Teaching periodontal pocket charting to dental students: a comparison of computer assisted learning and traditional tutorials

AIM: The aim of this study was to compare the effectiveness of a computer assisted learning (CAL) programme with that of traditional small group tutorials in teaching theoretical and practical aspects of periodontal pocket charting. METHOD: Sixty-one third year undergraduate dental students were randomized to either receive a tutorial or to work through the CAL programme. Students using the CAL programme completed questionnaires relating to previous computer experience and the ease of use of the programme. All students were assessed immediately after the intervention by means of a confidence log, a practical exercise and a further confidence log. They were assessed again three weeks later by means of a confidence log and a multiple-choice written test. RESULTS: There were very few significant differences between groups for any of the assessments used. However, subjective comments indicated that students occasionally felt disadvantaged if they had not received a tutorial. CONCLUSION: CAL and traditional teaching methods are equally effective in teaching periodontal pocket charting to undergraduate dental students

Safeguarding children in dentistry: 1. Child protection training, experience and practice of dental professionals with an interest in paediatric dentistry

* Few dental professionals with child protection training have experience of making referrals. * There is a wide gap in practice between recognising signs of child abuse and neglect and responding effectively. * This may indicate missed opportunities to save children from continuing abuse. * There is a need for improved child protection information, support and training for dental professionals. Abstract Following several highly publicised inquiries into the deaths of children from abuse and neglect, there has been much recent interest in the role and responsibility of all health professionals to protect children at risk of maltreatment. The findings of a postal questionnaire, sent in March 2005 to 789 dentists and dental care professionals with an interest in paediatric dentistry working in varied settings in the UK, are presented in a two-part report and discussed in the context of current multi-agency good practice in safeguarding and promoting the welfare of children. This first part explores reported child protection training, experience and practice. There was a significant gap between recognising signs of abuse and responding effectively: 67% of respondents had suspected abuse or neglect of a child patient at some time in their career but only 29% had ever made a child protection referral. The dental profession is alerted to the need to ensure necessary appropriate action to safeguard children is always taken when child abuse or neglect are suspected

Establishing comprehensive oral assessments for children with safeguarding concerns.

The dental profession is well placed to contribute important information in child protection cases but no previous research has been reported that assesses the volume or impact of this information. Comprehensive oral assessment clinics were introduced and established as an integral part of comprehensive medical assessments for children with welfare concerns in Greater Glasgow and Clyde. An assessment protocol and standardised paperwork for comprehensive oral assessments were developed to enhance information sharing and patient access to appropriate care. Two cases are presented and discussed to demonstrate the value of dental input

The Hall Technique 10 years on: its effect and influence

Dental caries 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 infective risks to the host of untreated caries in primary teeth but also the risk of damage to successor permanent teeth. 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. The Hall technique has outperformed other techniques in randomised clinical trials. In this Opinion Article I will take a look back at the Innes et al. paper, first published in this Journal in 2006, that introduced the Hall Technique and the subsequent scientific literature which provided us with high quality scientific evidence of the efficacy of the technique. I will evaluate how this new technique has affected the management of early childhood caries and hence its influence on wider oral and general health

The effect of transmucosal 0.2mg/kg Midazolam premedication on dental anxiety, anaesthetic induction and psychological morbidity in children undergoing general anaesthesia for tooth extraction

<b>Background:</b> The project aims were to evaluate the benefit of transmucosal Midazolam 0.2mg/kg pre-medication on anxiety, induction behaviour and psychological morbidity in children undergoing general anaesthesia (GA) extractions. <b>Method:</b> 179 children aged 5-10 years (mean 6.53 years) participated in this randomised, double blind, placebo controlled trial. Ninety children had Midazolam placed in the buccal pouch. Dental anxiety was recorded pre operatively and 48 hours later using a child reported MCDAS-FIS scale. Behaviour at anaesthetic induction was recorded and psychological morbidity was scored by the parent using the Rutter Scale pre-operatively and again one-week later. Subsequent dental attendance was recorded at one, three and six months after GA. <b>Results:</b> Whilst levels of mental anxiety did not reduce overall, the most anxious patients demonstrated a reduction in anxiety after receiving midazolam premedicationmay (p=0.01). Neither induction behaviour nor psychological morbidity improved. Irrespective of group, parents reported less hyperactive (p= 0.002) and more prosocial behaviour (p=0.002) after the procedure:;, older children improved most (p=0.048), Post GA Dental attendance was poor and unrelated to after the procedure and unaffected by premedication. <b>Conclusion:</b> 0.2mg/kg buccal Midazolam provided some evidence for reducing anxiety in the most dentally anxious patients. However, induction behaviour, psychological morbidity and subsequent dental attendance were not found to alter between the premedication groups

Spontaneous regression of congenital epulis: a case report and review of the literature

<p>Abstract</p> <p>Introduction</p> <p>Congenital epulis is a rare lesion found on the alveolar process of a newborn child, diagnosed soon after birth. The lesion has a site predilection for the anterior maxillary alveolar process and a 9:1 sex predilection for females. Once diagnosed the traditional management of the lesion has been surgical excision under general anesthesia.</p> <p>Case presentation</p> <p>The purpose of this case report is to describe spontaneous regression of congenital epulis in a three week old healthy African American female child. She presented with a 1.5 cm bilobed sessile nodular lesion in the region of the right maxillary cuspid. The clinical impression was congenital epulis. Since the lesion was not interfering with feeding and respiration, a conservative approach was taken. The child was followed-up for 18 months, during which the lesion progressively regressed.</p> <p>Conclusions</p> <p>Conservative management prevented unnecessary surgery and anesthesia exposure in a neonate.</p

Prevalence of sealants in relation to dental caries on the permanent molars of 12 and 15-year-old Greek adolescents. A national pathfinder survey

<p>Abstract</p> <p>Background</p> <p>The use of sealants as an effective measure for the prevention of pit and fissure caries in children has been well documented by several studies; either they are used on an individual or on a public health basis. In order to plan and establish a national preventive program with sealants in a community, it is mandatory to know the epidemiological pattern of caries along with other variables influencing their use and effectiveness. Aims: To assess the utilization and distribution pattern of pit and fissure sealants on the first and second permanent molars of Greek adolescents and to evaluate whether the existing usage of sealants and some socio-demographic factors are correlated to caries prevalence on the population examined</p> <p>Methods</p> <p>A stratified cluster sample of 2481 Greek adolescents was selected according to WHO guidelines (1224 twelve and 1,257 fifteen-year-old), living in urban and rural areas in 11 districts within the country. Five calibrated examiners carried out clinical examinations, recording caries experience at the dentine threshold (BASCD criteria) and presence or absence of sealants along with Socio-demographic indicators associated with oral health. Mann Whitney and Pearson's chi-square non parametric tests were utilized for assessing the data. The level of significance was p < 0.05.</p> <p>Results</p> <p>Sealants utilization varied considerably within the different districts, with 8,3% of the 12 and 8,0% of the 15-year-old adolescents having at least one sealed molar. Sealants reduced DMFS scores by 11% in the 12-year-olds and by 24% in the 15-year-olds, while 15-year-old adolescents from rural areas had a statistically significant (p = 0.002) less chance of having sealants (71%) compared to children from urban areas. Girls had higher chance to receive sealants in both age groups (26% for the 12 and 19% for the 15-year-old) as well as patients that visited the dentist for prevention compared to those visiting the dentist because they thought they needed a restoration or because they were in pain.</p> <p>Conclusions</p> <p>The finding that sealants reduced DMFS scores despite their very low utilization, along with the high prevalence of dental caries found on the occlusal surfaces of the posterior teeth of Greek adolescents, is calling for a national preventive program with sealants which could eliminate caries to a larger extent.</p

Pit and fissure sealants in dental public health – application criteria and general policy in Finland

<p>Abstract</p> <p>Background</p> <p>Pit and fissure sealants (sealants) are widely used as a non-operative preventive method in public dental health in Finland. Most children under 19 years of age attend the community-organized dental health services free of charge. The aims of this study were to find out to what extent sealants were applied, what the attitudes of dental professionals towards sealant application were, and whether any existing sealant policies could be detected among the health centres or among the respondents in general. The study evaluated changes that had taken place in the policies used during a ten year period (1991–2001).</p> <p>Methods</p> <p>A questionnaire was mailed to each chief dental officer (CDO) of the 265 public dental health centres in Finland, and to a group of general dentists (GDP) applying sealants in these health centres, giving a total of 434 questionnaires with 22 questions. The response rate was 80% (N = 342).</p> <p>Results</p> <p>A majority of the respondents reported to application of sealants on a systematic basis for children with increased caries risk. The criteria for applying sealants and the actual strategies seemed to vary locally between the dentists within the health centres and between the health centres nationwide. The majority of respondents believed sealants had short- and long-term effects. The overall use of sealants decreased towards the end of the ten year period. The health centres (N = 28) choosing criteria to seal over detected or suspected enamel caries lesion had a DMFT value of 1.0 (SD ± 0.49) at age 12 (year 2000) compared to a value of 1.2 (SD ± 0.47) for those health centres (N = 177) applying sealants by alternative criteria (t-test, p < 0.05).</p> <p>Conclusion</p> <p>There seems to be a need for defined guidelines for sealant application criteria and policy both locally and nationwide. Occlusal caries management may be improved by shifting the sealant policy from the traditional approach of prevention to interception, i.e. applying the sealants over detected or suspected enamel caries lesions instead of sealing sound teeth.</p