• Impact of oral rehabilitation on the quality of life of partially dentate elders in a randomised controlled clinical trial: 2 year follow-up.

      McKenna, Gerald; Allen, Patrick Finbarr; Hayes, Martina; DaMata, Cristiane; Moore, Ciaran; Cronin, Michael (Plos One, 2018-01-01)
      This randomised clinical trial aimed to compare the impact of two different tooth replacement strategies for partially dentate older patients namely; removable partial dentures (RPDs) and functionally orientated treatment based on the shortened dental arch (SDA) concept, on Oral Health-related Quality of Life (OHrQOL). 89 patients completed a randomised clinical trial. Patients were recruited in two centres: Cork University Dental Hospital (CUDH) and a Geriatric Day Hospital (SFDH). 44 patients were randomly allocated to the RPD group and 45 to the SDA group where adhesive bridgework was used to provide 10 pairs of occluding contacts. The impact of treatment on OHrQOL was used as the primary outcome measure. Each patient completed the Oral Health Impact Profile (OHIP-14) at baseline, 1, 6, 12 and 24 months after treatment. Both treatment groups reported improvements in OHIP-14 scores at 24 months (p<0.05). For the SDA group OHIP-14 scores improved by 8.0 scale points at 12 months (p<0.001) and 5.9 scale points at 24 months (p<0.05). For the RPD group OHIP-14 scores improved by 5.7 scale points at 12 months (p<0.05) and 4.2 scale points at 24 months (p<0.05). Analysis using ANCOVA showed that there were significant between group differences recorded in both treatment centres. 24 months after intervention the SDA group recorded better OHIP-14 scores by an average of 2.9 points in CUDH (p<0.0001) and by an average of 7.9 points in SFDH (p<0.0001) compared to the RPD group. Patients in the SDA group maintained their improvements in OHrQOL scores throughout the 24 month study period. For the RPD group the initial improvement in OHrQOL score began to diminish after 6 months, particularly for those treated in SFDH. Thus, the benefits of functionally orientated treatment increased over time, particularly for the older, more systemically unwell cohort in SFDH.
    • Multiple myeloma presenting as mandibular pain

      Crowley, Miriam (Irish Dental Association, 2016-10)
      Introduction: Multiple myeloma (MM) is a systemic malignancy of plasma cells defined by monoclonal production of circulating immunoglobulins. Bone pain is a presenting feature in the majority of cases. Treatment may involve intravenous use of bisphosphonates, chemotherapy or haematopoietic stem cell transplantation. Here, we illustrate a first presentation of MM in a patient with mandibular pain and discuss radiographic, diagnostic and treatment challenges of orofacial issues in patients with MM. Case report: A 69-year-old lady presented to an emergency oral surgery clinic with a month-long history of unilateral left-sided pain in her jaw. Examination revealed a buccolingual swelling of 2cm diameter in the lower left premolar region. Radiographic images demonstrated a 2cm lytic lesion in her mandible corresponding with the symptomatic region. Aspiration of the lesion was performed and histological analysis indicated an abundance of atypical plasma cells. Subsequent biopsy revealed sheets of plasmacytoid cells suggesting evidence of a plasmacytoma. Skeletal survey, bone marrow biopsy and serum analysis confirmed the presence of MM. Discussion: MM, although a systemic malignancy, can present via a variety of orofacial manifestations. The presence of a lytic lesion on plain radiographs should alert the dental practitioner to the possibility of the diagnosis. Treatment of orofacial bone pain may respond to intravenous bisphosphonates but care must be taken to avoid osteonecrosis of the jaw. Conclusion: This case is an important reminder of the potential oral presentations of MM and underlines the importance of radiographic evaluation in patients with atypical symptoms and presentations.
    • Dentists’ requirements for continuing professional development in Ireland. A pilot study conducted at University College Cork

      Stewart, Christopher; Kinirons, Martin (Journal of the Irish Dental Association, 2015-02)
      This research was a pilot study of the ways in which the continuing professional development (CPD) needs of dentists could be provided. A web-based questionnaire facility was used to enable dental practitioners to register their level of interest in a range of clinical topics presented as CPD lectures and practical courses to provide hands-on experience. The findings were reviewed with reference to the available literature on dental CPD. The study sought to inform development of dental CPD programmes.
    • Adverse reactions to facial dermal fillers: a case report

      Kehily, Elaine; Hayes, Martina; McCreary, Christine (Journal of the Irish Dental Association, 2015-02)
      Our current social and cultural environment places great importance on our appearance. Collagen, the major structural component of the dermis, serves to strengthen and support the skin. As we get older, decreased production of collagen by fibroblasts occurs, leading to loss of tissue bulk and elasticity.1 As a result, deep folds, wrinkles and rhytides can develop. Injectable soft tissue fillers (ISTFs) provide an attractive option in facial rejuvenation. ISTFs can be categorised into biodegradable and non-biodegradable substances. Biodegradable fillers (such as bovine collagen and hyaluronic acid) are safer to use; however, they have a relatively short lifespan (three to 12 months).2 Non-biodegradable fillers (such as silicone) have a longer tissue presence but cause more adverse reactions than the biodegradable fillers.3 ISTFs are usually injected into the deep dermis or the dermal-subdermal junction (Figure 1).4
    • Motivational interviewing for dental clinicians

      Curtin, Sharon; Trace, Anna; Ziada, Hassan (Irish Dental Association, 2014-03)
      Motivational interviewing (MI) is a client centred therapeutic approach, which has been found to be an effective intervention for healthcare change, as it helps to enhance clients’ commitment to the process of change and enables them to resolve their ambivalence to it.1 It is also highly effective when used as a prelude to treatment, for example cognitive behavioural therapy, and its effects appear to endure over time.2 This endurance is attributed to its effects on retention of what is learned and on adherence to the treatment. MI is relevant for healthcare professionals, especially those working in the medical setting where, as Miller and Rollnick3 point out, “motivational issues in patient behaviour change are quite common” (p.35). Furthermore, research has shown that clients working with MI-trained healthcare practitioners were more highly motivated to change.
    • Intracranial abscess secondary to dental infection

      Brady, Paul; Bergin, Sarah; Cryan, Bartley; Flanagan, Oisin (Irish Dental Association, 2014-03)
      The oral cavity is considered as being home to a rich and abundant microflora, including Aggregatibacter actinomycetemcomitans (A. ac tinomyc etemcomitans), which is recognised as one of the major pathogens in destructive periodontal disease.1 A cerebral abscess linked to a dental source is a rare occurrence, since in most individuals the blood-brain barrier, along with the immune response, will exclude bacteria. In this age of antibiotics and with modern living conditions, pyogenic brain infections of odontogenic origin are uncommon in western society. It has been postulated that oral microorganisms may enter the cranium by several pathways: 1) by direct extension, 2) by haematogenous spread, 3) by local lymphatics, and 4) indirectly, by extraoral odontogenic infection. Brain abscesses thought to be of dental origin have been reported to have a lethal outcome.2
    • An audit of orthodontic treatment eligibility among new patients referred to a Health Service Executive orthodontic referral centre

      Meade, Maurice J; Millett, Declan T (Irish Dental Association (IDA), 2013-10)
      Aim: The aim of this audit was to evaluate orthodontic treatment eligibility among new patients referred for assessment from primary dental care clinics in the Health Service Executive (HSE) South region to a HSE orthodontic referral centre. Method: A data collection form was designed and applied prospectively to consecutive new patient referrals who attended diagnostic clinics at the Orthodontic Unit, Cork University Dental School and Hospital, between October 2011 and February 2012. Orthodontic treatment eligibility was based on guidelines introduced by the HSE in 2007. Results: Data on 291 patients (147 males and 144 females) with a mean age of 11.6 years (SD ± 2.4 years; range 8-19 years) were evaluated. Of the 83 (29%) patients eligible for orthodontic treatment under the guidelines, the most commonly diagnosed malocclusion traits were a crossbite with greater than 2mm discrepancy between retruded contact position and intercuspal position (24 patients), followed by an overjet greater than 9mm (21 patients). Conclusions: A total of 29% of new patient referrals were deemed eligible for orthodontic treatment under HSE eligibility guidelines introduced in 2007. Reduction of new patient referrals not eligible for treatment, under these guidelines, is required to enable more efficient use of resources.
    • The clinical relevance of orthognathic surgery on quality of life

      Murphy, C.; Kearns, G.; Sleeman, D.; Cronin, M.; Allen, P.F. (2012-09-19)
    • Unilateral coronoid hyperplasia associated with early childhood facial trauma: a case presentation

      Sleeman, Duncan; Warren, Emma; McAuliffe, Micheal (Irish Dental Association, 2012-08)
    • Milestones in oral health services in the Republic of Ireland

      McDonnell, M (Irish Dental Association, 2012-06)
    • Supporting career choices in dentistry

      Curtin, S; Ray, NJ; McKenna, G (Irish Dental Association, 2012-02)
      Abstract of Article
    • An audit of the caries status of patients about to start orthodontic treatment

      Meade, Maurice J; Millett, Declan T (Irish Dental Association, 2011-06)
    • Impact of chronic oral mucosal disease on daily life: preliminary observations from a qualitative study.

      Riordain, R Ni; Meaney, S; McCreary, C; Cork University Dental School and Hospital, Wilton, Cork, Ireland. richeal.niriordain@ucc.ie (2011-04)
      Chronic oral mucosal conditions impact upon the experience of daily life of patients in a variety of areas from physical health and functioning, to concerns about their future. The role of the oral medicine practitioner in treating patients with chronic oral mucosal diseases extends beyond active management and symptomatic relief to the management of all aspects of these conditions that impact upon their daily lives.
    • Factors influencing the provision of removable partial dentures by dentists in Ireland.

      Allen, Finbarr; Cork Dental School and Hospital, Wilton, Cork. f.allen@ucc.ie (2011-03-15)
      Factors influencing clinical treatment of partially dentate patients are varied, and there is a need to identify factors influencing success in the provision of removable partial dentures. The aim of this study was to assess the attitudes of general dental practitioners (GDPs) in Ireland towards tooth replacement and use of RPDs, in partially dentate older adults. The sample frame was the Register of Dentists in Ireland; data were also collected from a sample of dentists practising under NHS regulations in Northern Ireland. Validated questionnaires were sent to all dentists on the Register of Dentists in the Republic of Ireland, and dentists working under NHS regulations registered with the Central Services Agency in Northern Ireland. Content of the questionnaire included details of the dentist themselves, their dental practice and the profile of partial denture provision. They were also asked to give their views on factors influencing the success or failure of an RPD, the process of providing RPDs and their attitudes to RPD provision. A total of 1,143 responses were received, a response rate of 45%. A mean number of 61 RPDs per annum were provided, with 75% of dentures provided being acrylic based. Respondents indicate their belief that cobalt-chromium based dentures had a longer prognosis than acrylic dentures, but less than half (46%) claim to design the frameworks themselves. Patients' attitudes are considered influential in the success of RPD provision, and their influence on appearance is considered the most important factor influencing success. The most important factors influencing failure are: the patient not requesting a denture; an RPD restoring unbounded saddles; and, lower RPDs. Although considered important, approximately 60% of the sample do not routinely organise follow-up appointments for patients provided with RPDs. The fee structures in the DTSS and DTBS are considered a barrier to quality in the provision of partial dentures.
    • Oral medicine and the elderly.

      McCreary, Christine; Ní Ríordáin, Richeal; Cork University Dental School and Hospital, Wilton, Cork, Ireland. (2011-03-15)
      A focus often exists in dental practice on the maintenance and management of the dentition and the periodontium, however, conditions of the oral mucosa and orofacial pain can cause significant problems for older patients. Oral mucosal conditions are more prevalent in older patients and many orofacial pain disorders, such as burning mouth syndrome and trigeminal neuralgia, are more common in patients over the age of 50 years. Although these conditions may not be routinely managed in general practice, identification of these patients in primary care and appropriate referral will lead to more prompt and effective treatment. CLINICAL RELEVANCE: Dental practitioners need to be able to identify what is considered to be within the normal physiological limits of the ageing oral tissue and hence what is abnormal and requires further investigation to facilitate appropriate referral.
    • Gerodontology--how big is the challenge in Ireland?

      Allen, Finbarr; McKenna, Gerald; Mata, Cristiane; Cronin, Michael; Woods, Noel; O'Mahony, Denis; Allen, Edith; Cork Dental School and Hospital, Wilton, Cork. f.allen@ucc.ie (2011-03-14)
      Population trends suggest that the Irish population is ageing, and that this population will have substantial treatment needs. These patients will be better informed than previous generations, and will demand treatment aimed at preserving a natural dentition. This will impact upon delivery of oral healthcare and manpower planning needs to consider how to address the increased demand for dental care. Poor oral health is associated with systemic health problems, including cardiovascular disease, respiratory disease and diabetes mellitus. It also has a negative impact upon quality of life, and the World Health Organisation has encouraged public healthcare administrators and decision makers to design effective and affordable strategies for better oral health and quality of life of older adults, which, in turn, are integrated into general health management programmes. Treatment concepts such as minimally invasive dentistry and the shortened dental arch concept are discussed in the context of these demographic changes and recommendations.
    • The effectiveness of 2-implant overdentures - a pragmatic international multicentre study.

      Rashid, F; Awad, M A; Thomason, J M; Piovano, A; Spielberg, G P; Scilingo, E; Mojon, P; Müller, F; Spielberg, M; Heydecke, G; Stoker, G; Wismeijer, D; Allen, F; Feine, J S; Faculty of Dentistry, Ajman University of Science and Technology, Ajman, UAE. (2011-03)
      The purpose of this multicentre observational study was to determine patient satisfaction with either conventional dentures or mandibular 2-implant overdentures in a 'real world' setting. Two hundred and three edentulous patients (mean age 68·8 ± 10·4 years) were recruited at eight centres located in North America, South America and Europe. The patients were provided with new mandibular conventional dentures or implant overdentures supported by two implants and ball attachments. At baseline and at 6 months post-treatment, they rated their satisfaction with their mandibular prostheses on 100-mm visual analogue scale questionnaires. One hundred and two (50·2%) participants had valid baseline and 6-month satisfaction data. Although both groups reported improvements, the implant overdenture group reported significantly higher ratings of overall satisfaction, comfort, stability, ability to speak and ability to chew. These results suggest that edentulous patients who choose mandibular implant overdentures have significantly greater improvements in satisfaction, despite their relatively higher cost, than those who choose new conventional dentures.
    • The importance of oral health for the systemic well being of an ageing population.

      McKenna, G; Allen, P F; O'Mahony, D; DaMata, C; Cronin, M; Woods, N (2011-02-22)
    • Catecholamine-o-methyltransferase polymorphisms are associated with postoperative pain intensity.

      Lee, Peter J; Delaney, Patrick; Keogh, John; Sleeman, Duncan; Shorten, George D; Departments of Anaesthesia and Intensive Care Medicine, University College Cork, Ireland. peterjohnlee@hotmail.com (2011-02)
      we report an early demonstration of a COMT SNP association with a clinically meaningful pain outcome after elective surgery.
    • Tooth size discrepancies in Irish orthodontic patients among different malocclusion groups.

      O'Mahony, Gerard; Millett, Declan T; Barry, Mark K; McIntyre, Grant T; Cronin, Michael S; Cork University Dental School and Hospital, Wilton, Ireland. (2011-01)
      The prevalence of anterior tooth size discrepancies in this sample of Irish orthodontic patients was 37.9%. There were no statistically significant differences in the prevalence of mean overall TSDs with regard to malocclusion or gender. In the male group, the mean anterior tooth size ratio was higher in Class III and in Class II division 2 malocclusion than in Class II division 1 and higher in Class II division 2 malocclusion than in Class I malocclusion.