• Access to dental care-parents' and caregivers' views on dental treatment services for people with disabilities.

      Prabhu, Neeta T; Nunn, June H; Evans, D J; Girdler, N M; Department of Pediatric Dentistry, Westmead Hospital, Sydney, Australia. neetaprabhu@hotmail.com (2010-03)
      The goal of this study was to elicit the views of patients or parents/caregivers of patients with disabilities regarding access to dental care. A questionnaire was generated both from interviews with patients/parents/caregivers already treated under sedation or general anesthesia as well as by use of the Delphi technique with other stakeholders. One hundred thirteen patients from across six community dental clinics and one dental hospital were included. Approximately, 38% of the subjects used a general dental practitioner and 35% used the community dental service for their dental care, with only 27% using the hospital dental services. Overall waiting time for an appointment at the secondary care setting was longer than for the primary care clinics. There was a high rate of parent/caregiver satisfaction with dental services and only five patients reported any difficulty with travel and access to clinics. This study highlights the need for a greater investment in education and training to improve skills in the primary dental care sector.
    • An audit comparing the discrepancies between a verbal enquiry, a written history, and an electronic medical history questionnaire: a suggested medical history/social history form for clinical practice.

      Carey, Barbara; Stassen, Leo; Dublin Dental School and Hospital, Lincoln Place, Dublin 2. (2011-04)
      In everyday practice, dentists are confronted with an increasing number of patients with complex medical problems. There is divergence of opinion among dentists regarding how to obtain a thorough medical/social history.
    • Case report: Management of severe posterior open bite due to primary failure of eruption.

      Mc Cafferty, J; Al Awadi, E; O'Connell, A C; Division of Public and Child Dental Health, Dublin Dental School and Hospital, Dublin 2. Ireland. mccaffej@tcd.dental.ie (2010-06)
      In this unique case, a profound unilateral posterior open bite occurred due to primary failure of eruption of the maxillary and mandibular teeth on the affected side. Orthodontic therapy was used to modify the position of the permanent canines and premolars to reduce the posterior open bite.
    • Characteristics of patients with orofacial granulomatosis.

      McCartan, B E; Healy, C M; McCreary, C E; Flint, S R; Rogers, S; Toner, M E; School of Medicine, Royal College of Surgeons in Ireland, Dublin School of Dental Science, Trinity College Dublin, Ireland. (2011-10)
      Orofacial granulomatosis has mostly been described in reports of very small numbers of cases. Few large case groups have been described. The aim of this study was to describe the demographics, symptoms, clinical features and laboratory findings in a large cohort of cases.
    • Dental caries and its association with sociodemographics, erosion, and diet in schoolchildren from southeast Brazil.

      Auad, Sheyla Marcia; Waterhouse, Paula Jane; Nunn, June Heather; Moynihan, Paula Jane; Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil. smauadtc@gmail.com (2009-05)
      Dental caries was associated with sociodemographics, but not with erosion. There were no dietary factors identified in common for caries and erosion.
    • Disease outcome for children who present with oral manifestations of Crohn's disease.

      Hussey, S; Fleming, P; Rowland, M; Harty, S; Chan, L; Broderick, A; Drumm, B; Bourke, B; Dublin Dental University Hospital, Trinity College Dublin, Dublin 2, Ireland. (2011-06)
      OCD resolved in the majority of children treated for intestinal Crohn's disease. The occurrence of mouth lesions during follow-up of children who had oral manifestations at initial diagnosis was not a marker for Crohn's disease activity elsewhere in the intestinal tract.
    • Eastern Health Board Regional Orthodontic Service: an initial audit.

      Dowling, P A; Fitzpatrick, P J; Garvey, M T; McNamara, C M; Department of Public and Child Dental Health, Dublin Dental Hospital. (1997)
      This initial audit of 600 recently assessed Eastern Health Board orthodontic patients suggests that a large number of them (47 per cent) requires referral for routine restorative and preventive dental care. Closer links are needed with general dental practitioners and community dental surgeons to resolve these needs. The trend for a high referral of females and Class 11 Division 1 malocclusion type correlated well with studies in other countries.
    • The effect of skeletal pattern on determining articulator settings for prosthodontic rehabilitation: an in vivo study.

      Canning, Tom; O'Connell, Brian C; Houston, Frank; O'Sullivan, Michael; Dublin Dental School and Hospital, Trinity College, Dublin, Ireland. (2011-01)
      During extensive prosthodontic treatment, the use of an accurately adjusted articulator is recommended to simulate mandibular movements. This clinical study was undertaken to assess any possible effect of the underlying skeletal pattern on programming articulator settings.
    • An effective bleaching technique for non-vital, discoloured teeth in children and adolescents.

      Leith, Rona; Moore, Abigail; O'Connell, Anne C; Department of Public and Child Dental Health, Dublin Dental School and Hospital, Dublin. rona.leith@dental.tcd.ie (Irish Dental Association, 2009-08)
      Discolouration of a permanent incisor may have a significant social impact on children and adolescents. Intervention should be minimally destructive of tooth tissue and should not compromise future restorative options. This paper reviews the technique of inside/outside bleaching, and proposes it as an efficient, effective and acceptable method for use in the compliant younger patient with an unaesthetic non-vital tooth.
    • An effective bleaching technique for non-vital, discoloured teeth in children and adolescents.

      Leith, Rona; Moore, Abigail; O'Connell, Anne C; Department of Public and Child Dental Health, Dublin Dental School and Hospital, Dublin. rona.leith@dental.tcd.ie (2009-08)
      Discolouration of a permanent incisor may have a significant social impact on children and adolescents. Intervention should be minimally destructive of tooth tissue and should not compromise future restorative options. This paper reviews the technique of inside/outside bleaching, and proposes it as an efficient, effective and acceptable method for use in the compliant younger patient with an unaesthetic non-vital tooth.
    • Functional surgery of the temporomandibular joint with conscious sedation for "closed lock" using eminectomy as a treatment: a case series.

      Stassen, Leo F; O'Halloran, Michael; Dublin Dental School and Hospital, Lincoln Place, Dublin 2, Ireland. (2011-06)
      The use of local anesthesia and CS is an alternative to GA for performing TMJ procedures in appropriately selected patients. The advantage of direct visualization of the meniscus and its movements in the nonasleep patient requires further evaluation.
    • Maxillary anterior tooth dimensions and proportions in an Irish young adult population.

      Condon, M; Bready, M; Quinn, F; O'Connell, B C; Houston, F J; O'Sullivan, M; Division of Restorative Dentistry and Periodontology, Dublin Dental School and Hospital, Trinity College, Dublin, Ireland. (2011-07)
      This study was undertaken in a young Irish population to determine the dimensions and ratios of the six maxillary anterior teeth. One hundred and nine Irish subjects (age 18-25 inclusive) had irreversible hydrocolloid impressions made of their maxillary dentition poured in type V stone. Clinical crown dimensions were measured with a digital calliper. The stone casts were digitally photographed in a standardised manner enabling calculation of various ratios between the maxillary anterior teeth. Sexual dimorphism existed for various tooth dimensions; most notably canine teeth were in the region of 0·8 mm longer and 0·6 mm wider in males. Central and lateral incisors were found to be 0·5 mm wider in males. It is, therefore, recommended that dimensional tooth guidelines should be given for each of the sexes and not on a population basis. With regard to tooth proportion ratios, no significant differences were found between genders or the left and right sides for any of the measurements or ratios measured. The digitally recorded tooth proportions were similar for both sexes, and the Golden Proportion guidelines could only be applied to the lateral incisor/central incisor widths (0·618). Identified width proportions for the canine/central incisor were 0·58 and for canine/lateral incisor 0·89.
    • Microbiological screening of Irish patients with autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy reveals persistence of Candida albicans strains, gradual reduction in susceptibility to azoles, and incidences of clinical signs of oral candidiasis without culture evidence.

      McManus, Brenda A; McGovern, Eleanor; Moran, Gary P; Healy, Claire M; Nunn, June; Fleming, Pádraig; Costigan, Colm; Sullivan, Derek J; Coleman, David C; Microbiology Research Unit, Division of Oral Biosciences, Dublin Dental University Hospital, University of Dublin, Trinity College Dublin, Dublin 2, Republic of Ireland. (2011-05)
      Patients with autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) are prone to chronic mucocutaneous candidiasis, which is often treated with azoles. The purpose of this study was to characterize the oral Candida populations from 16 Irish APECED patients, who comprise approximately half the total number identified in Ireland, and to examine the effect of intermittent antifungal therapy on the azole susceptibility patterns of Candida isolates. Patients attended between one and four clinical evaluations over a 5-year period, providing oral rinses and/or oral swab samples each time. Candida was recovered from 14/16 patients, and Candida albicans was the only Candida species identified. Interestingly, clinical diagnosis of candidiasis did not correlate with microbiological evidence of Candida infection at 7/22 (32%) clinical assessments. Multilocus sequence typing analysis of C. albicans isolates recovered from the same patients on separate occasions identified the same sequence type each time. Fluconazole resistance was detected in isolates from one patient, and isolates exhibiting a progressive reduction in itraconazole and/or fluconazole susceptibility were identified in a further 3/16 patients, in each case correlating with the upregulation of CDR- and MDR-encoded efflux pumps. Mutations were also identified in the ERG11 and the TAC1 genes of isolates from these four patients; some of these mutations have previously been associated with azole resistance. The findings suggest that alternative Candida treatment options, other than azoles such as chlorhexidine, should be considered in APECED patients and that clinical diagnosis of oral candidiasis should be confirmed by culture prior to the commencement of anti-Candida therapy.
    • Microbiological screening of Irish patients with autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy reveals persistence of Candida albicans strains, gradual reduction in susceptibility to azoles, and incidences of clinical signs of oral candidiasis without culture evidence.

      McManus, Brenda A; McGovern, Eleanor; Moran, Gary P; Healy, Claire M; Nunn, June; Fleming, Pádraig; Costigan, Colm; Sullivan, Derek J; Coleman, David C; Microbiology Research Unit, Division of Oral Biosciences, Dublin Dental University Hospital, University of Dublin, Trinity College Dublin, Dublin 2, Republic of Ireland. (2011-05)
      Patients with autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) are prone to chronic mucocutaneous candidiasis, which is often treated with azoles. The purpose of this study was to characterize the oral Candida populations from 16 Irish APECED patients, who comprise approximately half the total number identified in Ireland, and to examine the effect of intermittent antifungal therapy on the azole susceptibility patterns of Candida isolates. Patients attended between one and four clinical evaluations over a 5-year period, providing oral rinses and/or oral swab samples each time. Candida was recovered from 14/16 patients, and Candida albicans was the only Candida species identified. Interestingly, clinical diagnosis of candidiasis did not correlate with microbiological evidence of Candida infection at 7/22 (32%) clinical assessments. Multilocus sequence typing analysis of C. albicans isolates recovered from the same patients on separate occasions identified the same sequence type each time. Fluconazole resistance was detected in isolates from one patient, and isolates exhibiting a progressive reduction in itraconazole and/or fluconazole susceptibility were identified in a further 3/16 patients, in each case correlating with the upregulation of CDR- and MDR-encoded efflux pumps. Mutations were also identified in the ERG11 and the TAC1 genes of isolates from these four patients; some of these mutations have previously been associated with azole resistance. The findings suggest that alternative Candida treatment options, other than azoles such as chlorhexidine, should be considered in APECED patients and that clinical diagnosis of oral candidiasis should be confirmed by culture prior to the commencement of anti-Candida therapy.
    • Oral features and dental health in Hurler Syndrome following hematopoietic stem cell transplantation.

      McGovern, Eleanor; Owens, Laura; Nunn, June; Bolas, Andrew; Meara, Anne O'; Fleming, Padraig; Dental Department, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland. eleanor.mcgovern@olchc.ie (2010-09-01)
      Patients with Hurler Syndrome post-HSCT are likely to have delayed dental development, a malocclusion, and dental anomalies, particularly hypodontia and microdontia.
    • Patch testing for food-associated allergies in orofacial granulomatosis.

      Fitzpatrick, Laura; Healy, Claire M; McCartan, Bernard E; Flint, Stephen R; McCreary, Christine E; Rogers, Sarah; Dublin Dental School and Hospital, Dublin, Ireland. (2011-01)
      Both standard and urticarial patch tests are required to detect food allergies in orofacial granulomatosis. The difficulties of patient self-recording of urticarial tests can be eliminated by retaining patients in the testing unit for professional reading of patches at 60 min.
    • The prevalence of dental caries and fissure sealants in 12 year old children by disadvantaged status in Dublin (Ireland).

      Sagheri, D; McLoughlin, J; Clarkson, J J; Department of Public and Child Dental Health, Dublin Dental School and Hospital, Trinity College, Ireland. darius.sagheri@dental.tcd.ie (2009-03)
      This study demonstrated a social gradient in the presence of fissure sealants, but no such gradient in dental caries levels. This demonstrates the importance of population-based measures in the prevention of dental caries, such as water fluoridation, in reducing oral health inequalities.
    • Relationship between bilateral congenital absence of maxillary lateral incisors and anterior tooth width.

      Yaqoob, Omar; DiBiase, Andrew T; Garvey, Therese; Fleming, Padhraig S; Resident in orthodontics, Kent and Canterbury Hospital, Canterbury, Guy's Hospital, London, United Kingdom. (Mosby, 2011-03)
      The objective of this study was to assess the relationship between anterior tooth width and the presence or absence of maxillary lateral incisors.
    • Supernumerary pre-molar teeth in the mandible.

      O'Dowling, Ian (Irish Dental Association, 2009-12)
    • Tooth agenesis in patients referred to an Irish tertiary care clinic for the developmental dental disorders.

      Hashem, Atef A; O'Connell, Brian; Nunn, June; O'Connell, Anne; Garvey, Therese; O'Sullivan, Michael; Division of Restorative Dentistry & Periodontology, Dublin Dental School & Hospital, Lincoln Place, Dublin 2. (2010)
      PURPOSE: This study was carried out to determine the prevalence, severity and pattern of hypodontia in Irish patients referred to a tertiary care clinic for developmental dental disorders. MATERIALS AND METHODS: Details of 168 patients with hypodontia referred during the period 2002-2006 were entered in a database designed as a national record. Tooth charting was completed using clinical and radiographic examinations. The age of patients ranged from 7-50 years, with a median age of 20 years (Mean: 21.79; SD: 8.005). RESULTS: Hypodontia referrals constituted 65.5% of the total referrals. Females were more commonly affected than males with a ratio of 1.3:1. The number of referrals reflected the population density in this area; the majority were referrals from the public dental service. Mandibular second premolars were the most commonly missing teeth, followed by maxillary second premolars and maxillary lateral incisors; maxillary central incisors were the least affected. Symmetry of tooth agenesis between the right and left sides was an evident feature. Slightly more teeth were missing on the left side (n = 725) than on the right side (n = 706) and in the maxillary arch (n = 768) as compared to the mandibular arch (n = 663). Some 54% of patients had severe hypodontia with more than six teeth missing; 32% had moderate hypodontia, with four to six teeth missing. The most common pattern of tooth agenesis was four missing teeth. CONCLUSION: Hypodontia was a common presentation in a population referred to this tertiary care clinic. The pattern and distribution of tooth agenesis in Irish patients appears to follow the patterns reported in the literature.