J. J. Murray

The long-term effects of treatment on the dental condition of children surviving malignant disease

Fifty‐two long‐term survivors of childhood leukemia or solid tumors had a clinical dental examination along with 49 of their siblings. The 52, with an additional 30 examined in a previous study, were studied radiologically with a panoramic tomogram. All children with leukemia had received chemotherapy for 2 or 3 years and irradiation on standard protocols and the solid tumor group had received chemotherapy for 6 to 24 months. There was no difference between siblings and patients for dental caries, gingivitis, and oral hygiene, mouth opening, overjet, and overbite. More solid‐tumor patients had abnormal occlusion (P < 0.02) and those with abnormalities tended to have been treated at an earlier age. Enamel opacites and hypoplasia were more common in patients than siblings and in the leukemia than in the solid tumor group. Sixty‐five percent of the children had abnormalities on radiologic examination including failure of the tooth to develop, small crown, hypoplasia of the crown, and abnormal root development. In most cases the radiologic abnormality could be correlated in time with the patients treatment and a knowledge of the normal time of tooth development. Three teeth extracted during the course of the study were examined histologically and these showed prominent incremental lines which could be correlated in time with vincristine treatment.

Major clinical findings from a dental survey of elderly people in three different English communities

A random sample of 2280 subjects aged 60 years or over from three areas of England were examined clinically in order to assess their dental health and needs. Between 33% (south of England) and 57% (north of England) were edentulous. Twenty per cent of all dentate subjects were edentulous in one arch and thus still required a complete denture. Amongst the dentate subjects geographical differences were small, but social class and behavioural differences were large. Dental non-attenders were the group who stood out as having much poorer oral health, averaging six fewer natural teeth than attenders. Nearly 50% of all teeth either had coronal fillings or needed them. Root caries was common, 20-22% of vulnerable teeth were affected and there was an age related increase in disease risk. The mean number of teeth with decayed roots per subject (0.8) was similar to the mean number with decayed coronal surfaces (0.9). Moderate tooth wear and moderate periodontal disease were both widespread. A minority of subjects had a functional dentition of 21 or more teeth. Major changes in the dental status of older adults have taken place in the last 30 years and these will continue, resulting in lower levels of edentulousness but a large need for maintenance of existing restorations

The polymerization contraction of visible-light activated composite resins

Abstract The polymerization contraction of a number of commercially available composite resin restorative materials has been determined using a minimal load transducer to monitor dimensional change. The putative posterior composite materials underwent least contraction during setting, and there was moderate correlation between polymerization contraction and both the exotherm on polymerization and the filler loading (for non-microfine materials). Polymerization contraction was influenced by the shade of the material under test and the duration of the exposure to the activating light source.

Adult Dental Health Survey 2009: relationships between dental attendance patterns, oral health behaviour and the current barriers to dental care.

The importance of understanding barriers to dental attendance of adults in the UK was acknowledged in the first Adult Dental Health Survey in 1968 and has been investigated in all subsequent ADH surveys. In 1968, approximately 40% of dentate adults said they attended for a regular check-up; by 2009 this was 61%. Attendance patterns were associated with greater frequency of toothbrushing, use of additional dental hygiene products, lower plaque and calculus levels. Just under three-fifths of adults said they had tried to make an NHS dental appointment in the previous five years. The vast majority (92%) successfully received and attended an appointment, while a further 1% received an appointment but did not attend. The remaining 7% of adults were unable to make an appointment with an NHS dentist. The majority of adults were positive about their last visit to the dentist, with 80% of adults giving no negative feedback about their last dentist visit. Cost and anxiety were important barriers to care. Twenty-six percent of adults said the type of treatment they had opted for in the past had been affected by the cost and 19% said they had delayed dental treatment for the same reason. The 2009 survey data demonstrated a relationship between dental anxiety and dental attendance. Adults with extreme dental anxiety were more likely to attend only when they had trouble with their teeth (22%) than for a regular check-up.

The 5-year results of a clinical trial comparing a glass polyalkenoate (ionomer) cement restoration with an amalgam restoration.

A clinical trial comparing the efficacy of a glass polyalkenoate cement (GPC) restoration with an amalgam cement restoration (ACR) in the management of caries in the deciduous molar dentition was undertaken. Two hundred and thirty-eight restorations, that is 119 pairs, were placed in 76 patients with an age range of 5 to 11 years. The durability of these restorations was assessed during a 5-year follow-up period, using modified United States Public Health Service criteria. The glass polyalkenoate cement restorations occupied 16% of the occlusal surface of the tooth compared to 28% for the amalgam restorations, had a lower median survival time (33.4 [SE 2.26] months compared to 41.4 [SE 2.24] months) and underwent greater loss of anatomical form and marginal integrity than the paired amalgam controls

Adult Dental Health Survey 2009: transformations in British oral health 1968-2009

This series of four papers reports and interprets the findings of the Adult Dental Health Survey (ADHS), 2009, published in early 2011. This is the fifth in a series of surveys repeated every decade since 1968. The evolution of the surveys and the way the supporting methodology has changed to meet the changing needs and circumstances over the last 40 years is described. In 1968, 37% of adults in England and Wales were edentate. By 2009, only 6% of the combined population of England, Wales and Northern Ireland were edentate. Among the dentate in 1968, there were a mean of 21.9 teeth. By 2009, not only had the dentate increased by 30 percentage points as a fraction of the population, but the number of teeth in this group had also increased by nearly four teeth on average to 25.7. There were significant variations in oral health according to geography and social variables and smaller differences according to sex. The retention of 21 or more teeth is widely used as a way of defining a minimum functional dentition. The proportion of adults with 21+ teeth increased from 73% in 1978 to 86% in 2009. Further huge improvements are projected as younger generations age, assuming future tooth loss continues at current low rates. We might expect that over 90% of those aged 35-44 in 2009 have a realistic prospect of retaining a functional natural dentition of 21 or more teeth by age 80.

Dental health of survivors of malignant disease.

A full dental examination on 64 children aged from 3 to 20 years who were in long term remission from malignant disease showed normal facial growth, caries incidence, and periodontal indices. There was increased incidence of hypodontia and hypoplasia which in some could be ascribed to the original disease or its treatment.

The management of occlusal caries in permanent molars. A 5-year clinical trial comparing a minimal composite with an amalgam restoration.

A clinical trial comparing the efficacy of an occlusal amalgam restoration with a minimal composite restoration and fissure sealant in the management of occlusal caries in young patients has been performed. One hundred and fifty pairs of restorations were placed in 103 patients and assessed during the 5-year follow-up period. Nineteen restorations failed during this period: 11 amalgam and 8 minimal composite. There was some deterioration in anatomical form and marginal integrity of the remaining amalgam restorations. Of the remaining minimal composites, seven suffered clinically detectable wear and a further five had some marginal staining. Forty-nine of the minimal composites needed to have repairs to the fissure sealant. The amalgam restorations occupied, on average, 25% of the occlusal surface of the tooth, compared with 5% for the minimal composite resin. The results after a 5-year follow-up showed no significant difference in median survival times between the amalgam and the minimal composite restorations

An Erosion Test for Dental Cements

A new method for the in vitro measurement of the erosion of dental cements is described which allows repeated, gentle removal of loose surface debris and provides a direct quantitative measurement of material lost. A linear relationship for erosion against time is demonstrated for a glass polyalkenoate material under mildly acidic conditions. This test method is applicable to all acid/base-type cements and gives results comparable to those from in vivo tests.

The management of occlusal caries in permanent molars. A clinical trial comparing a minimal composite restoration with an occlusal amalgam restoration.

The management of occlusal caries in permanent molars. A clinical trial comparing a minimal composite restoration with an occlusal amalgam restoration