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Biomedical subjects

W M Thomson

Publications and source records attributed to W M Thomson.

At least 73 records · Page 4Linked to original sources
PubMed1996

Testing a child dental neglect scale in South Australia.

The concept of dental neglect may allow a better understanding of the complex relationship between individual behaviour, environmental factors and dental caries in children. Dental neglect has been previously explored among elderly people, but little is known of its occurrence among children. A study of children's use of dental services in South Australia provided demographic and attitudinal data from parents of each of a stratified sample of 2659 children from age groups 10-11 and 14-15 years. Dental examinations were undertaken of a random sub-sample of 769 children. Parental responses were sought to seven statements on different aspects of dental neglect. Factor analysis revealed two factors, one of which confirmed a general "dental neglect" phenomenon (which was significantly associated with all seven items); the other revealed an "avoidance of care" phenomenon which involved only two of the items. The internal consistency of responses across all seven items was confirmed (Cronbach's alpha = 0.74), and the scores for the seven were summed to create a composite dental neglect variable. Linear regression analysis revealed that dental neglect was greater among males, younger children, those whose mothers had had less education, children who had not received dental care in the previous two years, and those for whom the responding parent's last dental visit was symptom-driven rather than for a routine examination. The dental neglect variable was then dichotomised in order to examine its association with caries experience. Among the older children, those in the higher dental neglect group had significantly higher overall permanent caries experience (DMFS), and greater numbers of decayed permanent tooth surfaces (ANOVA, P < 0.05). The outcome of this study indicates that the Dental Neglect Scale may have utility in predicting and understanding variation in dental health, and in designing and targetting dental health promotion strategies.

Adolescent↗
PubMed1996

Patient mobility in Australian dentistry.

Data on the mobility of dental patients are scarce. The aim of this study was to investigate movement among dentists of a representative sample of the Australian public. A postal questionnaire was completed by a random subsample of 1,010 participants in the 1995 National Dental Telephone Interview Survey. The response rate was 85.2 per cent. Approximately one-third of the 885 dentate respondents reported attending a different dentist to that attended two years previously; this was substantially higher (over half) among those whose last visit was not in the private sector. Most (81.8 per cent) of those who had changed dentist had done so for reasons which were beyond the immediate control of the dental profession, but 15.2 per cent had changed because they were unhappy with the care provided by the previous dentist, and 3.0 per cent had changed because the previous dentist was too expensive. Perceived freedom to change dentist was greater among individuals who used the private sector, spoke English in the home, and who were not holders of health cards. The findings of this study indicate that the Australian public manifests a moderate degree of movement among dental providers, and that such movement is greater among users of public-sector dental services.

Adolescent↗
PubMed1996

Self-reported dental status and treatment need among elderly people.

A convenience sample of 180 elderly residents of Council flats in Wanganui were interviewed about their dental health and experiences of dental care. Thirty percent of the sample were dentate, and this was higher among younger subjects. Life-long or mostly life-long dental attendance was reported by 43 percent, and this was higher among individuals of higher socioeconomic status and those who had been educated to secondary school level or more. Life-long attenders were more likely to be dentate. Approximately one-third of subjects reported a current problem or dental treatment need.

Age Factors↗
PubMed1996

Dental anxiety among Australians.

This study aimed to estimate the prevalence of dental anxiety and examine its associations among a representative sample of Australians aged 18 and over. A random sub-sample of participants in a national dental telephone interview survey completed a follow-up postal questionnaire (response rate 85.2 per cent) which included Corah's Dental Anxiety Scale (DAS). The prevalence of dental anxiety (defined by a DAS score of 13 or more) in the sample was 14.9 per cent, with overall severity represented by the mean score of 9.04 (sd, 3.45). The prevalence and severity of dental anxiety were greater among women than men, and in the 35-44 age group. High-anxiety individuals reported more deferring of dental care, and more frequently reported an episodic dental visiting pattern. Although there were no differences in dental anxiety by self-reported dental status, individuals who reported impact from their oral conditions had higher dental anxiety. These associations with social impacts and deferment of care indicate that dental anxiety may be an important dental public health problem in Australia.

Adolescent↗
PubMed1995

Dental caries experience and use of prescription medications among people aged 60+ in South Australia.

Medication has long been implicated as a potential risk factor for dental caries among elderly people, although epidemiological studies have reported inconsistent associations between medication usage and dental caries experience. This paper aimed to describe the frequency of medication usage, and to examine associations between medication usage and dental caries experience among non-institutionalized persons aged 60+ years in South Australia. A cross-sectional survey design was used to collect interview data about prescription medication usage from 1,650 people. Oral examinations were conducted among 848 people to obtain information about coronal and root canes experience. The number of prescribed medications taken ranged from 0 to 17, and the mean number taken was 1.8 (sd, 1.9). This was higher in older subjects and females. Four medication categories accounted for almost three-quarters of the medications taken; of those, cardiovascular drugs (including diuretics) accounted for three, with analgesics the only non-cardiovascular class. Subjects taking 3 or more prescription medications had a higher Root Caries Index (RCI, mean = 14.43; P < 0.01) than those taking one or two (mean = 11.50), and those who were taking none (mean = 12.02). Examination of particular medication types revealed that people who took antidepressants and antiulcer drugs had significantly higher RCI values (P < 0.05). There was only a moderate association between medication usage and root caries experience which may be attributable to xerogenic effects of medication, or non-causal associations with underlying medical conditions.

Aged↗
PubMed1994

Day-stay treatment for dental caries at a New Zealand hospital dental unit: a 5-year retrospective audit.

A retrospective audit of day-stay dental treatment for children under general anaesthesia at a New Zealand hospital dental unit showed that demand for such treatment has risen. Waiting times increased substantially over the 5-year period of the study--only 3.4 percent of children had to wait more than 3 months for treatment in 1989-1990, compared with 28.4 percent in 1993-1994. The re-treatment rate over the 5-year period was 4.2 percent. Extractions were the most common treatment item provided, followed by Class I and Class II amalgam restorations. A change of operator and an improvement in equipment in the 1993-1994 period contributed to a change in the range of treatment provided, and a concomitant increase in Dental Benefit revenue. Regional Health Authorities need to take a more realistic approach to purchasing such services so that safe practice is encouraged. Purchasing bodies in general need to give high priority to integrated child health promotion initiatives so that the need for day-stay dental treatment under general anaesthesia is ultimately reduced.

Adolescent↗
PubMed1994

Exploring dental operators' perceptions of their clinical tasks.

Clinical variation is a result of the complex interaction of operator, operating environment and client variables. This study explores intra-operator characteristics by applying a technique from psychology known as Repertory Grid to New Zealand dental therapists, in order to elicit the ways in which they view their work. Individual interviews were conducted with 13 dental therapists to elicit the full range of tasks that they perform and the various ways that they describe them. Each therapist then rated her own work activities or tasks on her personal set of bipolar descriptions (personal constructs). Principal components analyses of each individual's set of ratings produced graphs which portrayed the pattern of meanings which therapists attributed to their work activities. Common features among the 13 therapists' work perceptions were then identified and categorised according to five types of variables (therapist, client, procedural, time and interpersonal). Common features included operator perceptions of painfulness of procedures, complexity of decision-making, interaction with people, stress for the therapist, preventive care for the client, routineness of task and challenge for the therapist. This detailed information gives a better understanding of the complex ways in which therapists view their tasks and therefore make decisions in the clinical setting. It could be conveniently used to develop a questionnaire to assess the empirical relationships between intra-operator factors and clinical outputs.

Adult↗
PubMed1993

Presentation of data.

Explore the source record for details and available documents.

Data Interpretation, Statistical↗
PubMed1993

Medication and perception of dry mouth in a population of institutionalised elderly people.

AIM: (1) To estimate the prevalence of use of different medication categories; (2) to estimate the prevalence of xerostomia (dry mouth); and (3) to estimate the effects of xerostomic medication upon perceived dry mouth among institutionalised elderly people. SUBJECTS: A two-stage stratified random sample of three hundred and fifty-nine people aged 65 to 102 living in rest homes and geriatric hospitals in the Manawatu and Horowhenua districts. METHOD: Subjects were interviewed and dentally examined at their place of residence. Medication was noted from institutional records, and subjects' experiences of xerostomia were explored using the question "how often does your mouth feel dry?" RESULTS: The sample was found to be highly medicated, with a mean 3.6 different drugs per individual, and only 10% not taking any medication. Psychotherapeutics (42.3%), analgesics (32.9%), diuretics (31.2%) and laxatives (23.4%) were the most common drug categories. Of the 284 subjects who were able to answer, only those who were taking anticholinergic medication reported a higher prevalence of xerostomia. CONCLUSIONS: Institution-dwelling elderly people are a highly-medicated group. There is an increased risk of unwanted oral side-effects with certain drugs, and it is recommended that this is borne in mind when prescribing for elderly patients.

Aged↗
PubMed1993

Ethnicity and child dental health status in the Manawatu-Wanganui Area Health Board.

Dental caries data on 3,283 5-year-old children, taken at the completion of their first treatment in the School Dental Service as new school entrants, showed that non-Maori children were three times more likely than Maori children to have no experience of caries. Maori children were three times more likely to have high (five or more missing or filled teeth) caries experience than non-Maori children. Caries experience in Pacific Island children lay between the Maori and non-Maori children. Maori children were almost three times more likely to have had general anaesthesia for dental treatment than were non-Maori. From records of 3,329 Form II (aged 12 or 13) children taken at the conclusion of their last treatment in the School Dental Service, non-Maori children were found to be twice as likely than Maori to have had no experience of caries. Maori children were over twice as likely to have had high (five or more missing or filled permanent teeth) caries experience than non-Maori. It is unlikely that the dental health outcome differences between Maori and non-Maori children will be reduced by the current dental health care system unless dental health promotion becomes more effective and culturally appropriate.

Adolescent↗
PubMed1992

Dentures, prosthetic treatment needs, and mucosal health in an institutionalised elderly population.

A survey of 359 elderly residents of rest homes and geriatric hospitals in the Manawatu and Horowhenua regions showed that 80.5 percent were fully edentulous. Full upper and lower dentures were worn by 64 percent of the total sample, and 31 percent of the dentate group wore one or more partial dentures. Prosthetic treatment needs were dominated by full dentures: 18 percent of upper dentures and 26 percent of lower dentures were considered to need replacement. A further 24 percent of full lower dentures required relining. Only 7 percent of the dentures were named. One third of the subjects had mucosal lesions, the most common lesions being angular cheilitis (present in 18 percent of subjects), traumatic ulcers (14 percent), atrophic glossitis (12 percent), and leukoplakia (present in 8 percent of subjects). No malignant lesions were found.

Aged↗
PubMed1991

Dental status and treatment needs of a New Zealand institutionalised elderly population.

A survey of 359 elderly residents of rest homes and geriatric hospitals in the Manawatu and Horowhenua districts showed that approximately two-thirds were aged 80 or over, and 19.5 percent were dentate, with a mean 13.3 teeth per dentate subject. A mean of 4.6 teeth per dentate subject had caries of either the crown or root, or both. Older males had substantially higher extraction requirements than other subjects. The periodontal needs of the sample were generally low and dominated by the need for calculus removal.

Aged↗
PubMed1990

Root surface caries--an overview of aetiology, prevalence, prevention, and management.

Root surface caries is a specific clinical entity which has been receiving increasing attention in recent years. It has a complex, multi-factorial aetiology, but all the causal factors, and their relative contributions, are not yet clear. There appears to be a role for one or more microbiological agents, particularly in association with a diet involving frequent ingestion of fermentable sugars. Gingival recession is almost certainly a pre-requisite for the development of root surface caries, but intra-oral, site-specific differences in prevalence confuse the picture. Figures of between 20 and over 70 percent for gross prevalence have been reported, with demonstrated attack rates of between 15 and 28 percent of susceptible surfaces being affected. Difficulties in diagnosis may limit the reliability of these figures. The prevention of root surface caries is a two-phase process; the initial emphasis is on the prevention of gingival recession, and the later approach involves measures aimed at reducing the frequency of intake of known cariogenic foodstuffs, and increasing the resistance of susceptible root surfaces with topical fluoride. Medicines which can cause dry mouth must also be examined. The treatment of root surface caries involves a range of procedures, from topical fluoride to multi-surface, glass ionomer cement restorations.

Dental Caries↗
PubMed1986

Cholinergic neurons and the cardiovascular response produced by central injection of substance P in the normotensive rat.

The role of cholinergic neurons in central cardiovascular regulation is not well understood, however, activation of brain cholinergic neurons in several species evokes a hypertensive response. As with central cholinergic stimulation, intracerebroventricular (i.c.v.) injection of substance P (sP) elicits a pressor response in unanesthetized rats. The purpose of this study was to determine whether the cardiovascular effects following i.c.v. injection of this neuropeptide are mediated by central cholinergic neurons. Therefore, the cardiovascular response to sP was examined in control rats, and in animals pretreated centrally with classical pre- and post-synaptic cholinergic antagonists. Drugs were administered directly into the lateral ventricle while rats were freely-moving in their home cages. I.c.v. injection of sP produced a dose - dependent increase in arterial pressure and heart rate. The hypertensive response was significantly reduced by pretreatment with hemicholinium-3. This dose (20 ug) of hemicholinium-3 is capable of producing a maximal depletion of brain acetylcholine levels. The increase in heart rate to substance P was not as sensitive to hemicholinium-3 pretreatment as was blood pressure. Central pretreatment with the nicotinic receptor antagonist, hexamethonium was more effective than the muscarinic antagonist, atropine in blocking the pressor response to sP. Hexamethonium did not significantly alter the tachycardic response to the peptide, but atropine produced a small, but significant reduction in the response. Therefore, the pressor response to central injection of sP may be mediated to a large extent through cholinergic pathways involving nicotinic receptors.

Animals↗
PubMedDate not supplied

The occurrence of xerostomia and salivary gland hypofunction in a population-based sample of older South Australians.

This paper examines the prevalence of and concurrence between the symptoms of dry mouth (xerostomia) and reduced salivary flow (SGH) among a population-based sample of older South Australians. Participants in a longitudinal dental study of older people were asked a global question about their experience of dry mouth ("How often does your mouth feel dry?"), and those who responded "Always" or "Frequently" were categorized as xerostomic. Unstimulated whole salivary flow rate was measured, and individuals whose flow rate was less than 0.1 mL/min were categorized as SGH cases. Saliva samples were collected from 700 individuals, of whom 683 (97.7%) answered the dry-mouth question. The mean unstimulated salivary flow rate was 0.27 mL/min (SD 0.22). The prevalence of SGH was 22.1%, and the prevalence of xerostomia was 20.5%, but only 5.7% of participants had both conditions. Almost two-thirds of the sample had neither condition. Males and females differed in the degree of concurrence between the two conditions. It appears that, in the group studied, xerostomia and SGH were largely discrete conditions, supporting the assertion by other workers that low salivary flow may not be the key factor in the etiology of xerostomia among older people.

Aged↗
PubMedDate not supplied

Socio-economic and behavioural risk factors for tooth loss from age 18 to 26 among participants in the Dunedin Multidisciplinary Health and Development Study.

OBJECTIVE: To determine the risk factors associated with tooth loss between the ages of 18 and 26. METHODS: Dental examinations at ages 18 and 26 were conducted on Study members in the Dunedin Multidisciplinary Health and Development Study, and sociodemographic and dental service use data were collected using a self-report questionnaire. At age 15, an estimate of socio-economic status (SES) for each Study member had been obtained by classifying the occupation of the male parent. A case of tooth loss was defined as an individual who had lost one or more teeth (excluding third molars) due to caries between ages 18 and 26. Logistic regression and Poisson analysis were used to model the occurrence of tooth loss. RESULTS: Among the 821 study members who were examined at both ages, one or more teeth were lost because of caries by 85 (10.3%). After controlling for sex, SES and visiting pattern, baseline caries experience predicted subsequent tooth loss, with the odds increasing by 2.8 for every increase by 1 in the number of decayed surfaces present at age 18. Episodic dental visitors had 3.1 times the odds of their routine visiting counterparts of losing a tooth over the observation period. The number of teeth lost was, on average, 2.3 times higher among episodic dental visitors. CONCLUSIONS: Socio-economic inequalities in tooth loss appear to begin early in the life course, and are modified by individuals' SES and dental visiting patterns.

Adolescent↗