequently; (iv) had extensive plaque deposits; (v) used dental services only when they had a problem; (vi) had not recently seen a dentist; (vii) had lost at least one permanent tooth because of caries, and (viii) had a greater number of decayed tooth surfaces. CONCLUSIONS: Although further examination of its validity and reliability is indicated, the dental neglect scale appears to hold promise for use in dental health promotion, not only in highlighting population groups or individuals who would benefit from intensive health promotion efforts, but also in the evaluation of health promotion interventions.

Adult↗
PubMed2000

Incidence of dental anxiety in young adults in relation to dental treatment experience.

OBJECTIVES: To document the incidence of dental anxiety among individuals aged 18 years at baseline and 26 years at follow-up, and to determine if dental treatment experience continues to play a significant etiological role with respect to the onset of dental anxiety in young adults. METHODS: Dental anxiety scale (DAS; Corah, 1969) scores at ages 15, 18 and 26 were obtained for Study members in the Dunedin Multidisciplinary Health and Development Study. Dental examinations were conducted, and sociodemographic and dental service-use data were collected using a self-report questionnaire. Using a case definition of a DAS score of 13 or more, age 18-26 incident cases were identified and their dental treatment experience and service-use characteristics compared with the remainder. RESULTS: DAS scores at 18 and 26 were available for 792 (80.8%) of the 980 26-year-old Study members. An increase in dental anxiety prevalence was observed over the eight-year period, with an annualized incidence of 2.1%. Fewer incident cases had visited a dentist in the previous eight years, and there were no differences between incident cases and others in their eight-year DFS, FS or tooth-loss increments. A subgroup of "recurrent" cases was identified who were dentally anxious at 15 and 26 but not at 18, and their eight-year incidence of tooth loss due to caries was substantially higher than non-cases. CONCLUSIONS: Aversive conditioning experiences appear to be unrelated to the adult onset of dental anxiety, and it may be that particular temperamental or psychological traits are associated with the condition.

Adolescent↗
PubMed2000

Medication and dry mouth: findings from a cohort study of older people.

OBJECTIVES: The aim of this study was to examine the association between medication exposure and (1) unstimulated whole-salivary flow rate and (2) the severity of xerostomia among older people while adjusting for multiple medication use. METHODS: Data were obtained from participants remaining at the five-year follow-up phase of a cohort study of community-dwelling older South Australians. Medication exposure information was available at baseline and at five years, enabling examination of the effects on dry mouth of long-term exposure to medications. At the five-year follow-up, unstimulated salivary flow was estimated using the spit method, and xerostomia severity was estimated using the 11-item Xerostomia Inventory. Because of the potential difficulties posed by polypharmacy, a two-stage analytical approach was employed: (1) Classification and Regression Tree (CART) analysis was used as an exploratory device to elucidate the relationships among the dependent and independent variables, and (2) linear regression analysis was used as a complementary procedure. RESULTS: Unstimulated flow rate was lower among individuals who were female or taking antidepressants at both baseline and five years, and higher among smokers or people who were taking hypolipidemic drugs. Xerostomia severity was higher among females, or individuals taking: (1) an anginal at baseline and five years, (2) an anginal without a concomitant betablocker at five years, (3) thyroxine and a diuretic at five years, or (4) antidepressants or antiasthma drugs at both baseline and at five years. CONCLUSIONS: These results suggest that polypharmacy can be accounted for to a certain extent by using CART analysis in conjunction with more conventional approaches; and that the relationship between medications and dry mouth is a complex one, and differs according to which aspect of dry mouth is being examined.

Adrenergic beta-Antagonists↗
PubMed2000

The prevalence and intraoral distribution of periodontal attachment loss in a birth cohort of 26-year-olds.

BACKGROUND: Most research efforts in periodontal epidemiology have focused on middle-aged or older people, giving a picture of disease occurrence at a relatively late stage in the natural history of the condition. There is a paucity of comprehensive descriptive data from younger age groups. Understanding the epidemiology and clinical presentation of the condition earlier in the disease course may enable more appropriate interventions. METHODS: The aim of this study was to describe the occurrence of gingival recession, probing depth, periodontal attachment loss (AL), and gingivitis among participants at age 26 in the Dunedin Multidisciplinary Health and Development Study. Gingival recession and probing depth were measured at 3 sites per tooth in 2 randomly selected contralateral quadrants. RESULTS: At age 26, 980 (96.2%) of the surviving cohort participated and periodontal data were available for 914 individuals. Over 70% of the sample had one or more teeth with > or = 1 mm of gingival recession and it was observed at over 20% of midbuccal sites. Over 15% had 1 or more sites with probing depths of > or = 4 mm and nearly 20% had 1 or more sites with > or = 4 mm of AL. The extent of gingival recession was greatest for midbuccal sites on mandibular premolars, followed by midbuccal sites on maxillary premolars and mandibular molars. In the mandible, more distolingual sites had probing depths of > or = 4 mm, but a higher percentage of mesiobuccal sites was affected in the maxilla, and molars were the most affected, followed by premolars, incisors, and canines. Bleeding after probing was more extensive in the mandible than in the maxilla. CONCLUSIONS: Periodontal disease appears to be well-established among a small proportion of young adults. The prevalence of gingival recession was higher than expected, with clear differences by site. Pocketing and AL were more prevalent in mesiobuccal and distolingual sites than the buccal sites, with differences between the jaws.

Adult↗
PubMed1999

The West Coast Study. I: Self-reported dental health and the use of dental services.

This study examined self-reported dental health and the use of dental services in a sample of the population of the West Coast of the South Island of New Zealand. The study differs from previous national surveys in that it provides a regional focus in a relatively remote area of the country; it provides an estimate of the prevalence and severity of dental anxiety among New Zealanders, using an instrument with a long history of use and validation; and it estimates the social impact of oral conditions. A questionnaire was mailed to 450 adult members of the population chosen at random from the electoral roll. The overall response rate was 76.6 percent. A dental check-up was the most commonly reported reason for the last visit to the dentist, although presentation for a specific problem accounted for 63 percent of all dental visits. Some 78.8 percent of the respondents described themselves as dentate, and episodic dental visiting was reported by 53 percent of that group. Higher proportions of episodic use of dental services were observed among beneficiaries, those on low incomes, and those who were classified as dentally anxious. Six percent of respondents had their last dentally treatment funded by public monies, and a further 3.6 percent did not have to pay. Beneficiaries and Community Services Cardholders were more likely to make up these groups. While public funding ensures access to care for a substantial number of individuals. West Coast dentists are supplementing this care by providing treatment without charge for a small number of people. Various adverse impacts of oral conditions were reported by up to 8.6 percent of respondents; more Community Cardholders reported feeling self-conscious or embarrassed than non-Community Cardholders. Geographic isolation and lack of choice of dental practitioner did not appear to be factors in determining utilisation. The two characteristics associated with poorer self-reported dental health and infrequent use of dental services were lower socio-economic status and self-reported dental anxiety. The findings of this study provide regional-level confirmation of the general findings of the 1976 and 1988 national studies.

Adolescent↗
PubMed1999

The West Coast Study. II: Dental anxiety and satisfaction with dental services.

Dental anxiety is common, and is a notable factor in the avoidance of dental care. The dental satisfaction of users is an important indicator of the quality of dental care. A postal survey (response rate 76.6 percent) was used to investigate dental anxiety and dental satisfaction among a representative sample of 249 dentate adults living on the West Coast of the South Island of New Zealand. Dental anxiety was reported by 20.8 percent of respondents, and was more prevalent among beneficiaries (individuals in receipt of a Social Welfare benefit) and younger people. Dental satisfaction was lower among younger people and those who were dentally anxious, and was higher among people with a tertiary education. Differences in consumers' expectations were considered responsible for the latter findings. Where appropriate, dentists should be prepared to adapt their manner of communicating with patients.

Adolescent↗
PubMed1999

General dental practitioners' perceptions of removable prosthodontics in the undergraduate curriculum.

The undergraduate dental curriculum is undergoing rapid change and revision in dental schools worldwide. Decreasing edentulism, the advent of the clinical dental technician, and advances in technology (such as dental implantology) have led to changes in patient management and treatment options for general dental practitioners in New Zealand. The current undergraduate removable prosthodontic curriculum has seen very little change in past years at the School of Dentistry, University of Otago, and is under review to facilitate the teaching of general dental practice in the Final Year. A questionnaire-based survey of 150 general dental practitioners (response rate 74.6 percent) supported modification of the existing removable prosthodontics curriculum to improve its relevance to modern general dental practice. Integration of fixed and removable prosthodontic teaching was recommended.

Attitude to Health↗
PubMed1999

An example of measurement and reporting of periodontal loss of attachment (LOA) in epidemiological studies: smoking and periodontal tissue destruction.

The measurement and reporting of periodontal disease in epidemiological studies can be complex, with the common indices having well-recognised shortcomings. The aim of this study was to illustrate the use of the periodontal loss of attachment (LOA) approach in investigating the association between cigarette smoking and loss of periodontal attachment in a convenience sample of adults, in order to determine whether or not smoking was a risk indicator for periodontal disease. All participants were given a detailed periodontal clinical examination in two randomly assigned contralateral diagonal quadrants, with LOA measurements made at six sites per tooth. Information was also collected on participants' socio-demographic characteristics, oral hygiene practices, smoking history, and attitudes towards smoking. The 240 participants examined comprised 81 current smokers (CS), 79 former smokers (FS) and 80 nonsmokers (NS). Substantial differences and a gradient in disease existed for LOA among the three groups. CS exhibited the greatest (and NS the least) prevalence, extent, and severity of LOA. CS had more plaque and calculus than either of the other two groups, but the groups did not differ with respect to bleeding on probing. Overall, smoking was associated with the disease outcome, and this persisted after potential confounders were controlled using multivariate analysis. Although the observed differences may have been due to the self-selected nature of the sample, the gradient evident across the three smoking exposure groups suggests that smoking cessation can slow the progression of the disease. The LOA approach appears to be a versatile and informative method for recording, analysing, and presenting data on periodontitis in epidemiological studies.

Adult↗
PubMed1999

The Xerostomia Inventory: a multi-item approach to measuring dry mouth.

OBJECTIVE: To develop a valid multi-item method of measuring the symptoms of xerostomia which includes the wide range of xerostomia symptoms in a single quantitative measure. DESIGN: A combination of qualitative and quantitative approaches. SETTING: A cohort study in South Australia. PARTICIPANTS: Older people aged 65 years or more who were taking part in the South Australian Dental Longitudinal Study. MEASURES: Xerostomia symptoms were evaluated using a multi-item inventory format and, for comparison purposes, a standard single dry-mouth question. Resting whole-salivary flow rate was estimated using the 'spit' method. RESULTS: Xerostomia and flow-rate data were available for 636 individuals. Factor analysis revealed the presence of a discrete xerostomia dimension, represented by 11 items whose responses were summated to give a single Xerostomia Inventory (XI) scale score. This had a very low correlation with resting flow rate but a much stronger, positive correlation with the standard dry-mouth question responses. CONCLUSIONS: The XI shows adequate content and concurrent validity, and appears to be a promising advance on previous approaches to xerostomia symptomatology although further testing is required.

Aged↗
PubMed1998

Dental fear with and without blood-injection fear: implications for dental health and clinical practice.

The relation between dental, blood and injection fear and oral health was examined in 936 New Zealand 18-year-olds. Of the approximately ten percent (n = 96) of the sample who reported a dental fear, 1 in 10 also reported a fear of blood and 53% a co-morbid fear of injections. Study members with dental fear alone or co-morbid dental and blood or injection fear had significantly worse oral health (i.e. greater caries experience) than a no-fear comparison group or individuals with blood-injection fear only. Further, individuals with dental and blood or injection fear had a significantly higher level of recent tooth decay than individuals with dental fear alone. Time since last dental treatment also tended to be highest in this group. Implications for dental health and practice were discussed.

Adolescent↗
PubMed1998

Dental caries and changes in dental anxiety in late adolescence.

Little is known about changes in dental anxiety with ageing and their association with changes in oral health. This study examined the relationship between changes in dental caries experience and dental anxiety from 15 to 18 years of age among adolescent participants in the Dunedin Multidisciplinary Health and Development Study. Dental anxiety was estimated using the Corah Dental Anxiety Scale (DAS), and individuals with a DAS score of 13+ were identified as being dentally anxious. Dental examinations were performed on 649 individuals at ages 15 and 18, and a DMFS score was computed for each. Caries prevalence among those who were dentally anxious at both 15 and 18 years was significantly higher than for those who were not at either age. Regression analysis revealed that dental anxiety predicted caries incidence between ages 15 and 18 years. Dental anxiety is likely to be a significant predictor of dental caries experience, and may be a risk factor for dental caries incidence.

Adolescent↗
PubMed1997

Good teeth, bad teeth and fear of the dentist.

Studies of dental fear and oral disease suggest that conditioning processes are important in the acquisition of dental fear. At this time, however, definitive conclusions are premature as all research on the etiology of dental fear has been retrospective in design, with most confined to analogue or clinic samples. This study redressed these limitations by prospectively investigating the relationship between oral health (i.e. caries experience) at age 5 and 15 yr and the report of dental fear at age 18 in a large, unselected birth cohort. Caries experience at age 5 was not related to the development of dental fear in late adolescence. In contrast, caries experience at age 15 was significantly, and specifically, related to the report of dental fear at age 18. A ratio of caries severity at age 15, indicating the extent of multi-surface involvement, was inversely related to dental fear at age 18. This intriguing finding suggests that relatively brief dental treatment occasioned by low levels of dental disease may result in the incubation of dental fear in some individuals and that longer episodes of treatment may facilitate fear habituation. Theoretical and practical implications of these findings are discussed.

Adolescent↗
PubMed1997

The Australian public's perception of mercury risk from dental restorations.

The debate about mercury and dental amalgam has been one of the longest running in dentistry, and shows no signs of abating. This study aimed to investigate perceptions about mercury in dental fillings among a representative sample of the Australian public. A random sub-sample of participants in a national dental telephone interview survey completed a follow-up postal questionnaire which included four items on dental mercury. The postal survey response rate was 85.2%. Concern about mercury in dental fillings was expressed by 37.5%, while 16.2% reported having requested fillings that do not contain mercury. Avoidance of dental care because of concern about mercury in fillings was reported by 5.8%, but only 4.7% reported having had fillings replaced because they contained mercury. The data indicate that there is a substantial degree of concern about mercury and dental amalgam among the Australian public, but that the dental behavioural and treatment-pattern consequences of that concern are infrequent.

Adolescent↗
PubMed1997

Public perception of cross-infection control in dentistry.

Since the advent of HIV/AIDS at the beginning of the 1980s, concern has generated considerable impetus for change in cross-infection control procedures in dentistry. This process has been hastened partly by media coverage which, in tending to favour sensation over rational discourse, has played a not inconsiderable role in shaping public understanding and expectations. This study aimed to investigate public perceptions of cross-infection control in dentistry in Australia using a postal follow-up to the 1995 National Dental Telephone Interview Survey. The postal survey response rate was 85.2 per cent. Concerns about the procedures used by their dentist to sterilize instruments were reported by 13.3 per cent of respondents overall, and this was greater among non-health-card-holders, individuals who mainly spoke a language other than English in the home, and those who reported a non-routine dental visiting pattern. Avoidance or delaying of dental visits due to the perceived cross-infection risk was reported by an overall 3.6 per cent of people, and this was higher among females and those who expressed concern about cross-infection control. The profession has a responsibility to ensure that information on the measures which have been taken to reduce the risk of cross-infection in dentistry is disseminated as widely and as clearly as possible so that undue public concern and avoidance of dental care are minimized.

Acquired Immunodeficiency Syndrome↗
PubMed1997

Changes in self-reported dental anxiety in New Zealand adolescents from ages 15 to 18 years.

Little is understood of the natural history of dental anxiety. The aim of this study was to examine three-year changes in self-reported dental anxiety among adolescent participants in the Dunedin Multidisciplinary Health and Development Study. Dental anxiety was estimated at ages 15 and 18 by means of the Corah Dental Anxiety Scale (DAS). A DAS score of 13+ defined high dental anxiety. Participants were assigned to one of four dental-anxiety study groups (Chronic, Incident, Remitted, or Never) on the basis of changes in reported level of anxiety from ages 15 to 18. Results are reported for the 691 participants who completed the DAS at both ages. The sample's overall dental anxiety score decreased significantly from age 15 (mean, 8.79) to 18 (8.52) (paired t test, t = 2.37; P < 0.05). The Chronic and Never groups had small negative DAS increments, the Incident group showed a substantial positive increment, and the Remitted group recorded an even larger negative increment. Multivariate analysis showed that the DAS score at age 15 was the sole predictor of the change in DAS score for the Chronic and Remitted groups, and was a co-predictor for the Incident and Never groups. An episodic dental visiting pattern was a strong predictor of a positive change in DAS score for the Incident group; and for the Never group, a higher DMFS score at age 15 predicted a positive change in DAS score at 18, but being female was predictive of a decrement. This study indicates lower stability of dental anxiety in late adolescence than has been reported from other age groups.

Adolescent↗
PubMed1997

A medication capture and analysis system for use in epidemiology.

Epidemiological studies of elderly people have tended to avoid estimations of medication prevalence and adverse effects, partly because of the practical difficulties of capturing medication data and then rendering them analysable. This article describes a versatile coding system for medication data entry that greatly simplifies the process of medication analysis in epidemiological field studies. Five-digit numerical codes are used to identify individual preparations, and the system's hierarchical nature allows aggregation to a number of levels. To date, the MedCap (Medication Capture) system has been used successfully in 3 different ways in 2 major longitudinal studies of elderly people in Australia, and offers a possible solution to the practical difficulties of field pharmacoepidemiology.

Aging↗
PubMed1997

Predicted distribution of treatment needs for caries across three indicator age groups by the year 2031.

New Zealand is undergoing a demographic transition which is resulting in fewer young people and greater numbers of elderly people. A dental transition is also occurring by which more elderly people are retaining more teeth. Projections of the caries experience of three indicator adult age groups show that the bulk of future restorative demands on the dental-care system will come from those in the middle-aged and elderly groups. Such a trend requires an increase in gerodontological input at all levels of dental education and training.

Adult↗