A pilot outreach course in restorative dentistry based in community clinics began in 2001. As part of the evaluation, 48 fourth year students completed a questionnaire about their opinions of the new course, and about restorative dentistry clinics in the dental hospital. Time management was the most frequently mentioned gain from outreach. In relation to the dental school, students most often saw the specialised teaching staff as a gain. Outreach was equally or more important for students' confidence in clinical diagnosis of dental caries, treatment planning, direct restorations, communicating with patients, and managing patients, time, and resources. The dental hospital was equally or more important for their confidence in the diagnosis of periodontal disease, root planing, crowns, bridges, dentures, and communicating effectively with laboratory staff. Patients in outreach were seen as different from those at the dental hospital because they were unselected, and had different treatment needs. Meeting course requirements was the most frequent concern about outreach. In relation to the dental hospital, students were most often concerned about the quality of teaching and support available. Outreach and the dental hospital provided complementary experiences and the new course met its educational objectives.
The aims of the study were to determine the main aetiological factors involved in injuries to anterior teeth and to identify factors influencing the attendance for emergency care. This information is essential, first, for planning dental health education programmes aimed at reducing the incidence of dental trauma and, second, to devise strategies for its effective treatment. Of 2022 schoolchildren examined for evidence of dental trauma, 696 (34%) had experienced injury and were interviewed regarding this injury. Of these, 403 knew about their damaged front tooth, but only 330 recollected the incident causing the injury. Over one third of accidents occurred at home and a further 25% at school. The most common cause of injury was falling onto a hard surface or object (34%) with accidents involving bicycles or other sporting activities accounting for a further 30%. Factors found to be significantly related to attendance for emergency care were experience of pain, unattractive appearance of the injured tooth and social classification, with children from higher income, more affluent areas being more likely to seek treatment. The majority of dental injuries were the result of genuine accidents which were almost impossible to prevent. This study highlighted the need for attention to be brought to parents, children, lay people and health care professionals that all dental injuries should be examined by a dentist, not just those injuries resulting in pain or poor aesthetics.
This cluster randomized control trial demonstrated that the intervention program resulted in an improvement in knowledge of dental disease and an increase in the reported duration of brushing. These improvements were accompanied by a significant improvement in oral hygiene and a reported reduction in gingival bleeding.
BackgroundLimited research has been undertaken in Australia to assess the dental status of pre-school Aboriginal children. This cross-sectional study records the number of decayed, missing and filled teeth (dmft) and surfaces (dmfs) of pre-school Aboriginal children living in different locations in New South Wales (NSW), Australia.MethodsA convenience sample of young children from seven Aboriginal communities in rural, remote and metropolitan areas of NSW, was recruited. One calibrated examiner recorded the dmft/s of children with written parental consent.Results196 children were invited to participate and 173 children aged two to five years were examined, a response rate of 88.3 %. Forty percent (n = 69) of the children were diagnosed with dental caries with a mean of 2.1 (SD = 3.6). The dmft scores were significantly higher in remote locations when compared to rural (p = <0.0001) and metropolitan areas (p = 0.0155). Children 4–5 years old living in remote NSW had a mean dmft of 3.5 and mean dmfs of 8.0 compared with children living in rural areas who had a dmft and dmfs of 1.5 and 4.2 respectively. Untreated dental caries was the primary contributor to the scores, and children who had previously received dental treatment still had active carious lesions.ConclusionThere was a high prevalence of untreated dental caries among the Aboriginal children, particularly for those in remote locations.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-2673-6) contains supplementary material, which is available to authorized users.
VERIFIABLE CPD PAPER• Mandibular first molar root fi llings have low failure rates over a fi ve-year period.• Failure is most likely to occur in the first year following placement of the root fi lling.• Failure rates are similar for optimal versus sub-optimal appearance of root-fi llings on radiographs.• Coronal restoration is an important predictor of survival with crowns performing better than plastic restorations. I N B R I E F RESEARCHObjective To describe the quality and record the outcomes of root canal therapy on mandibular, first permanent molar teeth provided by GDPs working according to NHS contracts. Design Descriptive, retrospective cohort study. Setting Twelve general dental practices in Salford, North West England. Subjects and method All patients aged 20-60 years at tending the practices who had received a NHS-funded root filling in a mandibular first permanent molar between January 1998 and December 2003. The radiographic quality of root fillings in the teeth was assessed by an endodontic specialist and categorised into optimal, suboptimal and teeth which had no radiograph, or an unreadable radiograph. Teeth were also dichotomised into those restored with a crown and those restored with an intracoronal restoration. Failure as an outcome was defined as if a tooth was extracted, the root filling was replaced or periradicular surgery was performed on the tooth. Crude failure rates per 100 years were calculated for optimally, sub-optimally root filled teeth and for those with no or an unreadable radiograph, and according to how the tooth was coronally restored. Survival was assessed using Kaplan-Meier curves and Cox proportional hazards were used to determine factors linked with increased failures. Results One hundred and seventy-four teeth were included in the study, of which 16 failed. The crude failure rates per 100 years with a root filled tooth were very low and differed little (p = 0.9699) for optimally (2.6), sub-optimally (2.5) root filled teeth and for those with no or an unreadable radiograph (2.9), with approximately one in 37 root filled mandibular first molar teeth failing each year. The majority of root fillings fail within the first two years (N = 10, 62.5%). Some 67 teeth (38.5%) were restored with a crown, none of which failed during the follow up period compared to those with a plastic restoration (p = 0.0004). Conclusions The very low failure rates have significant implications for the design of research studies inves tigating outcomes of endodontic therapy. The similar failure rates for teeth that had optimal and suboptimal root fi llings suggest that endodontic treatment is not as technique sensitive as previously thought. The results also support the notion that the coronal restoration is more important than radiographic appearance of the root fi lling.
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