• 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.
    • 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.
    • 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)
      To describe the outcome for children with oral Crohn's disease (OCD) at diagnosis, and to determine if there was a difference in the Paediatric Crohn's Disease Activity Index (PCDAI) scores between those with and those without oral lesions at follow-up.
    • 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.
    • Emergence of hospital- and community-associated panton-valentine leukocidin-positive methicillin-resistant Staphylococcus aureus genotype ST772-MRSA-V in Ireland and detailed investigation of an ST772-MRSA-V cluster in a neonatal intensive care unit.

      Brennan, Gráinne I; Shore, Anna C; Corcoran, Suzanne; Tecklenborg, Sarah; Coleman, David C; O'Connell, Brian; National MRSA Reference Laboratory, St. James’s Hospital, Dublin, Ireland. gbrennan@stjames.ie (2012-03)
      Sequence type 22 (ST22) methicillin-resistant Staphylococcus aureus (MRSA) harboring staphylococcal cassette chromosome mec (SCCmec) IV (ST22-MRSA-IV) has predominated in Irish hospitals since the late 1990s. Six distinct clones of community-associated MRSA (CA-MRSA) have also been identified in Ireland. A new strain of CA-MRSA, ST772-MRSA-V, has recently emerged and become widespread in India and has spread into hospitals. In the present study, highly similar MRSA isolates were recovered from seven colonized neonates in a neonatal intensive care unit (NICU) in a maternity hospital in Ireland during 2010 and 2011, two colonized NICU staff, one of their colonized children, and a NICU environmental site. The isolates exhibited multiantibiotic resistance, spa type t657, and were assigned to ST772-MRSA-V by DNA microarray profiling. All isolates encoded resistance to macrolides [msr(A) and mpb(BM)] and aminoglycosides (aacA-aphD and aphA3) and harbored the Panton-Valentine leukocidin toxin genes (lukF-PV and lukS-PV), enterotoxin genes (sea, sec, sel, and egc), and one of the immune evasion complex genes (scn). One of the NICU staff colonized by ST772-MRSA-V was identified as the probable index case, based on recent travel to India. Seven additional hospital and CA-ST772-MRSA-V isolates recovered from skin and soft tissue infections in Ireland between 2009 and 2011 exhibiting highly similar phenotypic and genotypic characteristics to the NICU isolates were also identified. The clinical details of four of these patients revealed connections with India through ethnic background or travel. Our study indicates that hospital-acquired and CA-ST772-MRSA-V is currently emerging in Ireland and may have been imported from India on several occasions.
    • 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 purpose of this case series study was to evaluate the advantages and disadvantages of using local anesthesia and conscious sedation (CS) rather than general anesthesia (GA) for performing functional surgery on patients suffering from temporomandibular joint (TMJ) closed lock, using the eminectomy procedure. Performing this procedure using CS allows functional assessment of the TMJ meniscus at the time of surgery. The objectives of this study were to determine if this surgery is possible under CS, to determine the benefits of being able to see the meniscus in action, and to investigate the patients' acceptability for this form of anesthesia.
    • Life course social mobility and risk of upper aerodigestive tract cancer in men.

      Schmeisser, N; Conway, D I; McKinney, P A; McMahon, A D; Pohlabeln, H; Marron, M; Benhamou, S; Bouchardy, C; Macfarlane, G J; Macfarlane, T V; et al. (2010-03)
      The aim of this study was to explore associations between social mobility and tumours of the upper aero-digestive tract (UADT), focussing on life-course transitions in social prestige (SP) based on occupational history. 1,796 cases diagnosed between 1993 and 2005 in ten European countries were compared with 1585 controls. SP was classified by the Standard International Occupational Prestige Scale (SIOPS) based on job histories. SIOPS was categorised in high (H), medium (M) and low (L). Time weighted average achieved and transitions between SP with nine trajectories: H --> H, H --> M, H --> L, M --> H, M --> M, M --> L, L --> H, L --> M and L --> L were analysed. Odds ratios (ORs) and 95%-confidence intervals [95%-CIs] were estimated with logistic regression models including age, consumption of fruits/vegetables, study centre, smoking and alcohol consumption. The adjusted OR for the lowest versus the highest of three categories (time weighted average of SP) was 1.28 [1.04-1.56]. The distance of SP widened between cases and controls during working life. The downward trajectory H --> L gave an OR of 1.71 [0.75-3.87] as compared to H --> H. Subjects with M --> M and L --> L trajectories ORs were also elevated relative to subjects with H --> H trajectories. The association between SP and UADT is not fully explained by confounding factors. Downward social trajectory during the life course may be an independent risk factor for UADT cancers.
    • 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.
    • 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)
      Hurler Syndrome is associated with a deficiency of a specific lysosomal enzyme involved in the degradation of glycosaminoglycans. Hematopoietic stem cell transplantation (HSCT) in early infancy is undertaken to help prevent the accumulation of glycosaminoglycans and improve organ function.
    • 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)
      Food-associated allergies, especially to benzoates and cinnamon-related compounds, have been associated with orofacial granulomatosis and both standard and urticarial patch testing have been used to detect such allergies. Elimination diets have also been shown to be effective in some patients.
    • Role of medical history and medication use in the aetiology of upper aerodigestive tract cancers in Europe: the ARCAGE study.

      Macfarlane, T V; Macfarlane, G J; Thakker, N S; Benhamou, S; Bouchardy, C; Ahrens, W; Pohlabeln, H; Lagiou, P; Lagiou, A; Castellsague, X; et al. (2012-04)
      The study aimed to investigate the role of medical history (skin warts, Candida albicans, herpetic lesions, heartburn, regurgitation) and medication use (for heartburn; for regurgitation; aspirin) in the aetiology of upper aerodigestive tract (UADT) cancer.
    • 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.
    • 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. (Irish Dental Association, 2010-02)
      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.