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The article reports on the East of England Junior Papers Day at the British School of Racing in Newmarket, England. It states that the Junior Papers Day was sponsored by the Faculty of Dental Surgery of the Royal College of Surgeons of England. Winners include Roshan Sothinathan, a Senior House Officer (SHO) from Ipswich Hospital, Rory O'Connor, an SHO from Addenbookes Hospital, and Martin Lazenby, an SHO from Princess Alexandra Hospital. It also mentions the winners' audit presentations.

The article offers information on the East of England Junior Papers Day held at the British School of Racing in Newmarket, England. The event is said to be a regional study day following its inauguration of the College's involvement by prize certificates presentation in its quincentenary year of 2005. Among the featured winners for 2009 event are Roshan Sothinathan from Ipswich Hospital, Rory O'Connor from Addenbrookes Hospital, and Vikas Attargekar from Peterborough Hospital.

Reports on the prize awarded to Lieutenant Colonel Neil MacKenzie of the Royal Army Dental Corps at the 2004 Armed Forces Oral and Maxillofacial Tri-service Annual Conference in Catterick Garrison, North Yorkshire. Recognition of research paper on recurrent neck node metastases.

In many countries around the world community water fluoridation is a key element in the campaign for better dental public health. Its safety and effectiveness have been confirmed through decades of research, and the practice has been strongly endorsed by reputable health authorities. A strong evidence base is critical for the implementation of fluoridation and other public health measures. Health professionals must ensure that the highest quality evidence is promoted, and weak evidence identified and discredited. [ABSTRACT FROM AUTHOR]

Aim It is the aim of this paper to consider the factors associated with the need for re-intervention on direct-placement restorations placed within the general dental services of England and Wales.Methods A large age-stratified sample of adult patients and their dental intervention were tracked over 11 years to December 2001. For each tooth treated with a direct restoration the subsequent history of intervention on that tooth was consulted, and the next date of intervention, if any could be found in the extended data set, was obtained. The distribution of times to re-intervention for different types of restoration in different circumstances was obtained using Kaplan-Meier survival analysis.Results Data for over 80,000 different adult patients were analysed, of whom 46% were male and 54% female. A total of 503,965 restoration placements were obtained from the data over a period of 11 years. Single surface amalgam restorations were found to have the longest survival – 58% at ten years, and glass ionomer the shortest – at 38% at ten years.Conclusions Small amalgam restorations have longer survival times before re-intervention than large amalgam restorations such as MOD. Composite and glass ionomer restorations perform less well than amalgam restorations. Restorations placed by older dentists and restorations placed in older patients have shorter time to re-intervention. Patients who changed dentist were found to have restorations which performed less well than those placed in patients who did not change dentist. [ABSTRACT FROM AUTHOR]

Earlier this year English Heritage, the BDA Museum and The Lindsay Society for the History of Dentistry unveiled a plaque to Lilian Lindsay (1871-1960). This paper outlines the history and administration of the blue plaque scheme and celebrates the contributions made by dentists who have been commemorated with plaques. [ABSTRACT FROM AUTHOR]

The use of skill mix in medicine is now widespread, yet it appears that its use in dentistry is not as prominent. Unlike doctors, dentists are required to mitigate the financial risk produced by their capital investment and ensure an adequate cash flow to cover their annual running costs. Examining the financial incentives for employing dental care professionals is therefore an important step to understand why dentistry appears to lag behind medicine in skill mix. It is also apposite, given the announcement of the coalition government to develop a new contract, which could introduce incentives for the use of dental care professionals in this way. The purpose of this short paper is to examine whether skill mix is profitable for general dental practices under the existing NHS contract in England. [ABSTRACT FROM AUTHOR]

This paper outlines the development of the training of orthodontic therapists in the UK, the experiences of the first cohort to pass through the Bristol course, the roles and responsibilities of the therapist and possible issues with future orthodontic manpower planning. [ABSTRACT FROM AUTHOR]

This paper arises from a dissertation submitted to the University of Nottingham towards a Masters Degree in Clinical Education. The purpose of the paper is to describe and name the process that the dental profession is experiencing. The authors will argue that this phenomenon has all the hallmarks of an industrialisation process. It will become clear that this industrialisation process is not confined to the dental profession in the UK. The key drivers for this process are described, followed by the results and analysis of a small-scale research project designed to explore the reactions of professionals to the new methods of working. Finally, there is a discussion of the implications for dental education in this new era. [ABSTRACT FROM AUTHOR]

Introduction: This paper reports participation of dentists in continuing professional development (CPD) and factors affecting participation. Method: All general dental practitioners (GDPs) in three deaneries in England were surveyed. The overall response rate was 54% (n = 2082); by deanery it was 68% West Midlands, 45% South West and 44% Anglia. Findings across deaneries were remarkably similar. Comparisons with national data show no notable bias in the sample for gender, owners/partners and age/experience. Results: Most frequent forms of CPD were journal reading and courses in which almost all engaged. A score based on individual participation in CPD over the 12-month period was calculated. The mean score (hours) for participation in verifiable CPD was 31 (median 25) and for general, 29 (median 29). In terms of the GDC's Lifelong Learning Scheme, 57% were already undertaking 50 hours. Net of other effects, those less likely to be doing 50 hours are those with more years in practice and single-handed practitioners. Greater access to courses and media-based CPD is desired. Conclusion: Certain groups of dentists will need support to meet the requirements of the GDC's Lifelong Learning Scheme. Statutory peer review or clinical audit will significantly alter the CPD profile of most dentists. This has implications for facilitators. [ABSTRACT FROM AUTHOR]

Objective: The aim of this paper is to examine the factors that vocational trainers regard as important in a 'good' dentist and to assess whether they think recent graduates were achieving these factors.Design: The study was based on a statistical analysis of returns from a postal questionnaire.Setting: Postal questionnaires were sent to all vocational advisors in England who then sent them on to a number of their vocational trainers.Materials and Methods: The questionnaire was analysed using various statistical techniques including factor analysis. Analysis was undertaken to determine whether student or trainer characteristics influenced the trainer's responses.Results: The vocational trainers judged that the group of skills that contribute to technical ability are the most important component in making a 'good' dentist. However, the most important single skill is communication with patients, closely followed by diagnostic skills and communication with the dental team. The areas where trainees are most likely to fall short in terms of actual as compared to desired performance are in areas of technical ability.Conclusion: Overall, recent trainees scored rather well when compared with an idealised good dentist. However, it is clear that more evaluation of vocational training is needed. Recent studies, including this one have looked at several different aspects of vocational training. However, the time seems ripe for a full-scale prospective evaluation. [ABSTRACT FROM AUTHOR]

Objective To investigate the attitudes, knowledge and practices of general dental practitioners (GDPs), specialists and consultants in paediatric dentistry in London, towards child protection. Additionally, to determine if children attending paediatric dental casualty at the Eastman Dental Hospital (EDH) and those who need treatment of caries under general anaesthesia (GA) are on the child protection register (CPR).Design The survey was conducted by postal questionnaires with 14 closed questions. A total of 228 dentists were invited to participate in the study. Children who attended EDH and required treatment under GA or at paediatric dental casualty were checked against the CPR.Results The respond rate was 46% (105/228). Overall 15% (16/105) of dentists had seen at least one patient with suspected child abuse in the last six months, but only 7% (7/105) referred or reported cases to child protection services. Reasons for dentists not referring included: fear of impact on practice (10%; 11/105); fear of violence to child (66%; 69/105); fear of litigation (28%; 29/105); fear of family violence against them (26%; 27/105); fear of consequences to the child (56%; 59/105); lack of knowledge regarding the procedures for referral (68%; 71/105); and lack of certainty about the diagnosis (86%; 90/105). Of the 220 children attending for dental GA and casualty from October 2004 to March 2005, one child was found to be on the CPR.Conclusion More information and training is required to raise awareness of the potential importance of the role of dentists in child protection. Improved communication between dental and medical departments is important for safeguarding children. [ABSTRACT FROM AUTHOR]

Cleft care services in the UK have been nationally funded since centralisation 25 years ago and during this time have been able to demonstrate improved clinical outcomes. Integrated care systems have been introduced into legislature as part of the Health Care Act of 2022 and will be responsible for the paradigm shift of allocating funds on a regional basis for cleft care services in England from 2024. The proposed population-based funding formulas present an opportunity to improve current inequities in cleft care, including access to speech therapy and adult services. However, the regional footprint of integrated care systems does not align with that of the centralised cleft service system and represents a threat to the standardised patient-centred care that has taken two decades to build. Awareness needs to be raised so that cleft care providers can proactively adapt to this mandatory change to service funding to ensure that clinical standards are maintained and continue to improve., (© 2024. The Author(s), under exclusive licence to the British Dental Association.)

Background There is an urgent need to consider the skill-mix of the dental team to meet the oral health needs and demands of the population in general, and older people in particular. As people live longer and retain their teeth there will be a progressive change in both the volume and type of dental care required, and the demand for care. Operational research modelling provides the opportunity to examine and test future scenarios for National Health Service (NHS) care.Aim The aim of this research was to explore the required skill-mix of the dental team to meet future need and demand of older people in England to 2028 utilising operational research methods and to examine a range of future scenarios.Method A three-stage computer model was developed to consider demand for dental care, workforce supply and skill-mix. First, the demand model combined population demography and a marker of oral health with attendance and treatment rates based on NHS activity data. Monte Carlo simulation was used to give an indication of the uncertainty surrounding this projected demand. Second, projections on workforce supply and other assumptions relating to clinical hours, NHS commitment and workforce whole time equivalents (WTEs) were analysed to produce a range of estimates for the current and future workforce. Third, staff skill-mix competencies were examined and the data fed into an optimisation model. Linear programming was used to give the optimal workforce makeup and predictions for workforce requirements. Five future scenarios were run from 'no skill-mix' through to 'maximum skill-mix' in the dental team, and the outputs compared.Results The results indicate that by 2028 there will be an increase in demand for care among older people of over 80% to almost 8.8 million hours; however, Monte Carlo simulation suggests considerable uncertainty surrounding the demand model outputs with demand deviating from the average in terms of treatment hours by as much as 22%. Modelling a healthcare system with 'no skill-mix' resulted in the lowest volume of clinical staff equivalents (dentists: 8,668) providing care for older people, whereas maximum skill-mix involved more staff (clinical staff = 10,337, of whom 2,623 were dentists, 4,180 hygienist/therapists and 3,534 clinical dental technicians) if all care is provided at the relevant level of competence.Conclusion The model suggests that with widening skill-mix, dental care professionals can play a major role in building dental care capacity for older people in future. The implications for health policy, professional bodies and dental teamworking are discussed. [ABSTRACT FROM AUTHOR]

Background In April 2006, fundamental changes were made to the arrangements for commissioning state funded (National Health Service, NHS) dental care in England and Wales. These involved the dissolution of a universal national contract and the introduction of locally commissioned primary dental care services. Suggested advantages included the elimination of a fee-for-item 'treadmill', an increased emphasis on prevention and improved patient access. This change came at a time when many practitioners were opting to provide care outside the NHS.Objectives This study investigated dentists' experience of the new contract and compared this with attitudes determined in a previous survey of the same cohort of dentists conducted immediately before the changed commissioning arrangements.Methods Data were collected via a postal questionnaire, comprising a combination of 60 open and closed questions, mailed to 608 general dental practitioners in Wales.Results Four hundred and ninety-six (77%) questionnaires were returned. Four hundred and seventeen practitioners continued to provide NHS dental care. Only 46 (11%) of the 417 practitioners agreed that they liked the new method of remuneration and the majority (362 [86.8%]) perceived that they still delivered state-funded care in a 'treadmill' environment. This compares with 34.9% of dentists who perceived the new system as a 'treadmill' immediately before its implementation. Three hundred and forty-eight (83.4%) disagreed that they were able to spend more time on prevention and 356 (85.3%) did not feel they had more time to spend with patients – key objectives of the reforms. Two hundred and seventy-five (65.9%) respondents agreed that local NHS commissioners were controlling their business.Conclusion This survey, conducted 18 months after the implementation of the new commissioning arrangements, suggests that practitioners are deeply unhappy with local commissioning. It raises questions as to whether the changes have achieved the Government's stated objectives in reforming state-funded primary dental care. [ABSTRACT FROM AUTHOR]

ObjectiveTo determine the future intentions and motivations of general dental practitioners (GDPs) relating to NHS dental practice in South Yorkshire.DesignFocus group discussions.SettingGeneral dental practices providing NHS care within South Yorkshire, United Kingdom.Subjects (materials) and methodsTwenty-nine dental practitioners were purposively sampled and invited to take part in a series of focus groups. Focus groups were transcribed and data analysed to identify themes and concepts.Main outcome measuresThemes and concepts relating to the current and future provision of dentistry and the proposed 'new ways of working' of the new dental contract.ResultsThe data fell into three broad categories: the organisational structures of dentistry; the future of dentistry; and the CDS. This paper focuses largely on the second category, the future of NHS dentistry. The first category related to the organisational structures of dentistry, and encompassed perceptions that dentistry was not a high priority for the Government and that current changes were politically motivated and to be implemented by PCTs with a lack of capacity for the management of such wide-reaching changes. The second category covered the future of NHS dentistry. For some, NHS dentistry was in a precarious and uncertain position, coupled with a lack of clarity and information on the 'new ways of working' and exacerbated by problems in the recruitment and retention of future dental practitioners. The last category dealt with views in connection with the CDS.Conclusion(s)In this 'snapshot in time' there was considerable uncertainty and instability within the general dental service against a backdrop of major organisational change. There was a need for information, guidance, openness and communication between the Government, PCTs and GDPs surrounding the implementation of the new contract. [ABSTRACT FROM AUTHOR]

A review of the personal papers relating to Frank Harrison and held by the School of Clinical Dentistry in Sheffield reveal what a dedicated clinician he was and the significance of his achievements from over 100 years ago, both locally and nationally for his chosen profession and also for the people of Sheffield. In addition to being one of the first dentists in the world to experiment with X-rays in dentistry, and the first to write up his findings in a dental journal, he designed and patented dental instruments, wrote books, lectured on fine art (particularly Venetian and Florentine art), and gave lectures to the public in the hope that they would heed his message on the importance of maintaining good oral health. A search of national archives and library resources has added further information about his family and professional accomplishments. [ABSTRACT FROM AUTHOR]

Clinical experience in Outreach sites has taken place in many dental schools for a number of years. The wider recognition of Outreach as a useful learning environment has prompted many schools to share their experiences. The purpose of this paper is to share the findings of Leeds Dental Institute's experiences after the first year of Outreach learning in a purpose-built Outreach clinic. The learning outcomes for this activity were carefully tailored to the experiences available within this community setting and built as an integrated part of the BChD dental curriculum. The successful introduction of a model of independent but well supported and managed clinical teaching units as part of Leeds Dental Institute has allowed our dental students to access both modern learning and teaching in a community based locality, while retaining access to the conventional centre of teaching and clinical excellence in a dental school and hospital. [ABSTRACT FROM AUTHOR]

This paper describes the work undertaken by the Postgraduate Primary Care Trust (PCT) Dental Tutor for South Yorkshire and East Midlands Regional Postgraduate Dental Education Office during the first year of a two-year pilot. The tutor has special responsibility for facilitating the writing of Personal Development Plans (PDPs) and the introduction of Significant Event Analysis to the 202 general dental practitioners in the four Sheffield PCTs. Data were collected on significant events and the educational needs highlighted as a result. A hands-on workshop format was used in small practice groups and 45% of Sheffield general dental practitioners now have written PDPs compared with a 16% national average. A library of significant events has also been collated from the data collected. [ABSTRACT FROM AUTHOR]

During archaeological investigation by Gifford of St Pancras Old Church burial ground, on the eastern edge of Somers Town, London, in advance of construction of the new London terminus for the Channel Tunnel Rail Link, a full porcelain denture was discovered. The high quality porcelain dentures, manufactured in the late eighteenth century French style, may have been brought with their owner, Archbishop Arthur Richard Dillon, on his journey into exile. There is evidence of prolonged use, not only for cosmetic or vocal functions but also in mastication. The dentures are unique archaeological artefacts and represent a pivotal time in dental history, with the adoption of new materials and methods of manufacture. They reflect a period of significant social and economic change for the upper echelons of French society. This paper outlines the development of porcelain dentures, discusses the prosthesis, their owner, and a possible provenance. [ABSTRACT FROM AUTHOR]

Aims and objectives: The use of sedation in the management of pain and anxiety for the provision of dental care is as vital to the dental profession as are windscreen wipers to a motor vehicle. Not for use on every patient or every occasion, but in times of need to wipe away the tears, and essential for effective work. Training in sedation techniques should be a part of the undergraduate curriculum, and postgraduate opportunities need to be developed to support this important aspect of care. This paper examines a particular training course provided within the Department of Sedation and Special Care Dentistry at GKT Dental Institute, King's College London, leading to the Diploma in Conscious Sedation for Dentistry (Dip.D.Sed). The aim of this study was to investigate what impact the course has had on the practice of sedation. Three objectives were defined: 1) Students' evaluation of the course; 2) Students' practice in sedation prior to and on completion of the course; 3) Students' involvement in sedation training of dentists or dental nurses following completion of the course. Method: Information was obtained by postal questionnaire from students who had attended the course since its inception in 1997 to 2000. Results: 30 students completed and returned the questionnaire which represented a 100% response. There was an overall expression of satisfaction from students on the course content and the experience they had obtained. The range of experience was 70–100 treatment episodes over 40 clinical sessions. An increase in both the practice of sedation and the involvement in training (dental nurses and dentists) was also shown. The greatest clinical change was the increase in use of intravenous sedation by the students from the community dental service. Conclusion and recommendation: This study concluded that the objectives of the course had been achieved. The importance of providing training that enables the safe and effective provision of sedation within primary care as an operator sedationist was strengthened by this study. The value of an intermediate level between the two day section 63 course and the six month diploma course was suggested by students in this study. The development of a clinical attachment based on The Standard Course in Conscious Sedation was proposed as a possible option to fill the gap. The provision of postgraduate training in sedation is limited particularly in some areas of the UK. This problem should be addressed by increasing the opportunity for postgraduate training in sedation by dental schools and postgraduate deaneries. Work towards increasing the funding and opportunities for training in this important area of care needs to be undertaken. [ABSTRACT FROM AUTHOR]

This paper derives from research conducted in the North West of England which was funded by the South Cheshire Health Authority. The research was funded because anecdotal evidence within a charity HIV/ AIDS organisation in the region suggested that some HIV positive individuals had been experiencing difficulties accessing NHS dental care. Following previous studies, this paper therefore examines dentists' knowledge, attitudes and practices in order to assess which factors may be influential in affecting dentists' willingness to treat patients with HIV/AIDS and other blood-borne viruses. The study population consisted of all 330 dentists working within the South Cheshire region whose addresses were obtained from the Local Health Authority. A response rate of 46% was obtained and the results were analysed using basic descriptive statistics and the chi-squared (χ2) test. The results of this study suggest that age and type of dental practice are significant factors associated with treatment practices, attitudes and sense of ethical responsibility amongst dentists in the South Cheshire region. Consistent with previous studies, this could be interpreted as due to the impact of educational programmes. Further qualitative research is recommended in order to address these issues in more depth. [ABSTRACT FROM AUTHOR]

This essay places the early modern origins of the ethico-legal structure of medicine, in which eventually by exclusion or inclusion, dental activity shared, in the Humanist environment of the Italian Renaissance as it was imported into England in the first years of the sixteenth century. There were two linked stages to this, the first supported by the genius of Thomas Linacre (1460-1524), and the second by the administrative ability of Sir Thomas More (1478-1535). This paper concentrates on the evidence for the intellectual basis of More's medical legislation, and that which was made shortly after his death. [ABSTRACT FROM AUTHOR]

This paper describes the development of a local solution to the problem of the provision of out-of-hours dental care in Newcastle and North Tyneside in the north east of England. Focus groups were used to review the current provision of, and problems with, dental out-of-hours emergency provision. A consensus conference involving both general dental and medical practitioners, was subsequently used to develop possible alternative methods for the provision of out-of-hours emergency dental services. A centralised service delivered from a secure location in conjunction with general medical practitioners was developed which was dependent on a nurse-led triage. The linkage with NHS Direct may be an opportunity, in some locations, to integrate dental services more fully with other out-of-hours primary care services. The method described allowed a solution to be generated by practitioners themselves, thus giving ownership and acceptance to the chosen option. [ABSTRACT FROM AUTHOR]

Aim To pilot a local dental network (LDN) within the Hampshire and Isle of Wight region.Method An LDN Coordinating Group was set up, which was chaired by the local consultant in dental public health and included representatives from dental commissioning and performance management teams, dental practice advisory team, finance, Oxford and Wessex Dental Deanery and the Hampshire and Isle of Wight Local Dental Committee. The LDN successfully led the organisation of a leadership training course for local dentists, and produced recommendations for local oral surgery and orthodontics care pathways. Key to the success was the collaboration achieved between the commissioners, local postgraduate dental deanery and local dental committee.Results There were challenges associated with involving non-salaried dental practitioners without a source of funding, and with communicating with the wider dental community.Conclusions The new Wessex LDN needs to be adequately resourced and integrated into the local commissioning structure, as well as the wider health system, to function effectively. Most importantly, the LDN needs local dental professionals to embrace the opportunities for leadership and use their skills to inform and influence local dental commissioning for the benefit of the local population. [ABSTRACT FROM AUTHOR]

Aim To consider the survival of restorations in root filled and non-root filled teeth.Methods A data set was established consisting of patient's, 18 years or older. For each patient on the database with a tooth restored with a direct or indirect restoration with or without a root filling, the subsequent history of intervention on that tooth was consulted, and the next date of intervention, if any could be found in the data set, was obtained. Thus a data set was created of restored teeth and whether they have also received root fillings, with the dates of restoration and root filling placement and the dates, if any, of re-intervention. Modified Kaplan-Meier statistical analysis was used to quantify the distribution of time to intervention.Results Data for over 80,000 different adult patients were analysed, of whom 46% were male and 54% female. A total of 538,967 restoration placements were obtained from the data over a period of 11 years, of which 30,073 were root fillings.Conclusions Examination of the survival of restorations in teeth with and without root canal fillings indicated that those with root canal fillings have shorter intervals before re-intervention than teeth without root fillings. Restorations on root canal treated anterior teeth with post and cores had the lowest survival time. [ABSTRACT FROM AUTHOR]

On 4 February 2013 experts confirmed that the remains of the last English king to die in battle were found under a council car park in Leicester, England. Richard III, the last Plantagenet king, wore the crown from 1483 until his untimely death in 1485. There have been many myths published about him, even one with a dental reference. This paper explores what dentistry was like at the time of Richard III, reveals the truth behind the myths and sees how the University of Leicester's findings about his dentition and skull has provided an insight into his identification, lifestyle and final moments. [ABSTRACT FROM AUTHOR]

Inappropriate referrals leading to long waiting lists are a problem for many orthodontic departments throughout the country. This paper describes a method of triaging new patient referrals which aims to reduce the number of appointments generated for inappropriate referrals. The system has been used successfully at Hull Royal Infirmary to reduce new patient waiting times in line with government targets. [ABSTRACT FROM AUTHOR]

Unlike in adults, currently there are no nationally agreed guidelines for the assessment of periodontal diseases in children and adolescents. This paper considers the range of periodontal diseases that can affect youngsters and documents a simple periodontal screening system for the younger age groups. It includes principles of periodontal diagnosis and management for the practitioner to apply to the young patient and considers when to treat in practice and when to refer to a specialist. [ABSTRACT FROM AUTHOR]

The challenge for the twenty-first century for oral health is to reduce the social inequality observed in populations. This challenge has been made explicit by the Department of Health (DH) in England. Turning rhetoric into reality is difficult for all concerned whatever field or profession. A cohesive model that embraces philosophical ideals can help individuals achieve change as it provides structure on which to develop ideas. This paper describes a model of care in general dental practice that fits the requirements of the DoH in addressing social inequalities, in the context of developing general dental services. [ABSTRACT FROM AUTHOR]

In order for dental practices to gain the maximum benefit from an educational opportunity such as a course or workshop, it is important that the training received meets the needs of these practices and is delivered appropriately. This paper provides an account of an educational initiative undertaken within the Eastern deanery in 2003 and 2004, 'Essex Promoting Infection Control' (EPIC), which set out to establish training needs in infection control within general dental practices across Essex and then to design and deliver learning events to meet these needs. [ABSTRACT FROM AUTHOR]

This paper identifies the main factors which have influenced the nature of the undergraduate orthodontic curriculum presently taught at Newcastle University. It also outlines the philosophy that underpins the teaching, states the professional aims of the tutors and spells out the clinical objectives set for the students. [ABSTRACT FROM AUTHOR]

Objectives To describe the prevalence of oral diseases and their impact on oral-health-related quality of life in people with severe mental illness undertaking community-based psychiatric care.Methods A survey was conducted at eight outpatient psychiatric care clinics in Tower Hamlets, London, UK. One hundred and twelve consecutive patients with mental illness were invited to participate in this study. They were clinically examined and asked to complete the oral health impact profile (OHIP) questionnaire.Results The response rate was 79% (n = 89); 57 (64%) males and 58 persons over 45 years of age (65%) participated in this survey. Overall OHIP score was 25.4 (95% CI 23.3, 27.4), 70 (78%) were smokers and 45 (51%) had been to the dentist in the last two years. Forty-seven (53%) respondents had caries in at least one tooth, 60 (67%) had 21 teeth and more, and 14 (16%) used dentures. Advanced periodontal treatment was indicated in 42 (55%) of patients and 52.8% (n = 47) patients reported current pain.Conclusion Overall, this survey found that oral health has a great impact on patients with severe mental illness being treated in the community setting and their oral health is poorer than the national adult general population. Future research should consider the causes that relate to the poorer oral health in this population and potential health promotion mechanisms in this population to encourage an upstream approach to health. [ABSTRACT FROM AUTHOR]

Background There is a poor understanding of to how to recruit and involve primary care dentists in clinical trials.Aim To use a qualitative paradigm to explore the views of primary care dentists towards participating in clinical trials and develop an understanding of the factors that facilitate and prevent their involvement.Design, setting, subjects and methods An iterative approach was undertaken using a focus group (n = 6) followed by phased semi-structured interviews (n = 18). Data were analysed using thematic analysis and constant comparative analysis.Findings The semi-structured interviews generated nine codes which were organised into three themes: technical issues for trials in primary dental care, practical issues for research in primary dental care and primary care dentists as research consumers. Overall, primary care dentists had a poor understanding of research methodology and clinical research. Barriers to participation included loss of clinical freedom and control, practice disruption, patient welfare, staff workload, financial loss and time.Conclusions Barriers to primary dental care research need to be overcome through appropriate protocols, funding, training and support. Joint working of primary dental care teams and academic researchers is essential, along with a constructive and open dialogue, if clinical trials are to be successfully undertaken in a practice environment. [ABSTRACT FROM AUTHOR]

Introduction Retaining and Returning Advisers (RRAs) were appointed to postgraduate dental deaneries in England in 2002 as part of the Government's strategy to retain the dental workforce and support return to practice following a career break. The study aimed to review RRAs' activities and consider the overall success of the RRA initiative five years from inception (2007). Design and methods A case study design, conducted in three phases, drawing on qualitative data. In Phase 1, semi-structured interviews were held with all RRAs in England (n = 12). Phase 2 involved an electronic survey of all 12 postgraduate dental deans in England (n = 10). In Phase 3, analysis was undertaken and a final report prepared. Results RRAs have been flexible in responding to the changing policy context, and devolved funding for the role to the local, deanery level. They have adapted to support more diverse target groups including those seeking vocational training equivalence and underperforming dentists. Future priorities were envisaged to be associated with primary care trusts' commissioning and quality assurance responsibilities, and supporting all members of the dental team. Conclusion RRAs have become well-established in deaneries and have made a successful contribution to addressing workforce and educational needs for a diverse group of practitioners. [ABSTRACT FROM AUTHOR]

Objective To investigate current endodontic clinical practice in the north west of England and evaluate practitioner's training needs.Method A questionnaire was posted to 702 primary care dentists in the north west of England in January 2006. The questionnaire investigated aspects of dentists' endodontic clinical practice, the provision of endodontics within their practice, their recent postgraduate training in endodontics and their training needs.Results Responses to the questionnaire were received from 498 (70.9%) primary care dentists, of which 449 questionnaires contained useful information. Only 30% of respondents use rubber dam for isolation in all endodontic cases. The majority used radiographs either as the only method for establishing the working length (57.3%) or in conjunction with an apex locator (34.5%). Most dentists used sodium hypochlorite solution as an irrigant during the root canal treatment. Almost 55% used a combination of conventional hand files and rotary files to prepare root canals. Fifty-eight percent used the crown down technique while 35% used the step back technique for canal preparation. Almost two-thirds routinely used non-setting calcium hydroxide as an intra-canal medicament. Lateral condensation technique was the popular obturation method and the vast majority of respondents routinely took postoperative radiographs. Almost 25% of respondents had not received any teaching or training in endodontics in the past two years.Conclusions The results of this study suggest that primary care dentists in the north west of England have embraced modern techniques and follow most aspects of accepted endodontic practice. Despite the majority having postgraduate training in the last two years, only a minority used rubber dam routinely for endodontic treatment. [ABSTRACT FROM AUTHOR]

Objective The purpose of this ecological study was to investigate the relationship between uptake of orthodontic services and factors that might influence receipt of care at a population level.Method The dental practice board supplied data on claims for courses of active orthodontic treatment from April 2001 to March 2002 for children from the former county of Avon. These data were analysed in relation to deprivation, living in an urban/rural setting and the proportion of the population from a black or minority ethnic group (BME).Results In Avon, children from deprived and rural areas were significantly less likely to be undergoing an active course of orthodontic treatment. Children from an area with a high proportion BME were significantly more likely to be undergoing treatment.Conclusion This research demonstrates that children from more deprived and rural communities in Avon are less likely to receive orthodontic treatment. This has important policy implications for primary care trusts that have a responsibility to ensure equal access to care for all of their children. [ABSTRACT FROM AUTHOR]

Aim It is the aim of this paper to consider the factors associated with the need for re-intervention on direct-placement restorations placed within the general dental services of England and Wales.Methods A large age-stratified sample of adult patients and their dental intervention were tracked over 11 years to December 2001. For each tooth treated with a direct restoration the subsequent history of intervention on that tooth was consulted, and the next date of intervention, if any could be found in the extended data set, was obtained. The distribution of times to re-intervention for different types of restoration in different circumstances was obtained using Kaplan-Meier survival analysis.Results Data for over 80,000 different adult patients were analysed, of whom 46% were male and 54% female. A total of 503,965 restoration placements were obtained from the data over a period of 11 years. Single surface amalgam restorations were found to have the longest survival – 58% at ten years, and glass ionomer the shortest – at 38% at ten years.Conclusions Small amalgam restorations have longer survival times before re-intervention than large amalgam restorations such as MOD. Composite and glass ionomer restorations perform less well than amalgam restorations. Restorations placed by older dentists and restorations placed in older patients have shorter time to re-intervention. Patients who changed dentist were found to have restorations which performed less well than those placed in patients who did not change dentist. [ABSTRACT FROM AUTHOR]

Objectives Key reforms in England and Japan have called for greater clinical leadership from general dental practitioners to deliver improvements in the quality of care for patients. In England, the reorganisation of the National Health Service has led to the development of Local Professional Networks to ensure services are clinically led, patient and outcome focused. In Japan, the rapidly changing demographics have led to calls for general dental practitioners to become more active in meeting the emerging population health challenges. Both require engagement at a strategic and a local level. However, little is known about what is meant by clinical leadership in dentistry or what training needs exist. The aim of this study was to develop and pilot a questionnaire to understand what general dental practitioners feel is important about clinical leadership and how they rate themselves.Methods A 61-item questionnaire was developed from the literature, an earlier qualitative study and refined through cognitive interviews. Questionnaires were distributed to general dental practitioners across the North West of England and Tokyo, using random sequence generation. For each item, the participant had to record whether they thought the statement was an important component of clinical leadership and how they rated themselves. Both were rated using a seven-point Likert scale. Data reduction was undertaken using principal component analysis to examine for factor loadings within the questionnaire. Differences in mean scores were also used to highlight substantive differences in how general dental practitioners rated the different components of leadership and how they rated themselves.Results The response rate for the pilot was low (22.9% and 7.5% for North West and Tokyo respectively). The items that were considered to be important in leadership reduced to two components in the North West (accounting for 62.1% of the total variance): 'How to lead' and 'How not to lead'. In Tokyo, 56.4% of the total variance was explained by three components: 'Demonstrating personal qualities', 'Working with others' and 'How not to lead'. When the self-rated items were reduced, three factors were found to be important in the North West: 'Working with others', 'Setting direction' and 'Managing services' (55.1% of the variance). 'Working with others', 'Demonstrating personal qualities', 'Pragmatism', 'Setting direction' and 'Improving services' were found to be important in Tokyo (52.8% of the variance). The questionnaire items relating to integrity, team-working and having a positive attitude during difficult times were rated highly by both groups. Items relating to providing vision for team, being assertive and having a positive attitude had the greatest mean difference, suggesting possible areas of training need.Conclusion The nature of the pilot study and the poor response rate makes any conclusion difficult to infer. Among those that participated, leadership was understood to be more important at a practice level rather than at a strategic level. The questionnaire should be refined further based on the results of the pilot and the data reduction. [ABSTRACT FROM AUTHOR]

In November 2002, the BDA News carried an item, illustrated with a colour reproduction, describing a painting of a Georgian dentist's rooms by Joseph Mallord William Turner (1775-1851), one of the most respected of English artists, which was shortly to come up for auction at Christies' Rooms in London. This work, first exhibited in 1808, was entitled "The unpaid bill, or the dentist reproving his son's prodigality", and had originally been commissioned by the connoisseur Richard Payne Knight (1750-1824). "The examiner", a contemporary London journal, identifies the 'cradle-piece' for the commission as being a Rembrandt which Payne Knight owned, and the journalist Robert Hunt said that Turner had more than come up to the task of showing that a modern could handle light as well as the old master, 'for a picture of colouring and effect, it is ... inestimable'. [ABSTRACT FROM AUTHOR]

Introduction: This paper reports the impact of course attendance on the practice of dentists. Method: Phase One: A survey sent to all general dental practitioners (GDPs) in three deaneries in England. The survey included self-ratings of the impact of course attendance on practice. Phase Two: Interviews with 20 dentists before and two to three months after they had participated in a self-selected course. The response rate to the survey was 54% (n = 2082). Comparisons with national data showed no notable bias in the sample for gender, owners/partners and age/experience. An ordered logit model was used to explore the net effect of factors (including years' experience in general dental practice and gender) on dentists' ratings of course impact. Results: Course attendance was judged to impact on practice. Impact rating was affected by participation rate and years' experience. Barriers to implementation included cost, time, NHS constraints and personal or staff issues. Impact was enhanced when selection of courses was based on learning needs although courses may also serve usefully to confirm current practice. Conclusion: There is much that dentists themselves can do to enhance the impact of courses, principally by reflecting on learning needs. They should be supported in the development of personal learning plans. [ABSTRACT FROM AUTHOR]

In 1999 South Lancashire Health Authority published their Oral Health Improvement Plan in which they specifically identified drug users as a target group. In this paper the authors outline the development of a project, which aimed to improve access to dental services for this group. Essential to the relative success of the project was the inclusion of drug users and service providers at the outset. In addition perceived barriers, which exist between drug users and the profession have started to be broken down. [ABSTRACT FROM AUTHOR]

The popularity of caricature at the end of the eighteenth century allows a researcher to observe the social as well as the technical side of dentistry as it was then available throughout the kingdom. The value of these caricatures is further enhanced by the unconscious inclusion of everyday objects which a narrative account would not think it worthwhile including, even if such narrative account had existed. [ABSTRACT FROM AUTHOR]

The Consultant in Dental Public Health and the Local Dental Committee in East Lancashire have developed a local system, similar to that being set up for general medical practitioners, to help general dental practitioners whose performance is causing concern. GDPs approved it at an open meeting of practitioners. A Dental Performance and Assessment Group has been set up and one problem has already been resolved to everyone's satisfaction. The model is recommended to dentists in other areas. [ABSTRACT FROM AUTHOR]

Objectives Data on fluoride exposure of infants are sparse. This study aimed to estimate total daily fluoride intake (TDFI) of infants aged 1-12 months, living in non-fluoridated and fluoridated areas in north-east England.Methods Daily dietary fluoride intake was assessed using a three-day food diary coupled with analysis of fluoride content of food/drink consumed, using a F-ISE and diffusion method. A questionnaire with an interview was used to collect information on toothbrushing habits. TDFI was estimated from diet, plus fluoride supplements and dentifrice ingestion where used.Results Thirty-eight infants completed the study; 19 receiving fluoridated water (mean 0.97 mgF/l) and 19 receiving non-fluoridated water (mean 0.19 mgF/l). Mean (SD) TDFI for the infants living in fluoridated and non-fluoridated areas was 0.107 (0.054) and 0.024 (0.015) mg/kg body weight per day, respectively. Diet was the only fluoride source for 87% of infants and none used fluoride supplements. For infants for whom mouth/teeth cleaning was undertaken, dentifrice contribution to TDFI ranged from 24 to 78%.Conclusions Infants living in fluoridated areas, in general, may receive a fluoride intake, from diet only, of more than the suggested optimal range for TDFI. This emphasises the importance of estimating TDFI at an individual level when recommendations for fluoride use are being considered. [ABSTRACT FROM AUTHOR]

Aim To determine the attitudes of patients attending routine appointments at primary care dental clinics and general dental practices towards the possibility of chair-side screening for medical conditions, including diabetes, in the dental setting.Methods A brief, anonymous, self-administered questionnaire distributed to adult patients (≥18 years) attending 2 primary care dental clinics and 16 general dental practices in South-West England.Results One hundred and ninety-seven completed questionnaires were received from patients at primary care dental clinics and 429 from general dental practice patients. Overall, 87% of respondents thought that it was important or very important that dentists screened patients for medical conditions such as diabetes; 79% were very willing to let a dental team member carry out screening. The majority indicated willingness to be screened for various medical conditions during a visit to the dentist, with significantly higher proportions of respondents in the primary care clinics indicating willingness (hypertension: 83% vs 74%; heart disease: 77% vs 66%; diabetes 82% vs 72% [all p <0.02]). Nearly two thirds of primary care clinic respondents and over half of general practice patients indicated that they would be willing to discuss test results with the dental team. Overall, 61% had never knowingly been screened or tested for diabetes; 20% reported that they had been tested within the previous 12 months.Conclusion The majority of respondents supported the concept of medical screening in a dental setting and were willing both to have screening tests and discuss their results with the dental team. Patient acceptance is paramount for successful implementation of such screening programmes. [ABSTRACT FROM AUTHOR]

Aim This service evaluation assessed the need for sedation in a population of dental attenders (n = 607) in the North West of England.Methods Using the novel IOSN tool, three clinical domains of sedation need were assessed: treatment complexity, medical and behavioural indicators and patient reported anxiety using the Modified Dental Anxiety Scale.Results The findings suggest that 5% of the population are likely to require a course of treatment under sedation at some time. All three clinical domains contributed to the IOSN score and indication of treatment need. Females were 3.8 times more likely than males to be placed within the high need for sedation group. Factors such as age, deprivation and practice location were not associated with the need for sedation.Conclusions Primary care trusts (PCTs) need health needs assessment data in order to commission effectively and in line with World Class Commissioning guidelines. This study provides both an indicative figure of need as well as a tool by which individual PCTs can undertake local health needs assessment work. Caution should be taken with the figure as a total need within a population as the study has only included those patients that attended dental practices. [ABSTRACT FROM AUTHOR]

Background A variety of inherited and acquired conditions affect the dentition. The aim of this research was to investigate the oral health-related quality of life (OHRQoL) of children in relation to the status of their permanent incisors, at a significant transitional stage in their childhood.Method Two hundred and sixteen patients of the Charles Clifford Dental Hospital, Sheffield, aged between 10 and 11 years, were sent an OHRQoL questionnaire (CPQ11-14) three months before secondary school entry. Participants were categorised, according to clinical status, as having a visible dental difference (abnormal incisor aesthetics and/or orthodontic malocclusion) or no visible difference. Follow-up questionnaires were issued three months after secondary school entry to obtain repeat psychosocial data. Analysis of variance tests investigated the impact of clinical variables, self-reported satisfaction with dental appearance and gender on OHRQoL during educational transition.Results Ninety-two children participated in the baseline study and 71 of these children completed the follow-up questionnaire (43% and 77% response rates, respectively). Visible dental differences and dissatisfaction with dental appearance were associated with worse OHRQoL at baseline and follow-up.Conclusions Dental conditions which result in visible incisor differences are associated with higher levels of dissatisfaction with appearance and have potential to negatively impact on children's OHRQoL. [ABSTRACT FROM AUTHOR]