• 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.
    • 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 (Irish Dental Association, 2010-10)
      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.
    • Fluoridation and tooth wear in Irish adults.

      Burke, F M; Whelton, H; Harding, M; Crowley, E; O'Mullane, D; Cronin, M; Kelleher, V; Byrtek, M; Oral Health Services Research Centre, University Dental School and Hospital, University College Cork, Cork, Ireland. f.burke@ucc.ie (2010-10)
      The aim of this study was to determine the prevalence of tooth wear in adults in Ireland and its relationship with water fluoridation. The National Survey of Adult Oral Health was conducted in 2000/2001. Tooth wear was determined using a partial mouth examination assessing the upper and lower anterior teeth. A total of 2456 subjects were examined. In this survey, increasing levels and severity of tooth wear were associated with ageing. Men were more affected by tooth wear and were more likely to be affected by severe tooth wear than women. It was found that age, and gender were significant predictors of tooth wear (P < 0.01). Overall, there was no significant relationship between fluoridation and tooth wear in this study.
    • Fluorosis prevalence among German schoolchildren may not be associated with early kindergarten-based preventive programmes.

      Whelton, Helen P; Oral Health Services Research Centre, University Dental School & Hospital, Wilton, Cork, Ireland. H.Whelton@ucc.ie (2009-03)
    • Gerodontology – how big is the challenge in Ireland

      Allen, Dr Finbar; McKenna, Dr Gerald; Mata, Dr Cristiane (Irish Dental Association, 2010-06)
    • 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.
    • Head and neck cancer information on the internet: type, accuracy and content.

      Ni Riordain, Richeal; McCreary, Christine; Oral Medicine Unit, Cork University Dental School and Hospital, Wilton, Cork, Ireland. richeal.niriordain@ucc.ie (2009-08)
      This study aimed to determine the type, accuracy and content of information available on the internet regarding head and neck cancer. The search engine Google was used to generate a list of the top 100 websites about head and neck cancer. The websites were evaluated using the DISCERN instrument and the JAMA benchmarks and whether the site displayed the Health on the Net seal was also recorded. The search yielded 1,650,000 sites on the Google website. Of the top 100 sites, a total of 33 sites were suitable for analysis due to duplicate links, non-functioning links and irrelevant website. 45% achieved all four JAMA benchmarks and 18% achieved only 1 benchmark. No website receiving the maximum mark on the overall score and four websites received the lowest overall score regarding the DISCERN instrument. The question with the poorest response score was 'Does it describe how the treatment choices affect overall quality of life?' 39% of the websites displayed the Health on the Net (HON) seal. A wide variety of types of information are available on the internet regarding head and neck cancer with variable accuracy levels based on both Journal of the American Medical Association (JAMA) benchmarks and DISCERN. The onus lies with the practitioner to guide the patient regarding scientific reliability of information and to direct the patient in filtering the information sourced. The inclusion of quality of life related information is currently lacking and should be addressed to ensure a more comprehensive understanding for patients of treatment options.
    • The heights and weights of Irish children from the post-war era to the Celtic tiger.

      Perry, I J; Whelton, H; Harrington, J; Cousins, B; Department of Epidemiology and Public Health, University College Cork, Brookfield Health Sciences Complex, College Road, Cork, Republic of Ireland. i.perry@ucc.ie (2009-03)
      The data provide stark and compelling evidence on the evolution of the obesity epidemic in Irish children in tandem with the increase in economic prosperity.
    • 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.
    • 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.
    • 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)
    • Initial arch wires for alignment of crooked teeth with fixed orthodontic braces.

      Wang, Yan; Jian, Fan; Lai, Wenli; Zhao, Zhihe; Yang, Zhi; Liao, Zhengyu; Shi, Zongdao; Wu, Taixiang; Millett, Declan T; McIntyre, Grant T; Hickman, Joy; Department of Orthodontics, State Key Laboratory of Oral Diseases, West China College of Stomatology, Sichuan University, 14# Section 3, South Renming Road, Chengdu, Sichuan Province, China, 610041. (2010)
      There is some evidence to suggest that there is no difference between the speed of tooth alignment or pain experienced by patients when using one initial aligning arch wire over another. However, in view of the general poor quality of the including trials, these results should be viewed with caution. Further RCTs are required.
    • Initial management of paediatric dento-alveolar trauma in the permanent dentition: a multi-centre evaluation.

      Zaitoun, H; North, S; Lee, S; Albadri, S; McDonnell, S T; Rodd, H D; Department of Paediatric Dentistry, Charles Clifford Dental Hospital, Wellesley Road, Sheffield, S10 2SZ. halla.zaitoun@sth.nhs.uk (2010-03-27)
      This study identified marked delays in the management of some paediatric dental trauma to permanent incisor teeth which, in itself, could be suboptimal. Greater educational and clinical support would seem to be warranted in this area of service provision.
    • 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
    • Is tooth wear in the primary dentition predictive of tooth wear in the permanent dentition? Report from a longitudinal study.

      Harding, M A; Whelton, H P; Shirodaria, S C; O'Mullane, D M; Cronin, M S; Oral Health Services Research Centre, University College Cork, Ireland. m.harding@ucc.ie (2010-03)
      Males had more tooth wear than females. An association existed between tooth wear recorded at age 5 and molar tooth wear recorded at age 12. Tooth wear is a lifelong cumulative process and should be recorded in both the primary and permanent dentitions.
    • Juvenile idiopathic arthritis (JIA): a screening study to measure class II skeletal pattern, TMJ PDS and use of systemic corticosteroids.

      Mandall, Nicky A; Gray, Robin; O'Brien, Kevin D; Baildam, Eileen; Macfarlane, Tatiana V; Davidson, Joyce; Sills, John; Foster, Helen; Gardner-Medwin, Janet; Garrahy, Ann; Millett, Declan; Mattick, Rye; Walsh, Tanya; Ward, Steven; Orthodontic Department, Tameside General Hospital, Fountain Street, Ashton under Lyne, Lancashire OL6 9RW, UK. Nicky.Mandall@tgh.nhs.uk (2010-03)
      Just under one-third of oligoarticular and polyarticular JIA patients exhibited a moderate or severe class II skeletal pattern. It is, therefore, likely that any future clinical trial to investigate the effect of functional appliance treatment in JIA patients, will need multicentre co-operation to fulfil potential sample size requirements. Clinical signs and symptoms of temporomandibular joint pain dysfunction syndrome were low except for crepitus and click. However, radiographic evidence of condylar erosion was high particularly in the polyarticular group. Use of systemic corticosteroids was prescribed more in polyarticular cases and this is likely to reflect the severity of the disease.
    • The McKesson prop--an essential tool for the emergency physician?

      Murphy, A P; Doran, H J; O'Sullivan, I; Sleeman, D; Cusack, S P A; Department of Emergency Medicine, Cork University Hospital, Cork, Ireland. adrianmurphy06@eircom.net (2010-02)
      Facial trauma is a commonly encountered presentation to emergency departments. When associated airway compromise occurs, co-existing head and neck injuries serve to produce a challenging clinical situation. We describe two patients who suffered multi-system trauma, with severe maxillofacial injuries that necessitated prompt definitive airway management and mid-face stabilisation in the pre-hospital and emergency department phases of resuscitation. The McKesson prop is a simple yet highly effective tool for use in these injuries.
    • Milestones in oral health services in the Republic of Ireland

      McDonnell, M (Irish Dental Association, 2012-06)
    • 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.