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Unpredictable teeth.
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Traumatised teeth.
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The 1993 national survey of children's dental health.
The 1993 national survey report shows encouraging evidence of general improvements in children's dental health compared with earlier surveys in 1973 and 1983. There have been dramatic declines in dental caries at all ages and this is evident in the different parts of the United Kingdom and in all social classes. However, among 5-year-old children average caries levels have remained unchanged since 1983, although a higher proportion now have no known decay experience. The amount of decay treated by restoration as a proportion of total caries experience has fallen in all age groups and the disease appears to be becoming concentrated at higher levels in a diminishing number of children who are not obtaining dental care. A disturbing finding was the high prevalence of dental erosion, particularly in the primary dentition. Other findings included more than half of children in Scotland and Northern Ireland having fissure sealants, improved parental knowledge about preventing dental disease, reduced numbers of orthodontic extractions and a reduction of one-third in the rate of traumatised permanent incisors. Children must be regarded as the number one priority for dental services in order to safeguard the dental health of rising generations, and renewed efforts must be made to further reduce their disease levels through population based preventive measures.
The national diet and nutrition survey of 1.5 to 4.5 year old children: summary of the findings of the dental survey.
A dental health survey was included as part of a large scale study of nutrition in preschool children. The survey was carried out in 1992/93 and was published in spring 1995. Information on dental health status and on dietary intake was gathered from a total of 1658 children from 100 geographical sectors in the United Kingdom. This article summarises the main findings and highlights some of the most important findings regarding dental health and its relationship to dietary factors. Seventeen per cent of children had some caries experience and in 83% of cases this was untreated. Dental decay was most strongly related to social background. The factors most strongly related to caries prevalence were: receipt of income benefits, in the 1.5-2.5-year-old children; the educational status of the mother in the 2.5-3.5-year-old children and social class of the head of household in the 3.5-4.5-year-old children. Consumption of sugary drinks at bedtime, children being left to brush their teeth themselves, household expenditure on confectionery and geographical region were also strongly associated with caries prevalence.
In at the deep end--an insight into scuba diving and related dental problems for the GDP.
Scuba diving is one of the fastest growing sports in the world. It is inevitable that the general dental practitioner (GDP) will have patients who participate in this sport and they should be aware of a number of problems that a diver can experience that are associated with the teeth and related structures. The aim of this article is to introduce the GDP to the dental problems associated with diving and make recommendations on dental care for scuba divers.
The ups and downs of barodontalgia.
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Widespread child behaviour.
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Orthodontics. Part 1: Who needs orthodontics?
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The effectiveness of out-of-hours dental services: I. Pain relief and oral health outcome.
OBJECTIVE: To compare the effectiveness of four types of out-of-hours emergency dental service, including both 'walk-in' and telephone-access services. BASIC DESIGN: Questionnaire survey of patients attending weekend emergency dental services, with measurement of self-reported oral health status and dental pain (at attendance and follow-up) and retrospective judgements of change in oral health status. SETTING: Two health authorities in South Wales, UK. SUBJECTS: A total of 783 patients who completed questionnaires at attendance, and 423 who completed follow-up questionnaires. RESULTS: For patients who saw a dentist there were no consistent differences in the effectiveness of the four services, whether measured as pain relief, oral health gain or using patients' retrospective transition judgements about feeling better after their episode of emergency dental care. The proportion of patients reporting no improvement (transition judgements), either an hour after or the day after seeing the dentist, was surprisingly high (30-40% and 23-38% respectively). Although the 'rotas for all' - a telephone-access GDP-provided service for both registered and unregistered patients - achieved both the highest reductions in pain scores and the greatest improvements in dental health status between attendance and follow-up, this effect may reflect health gains due to care received after the episode of emergency dental care. CONCLUSIONS: Neither the setting where emergency dental patients are seen, nor the type of dentist who sees them, appear to have any significant effect on patient-reported health outcomes. Although further exploration of the factors that predict poor pain relief or low oral health gain is required, future research on these services should focus on the process of care and accessibility.
Irradiated jaws.
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A life-course approach to assess the relationship between social and psychological circumstances and gingival status in adolescents.
BACKGROUND: Several models have been proposed to explain the causes of periodontal diseases. None have adopted the life-course approach. OBJECTIVE: To investigate the relationship between social, psychosocial and biological conditions experienced in early life and through the life course and gingival bleeding on probing. METHODS: A two-phase study was carried out in Brazil. In Phase I, 652 13-year-olds were clinically examined and interviewed. In Phase II, 311 families were randomly selected for an interview to collect information on the teenager's state at birth and selected impacts in their early years of life. Clinical examination included assessment of dental caries, periodontal and dental trauma status. The data analysis used logistic regression and the models were determined using stepwise procedure. FINDINGS: Adolescents who were born in a non-brick house, who were living in an overcrowded house at 13 years of age, those whose mother had less than 8 years of education, who were at a lower school grade for their age, those who reported high levels of paternal punishment and those who were from reconstituted families were significantly more likely to experience high levels of bleeding gums after probing. CONCLUSION: Early life and life-course experiences were important determinants of the level of gingival bleeding after probing in adolescents.
Gaining access through a calcified pulp chamber: a clinical challenge.
Dental pulp is prone to dystrophic mineralization; this mineralization can be so extensive that the entire root canal system is obliterated. As a result, root canal treatment can become a difficult if not impossible task. This article presents the endodontic management of a tooth with an obliterated pulp chamber and associated with a discharging sinus in a teenage patient. The role of a calcium hydroxide lining to induce mineralization and cause the obliteration of the pulpal space is also discussed.
A retrospective evaluation of traumatized permanent teeth.
The purpose of this retrospective study (15 years follow-up) was to evaluate the long-term results of treatment to injured teeth following acute trauma. A total of 198 patients with 488 injured teeth were available for analysis. Uncomplicated crown fractures were restored with composite restorations in 106 teeth. 19% of the restorations had been replaced more than 10 times and at the final examination approximately 25% were rated as unacceptable, i.e. needing clinical treatment. Fixed prosthetic therapy had been provided for 106 teeth and endodontic treatment had been provided in 114. Colour changes appearing at late stage suggested obliteration, necrosis or endodontically treated teeth. Anterior composite restorations have been considered acceptable as semi-permanent restorations in patients of early school age (7-15 years), and may have been an advance on what was possible previously, but results of this clinical study suggest that they still do have major shortcomings. There remains a need for a simple, conservative method of restoring aesthetics to fractured and discoloured anterior teeth for clinical use in young patients of late school age.