Meldrum Am

Is Asthma a Risk Factor for Dental Caries? Findings from a Cohort Study

It has been suggested that asthmatic children may have a higher caries risk, both as a result of their medical condition and the physical and physiological effects of their pharmacotherapy. By examining the association over time between asthma and caries increment, this study tested the hypothesis that childhood asthma is associated with an increased caries increment. In a long–standing New Zealand cohort study, participants’ long–term asthma histories and the 3–year net caries increment between the ages of 15 and 18 years were examined. Of the 781 who were examined at 15 and 18 years, 39 participants were consistently taking anti–asthma medication at the ages of 9, 11, 13 and 15 years (and were labelled in this study as ‘medication–determined asthmatics’), 56 were identified as consistent wheezers at the ages of 9, 11, 13 and 15 years (‘wheeze–determined asthmatics’) and 36 were members of both groups. A smaller group (n = 9) was identified as being very–long–term asthmatics (asthma at 5 years of age and at the ages of 9, 11, 13 and 15 years). Some 206 study members were identified as having no history of asthma, asthma medication or significant wheeze at any time up to and including 18 years. The overall mean net caries increment between the ages of 15 and 18 years was 2.06 surfaces (SD, 3.76). There were no significant differences in caries increment between the 206 asthma–free participants and any of the asthma groups. This study provides little evidence for an asthma–caries causative relationship.

Professional storytelling in clinical dental anatomy teaching

The aim of the present work was to see if storytelling in a clinical dental anatomy course would increase student satisfaction. We enhanced teaching by spontaneous storytelling in problem‐based learning, in half of the third‐year dentistry class. At the end of the course, we administered an anonymous questionnaire to the students in the class, consisting of 12 questions that students had to answer on a Likert scale of 1–5. An overall satisfaction score was obtained and we used a linear mixed model to compare differences in satisfaction between the two groups, with “group” as the fixed effect. We also conducted an exploratory factor analysis of the responses to investigate whether there were distinct constructs within the data. Overall satisfaction is high, with students “with stories” having higher satisfaction than those “without stories.” The former group consistently gives higher satisfaction scores, regardless of which question is being asked. Factor analysis provides evidence that storytelling nurtures reflective learning, while students work on their clinical anatomy problems. Anat Sci Ed 1:84–89, 2008.

Influence of dental care on children's oral health and wellbeing.

Background Dental problems in early childhood can have a very significant effect not only on the oral health of young children but on their quality of life and that of their families. Added to this are the long term risks they carry into the permanent dentition.Aim To review current literature on the management of early childhood caries and its influence on wider oral and general health.Results Recent studies suggest that the risks for dental caries, periodontal disease, malocclusion and other general health problems including overweight and obesity may be increased in children who have had early childhood caries. Traditional restoration of damaged primary teeth has been shown to have only moderate outcomes depending on the techniques and materials used and the ability of children to cooperate because of age or other factors.Conclusions More recent interesting approaches that seal enamel caries, only partially remove carious dentine or attempt to entirely seal carious dentine lesions merit not only discussion but also longer term investigation. With increasing demands on health funding, dentistry must look at how the most appropriate care can be provided to allow children to reach adulthood with healthy permanent dentitions – something that less than half the population currently achieve.

Cultural fragmentation of knowledge in clinical teaching

This research looks at student experiences of learning in a clinical teaching situation. At the end of a course, students took part in a class that was led by a user of the health system, rather than their usual lecturer. We chose to study this class because we knew that it provided a very different learning experience for the students and therefore gave us an opportunity to contrast this with their normal science teaching experiences. The study highlighted how embedded learning and teaching had become in a science curriculum that supported the transmission of authorized factual knowledge. It was shown that students could recognize alternative forms of knowledge and that these were valued in different ways. Furthermore, they acknowledged that they could learn in new ways although both these ideas were poorly understood. The study allowed us to reflect on our own learning and expose an important paradox in the choices we made in course design.

Design of an oral health information brochure for at-risk individuals

Objective: Our aim was to develop written resource material for use in the Oral Health Information through Community Pharmacists project. Poor oral health is associated with cardiovascular disease and diabetes. Many people do not access dental services on a regular basis; however, they may access community pharmacies for help and advice about oral health problems. Community pharmacists may be a valuable point of oral health information for people with heart disease or diabetes. Design: This paper reports the development of the written resource material for the project groups. Methods: Brochure development was guided by Fishbein and Yzer’s integrative model, and pre-tested with seven focus groups representing the potential target groups. Feedback from the focus groups was analysed concurrently and modified versions of the brochures were presented to subsequent groups. Results: The use of both written and visual messages enhanced the readability of the brochures for the focus groups with attendant Flesch Reading Ease scores of 77.4 and 79.4, while the ‘Make a plan’ section prompted future action planning amongst the participants. Conclusion: Well-designed patient education materials with good content, aesthetics and readability are important to deliver health messages within the context of a planned intervention. The three final brochures will be used in the intervention trial of the project.

Resin Infiltration of Caries in Primary Molars in a Community Setting: 24-Month Randomized Controlled Trial Findings

This study aimed to assess whether resin infiltration of primary molar proximal lesions is more effective than noninvasive measures in radiographically controlling carious lesion progression into the dentin. A split-mouth randomized controlled trial included 90 children, each with 2 proximal lesions confined to the inner half of the enamel or ≤0.5 mm into the dentin. For each child, lesions were randomly allocated to test (infiltration: DMG Icon preproduct and fluoride varnish) or control (fluoride varnish) status. The primary outcome measure was 24-mo radiographic lesion progression. Placement of a restoration during the study period was counted as lesion progression. Proportions of teeth with progressed lesions were compared using the McNemar test. Children also reported on the treatment’s acceptability to them. Children (46% female) ranged in age from 6 to 9 y. Their mean number of decayed, missing, and filled teeth (d3mft) was 2.8 (SD 2.6). At baseline, 58% and 42% of children were at moderate and low risk, respectively. Test and control lesions presented with similar radiographic lesions at baseline. At the 24-mo follow-up, 6 children had moved and 30 teeth had exfoliated. In the test and control groups, 15 of 66 lesions (22.7%) and 30 of 69 lesions (43.5%) had progressed, respectively (P < 0.05). The 2-y therapeutic effect (based on pairwise radiographic readings) of infiltration over fluoride varnish was 20.8% (95% confidence interval, 10.6%−30.2%). Nearly all children (96.7%) had enjoyed their visit to the clinic, and more than two-thirds (72.2%) were not worried about returning for treatment. Infiltration is more efficacious than fluoride varnish for controlling carious lesion progression in proximal lesions in primary molars, and most children find the treatment acceptable (Australian New Zealand Clinical Trials Registry ANZCTR.org.au ACTRN12611000827932). Knowledge Transfer Statement: These study findings can help clinicians decide which caries management approach they wish to use to prevent progression of proximal lesions in primary molars. With consideration of cost and patient preference, this information could lead to more appropriate therapeutic decisions.