K. B. Hill

The reported impact of oral condition on children in the United Kingdom, 2003

Background The 2003 Childrens Dental Health Survey is the fourth in a series of decennial national childrens dental health surveys of the United Kingdom.Aims This paper is concerned with how children are reported to have been affected by their oral condition during the 12 month period immediately preceding the survey and how this relates to the childrens experience of caries, their dental attendance behaviour and their social class.Method The information was gathered by self-completion questionnaire distributed to the parents of half of the sample who were clinically examined in the dental survey.Results Some form of impact was reported by the parents of 22% of five-year-olds, 26% of eight-year-olds, 34% of 12-year-olds and 28% of 15-year-olds. The pattern of responses to the eight impact questions was broadly similar across age groups. The most frequently reported type of impact was pain in all age groups. Impacts on oral function, self-confidence, orally related activity and on the childs emotions were experienced by 4-10% of children of all ages. Fewer children (1-2%) were reported to have experienced more far reaching impacts affecting their social functioning, general health and life overall.Conclusions Most children were reported not to have experienced any of the problems covered by the questionnaire. Of those who did, most reported a single problem and for most this was pain. Nevertheless there was a group of children for whom oral function, self-confidence, orally related activity, emotions, social functioning, their health or their life in general were reported to have been affected by their oral condition. The nature of dental care which is appropriate for such children needs to be determined.

UK population norms for the modified dental anxiety scale with percentile calculator: adult dental health survey 2009 results.

BackgroundA recent UK population survey of oral health included questions to assess dental anxiety to provide mean and prevalence estimates of this important psychological construct.MethodsA two-stage cluster sample was used for the survey across England, Wales, and Northern Ireland. The survey took place between October-December 2009, and January-April 2010. All interviewers were trained on survey procedures. Within the 7,233 households sampled there were 13,509 adults who were asked to participate in the survey and 11,382 participated (84%).ResultsThe scale was reliable and showed some evidence of unidimensionality. Estimated proportion of participants with high dental anxiety (cut-off score = 19) was 11.6%. Percentiles and confidence intervals were presented and can be estimated for individual patients across various age ranges and gender using an on-line tool.ConclusionsThe largest reported data set on the MDAS from a representative UK sample was presented. The scale’s psychometrics is supportive for the routine assessment of patient dental anxiety to compare against a number of major demographic groups categorised by age and sex. Practitioners within the UK have a resource to estimate the rarity of a particular patient’s level of dental anxiety, with confidence intervals, when using the on-line percentile calculator.

National evaluation of personal dental services (PDS) pilots: main findings and policy implications.

Personal dental services (PDS) are new forms of NHS dental care in England that employ a locally negotiated contract as opposed to one based on a nationally negotiated scale of fees. These schemes have been specifically designed to tackle local problems related to access and oral health needs. This practice paper examines the main findings of a Department of Health-funded evaluation from 20 first and second wave PDS pilots. The paper reveals that all PDS pilots changed treatment profiles in an attempt to meet local oral health needs and/or promote access to NHS dentistry. Moreover, PDS pilots appeared to encourage a new skill-mix, provide job satisfaction and improve working conditions. PDS pilots appear to have provided an opportunity to change the culture of primary dental care provision to one based on quality rather than on activity and cost. Their experiences should help inform the implementation of NHS Dentistry: Options for Change.

Dental practitioners and ill health retirement: causes, outcomes and re-employment

Aim The aim of this project was, by means of a questionnaire to ill health retirees, to determine the factors which have contributed to the premature retirement of general dental practitioners (GDPs) due to ill health.Methods A questionnaire was designed to determine the effects of illness and ill health retirement (IHR) on the lives of those dentists who were affected. This was distributed to 207 dentists who were known to have retired because of ill health but were not suffering from serious, debilitating or life-threatening illnesses.Results A total of 189 questionnaires were returned. The mean age at retirement of respondents was 51.5 years, with a range of 31 to 62 years. Of the respondents, 90% selected general dental practitioner as their last job title. The most common cause of IHR was musculoskeletal disorders (55%), followed by mental and behavioural disorders (28%). A majority of respondents (90%) considered that their ill health was work related. Sixty-three percent of respondents stated that they were able to keep working until their retirement, 34% of respondents stated that they would have liked to have been offered part-time work as an alternative to full retirement, and 27% of dentists reported to have found re-employment since their retirement. In univariate analyses, re-employment of dentists after IHR was significantly associated with age, having dependants, cause of IHR, health having improved and wanting to work again. Multiple logistic regression analyses showed that a combination of age, having dependents and cause of IHR was predictive of re-employment status (p = 0.024).Conclusion This study used a database of dentists who were ill health retired and who were not suffering from life threatening illnesses The results confirmed that the majority were able to work up to their retirement and a similar number would have liked to continue working, particularly if part-time work had been possible. It seems likely that many of the ill health retirees could have been retained in the dental workforce with better support or opportunities for more flexible working.

Dental students' uptake of mobile technologies

Aim The aim of this study was to understand how new mobile technologies, such as smartphones and laptops, are used by dental students.Materials and methods A questionnaire was distributed to undergraduate dental students from years 1 to 4, at the University of Birmingham Dental School. Questionnaires were completed between February and April 2013.Results Two hundred and seventy questionnaires were completed. Laptops 55% (145) and smartphones 34% (88) were the most popular choice of device for connecting to the net and searching information. Laptops were preferred in first and second year. Students in year 3 preferred mobile phones, and by year 4 the use of mobile phones and laptops was similar. The top two application ideas chosen by students as the most useful on their smart phones were a dictionary for dental education (56%) and multiple choice questions (50%). Students who chose smartphones as their first choice or second choice of device strongly agreed that having the Internet on their smartphones had a positive impact on their dental education (55%). With laptops (48%), students preferred to be at home when using them while for smartphones (31%) they used them anywhere with a connection. E-mail (47%) and social networks (44%) were the top two Internet communication tools used most on laptops. Instant messaging was popular on smartphones (17%).Conclusions Depending on the year in the course, laptops and smartphones are the most popular choice of device and desktop computers are the least popular. Applications on smartphones are very popular and instant messaging is an upcoming form of communication for students.

Psychosocial characteristics of adults who experience difficulties with retching.

OBJECTIVES The current study aimed to reach a greater understanding of psychosocial variables in patients who gag, and is a recognised gap within current literature. Obtaining a profile of patients who gag could provide valuable information in relation to future treatment planning and management of this type of difficulty. METHODS All new patients aged > or =18 years, identified as having a difficulty with retching, and who attended the Anxiety Management Clinic, Department of Restorative Dentistry, Birmingham Dental Hospital, were invited to complete a brief questionnaire with questions related to general demographic data; difficulties with retching; and an oral health status measurement. This study has reported on 48 patients who attended the dental anxiety management clinic at Birmingham Dental Hospital and who presented with retching difficulties. One patient did not wish to take part in the study, leaving a final sample size of 47. The sample comprised 57% male (n=27) and 43% female (n=20) patients. RESULTS Retching was more commonly seen in the 40-49-year age group. Onset was frequently related to an earlier dental experience and over half the sample studied had experienced previous psychological difficulties. A fear of choking or suffocation was frequently expressed, supporting a cognitive model in terms of assessment and treatment. CONCLUSION A number of themes were identified which would be worthy of further exploration. For example, the impact of previous or existing physical health problems such as respiratory complaints, family history of retching, and prevalence of other psychological difficulties. Through participation in this study, patients were able to reach a greater awareness of this commonly encountered difficulty within dentistry.

Investigation of the oral health needs for homeless people in specialist units in London, Cardiff, Glasgow and Birmingham

AIM The aim was to assess the oral health needs of homeless people in dedicated homeless dental units in London, Cardiff and Glasgow and a homeless shelter in Birmingham in order to allow recommendations for service delivery to be made for this socially excluded group. METHODOLOGY Two questionnaires were designed, one to be completed by homeless people and the other by members of the dental team. A total of seventeen staff working in homeless dentistry completed questionnaires. Of these, nine were dentists, seven were nurses and one was a therapist. Twenty-seven homeless adults took part in interview. Of these, 22 were under active treatment at a homeless dental clinic and the remaining five were from the Birmingham homeless shelter who were not receiving dental care. RESULTS AND CONCLUSION This study found evidence that the oral health of homeless adults was poor, with a high level of dental need. The service use of homeless people is low, with low levels of registration and utilisation of accident and emergency services. In terms of the most suitable method of dental treatment, staff felt a dedicated homeless service was most appropriate, whereas there was almost an equal split of patients advocating the General Dental Service or the dedicated dental clinics.

National evaluation of personal dental services: the perspective of dentists and professionals complementary to dentistry.

In 2001, research was carried out to investigate the views of dentists and professionals complementary to dentistry on their experiences as part of the personal dental services pilots. This article outlines the main messages from the survey. Before 1997, NHS general dental services could only be delivered by general dental practitioners via a national contract with a nationally negotiated scale of fees. The NHS (Primary Care) Act 1997 allowed for the voluntary establishment of personal dental services (PDS) pilot schemes to test alternative ways of delivering dental services, in particular general dental services, through local contracting arrangements. In the PDS scheme, the contract for dental services was agreed between the commissioners (health authority or primary care trust) and one or more providers of dental services. Since then, the involvement of professionals complementary to dentistry (PCDs) has become an increasingly important issue. This investigation seeks to shed some light on the effectiveness of attempts to integrate the dental team and improve the contribution made by PCDs.

Maintaining dental implants--do general dental practitioners have the necessary knowledge?

Objective The aim of this study was to understand the opinion of general dental practitioners about the current level of implant education at both undergraduate and postgraduate levels.Materials and methods A questionnaire was sent to the general dental practitioners working in a group of practices in the West Midlands, UK. The completed responses were analysed.Results Ninety-one out of 101 dentists responded to the questionnaires (95.6%). Sixty-seven (77%) dentists stated that they learnt only theoretical aspects of dental implants during their undergraduate training. The majority of them stated that the training they received was not adequate. In addition, few barriers in dental implant provision by general dentists were also identified in the survey. The main barriers were risk of failures (56.3%), to avoid complications (65.5%) and the cost of learning (51.7%). The results were correlated to the implant competences set by the regulatory organisations such as General Dental Council and Association of Dental Education Europe.Conclusion The present study confirmed that the current implant education at both undergraduate and postgraduate levels in the UK does not instil confidence to the GDPs to provide and maintain dental implants.

Research Summary: Barriers to shared care for pre-school oral health

Objective To explore the oral health beliefs and practices of primary health care professionals which may act as barriers to the development of a model of shared care for the oral health of pre-school children.