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294 children aged 2-4 yr attending nursery schools in Northern Ireland were examined for dental caries and dental registration status under the capitation system in general dental practice. Their mean age was 3 yr 10 months. Sixty eight per cent were caries free, mean dmft was 1.10 and dt, mt and ft scores were 0.74, 0.28 and 0.09, respectively. With increasing age the prevalence of caries increased, though the very low care index (d/dmft) did improve in the older children. Seventy per cent reported being registered for dental care and their levels of dental caries were significantly higher than those who were not yet enrolled (P<0.001). For those not enrolled for dental care the main perceived barriers to seeking care related to lack of symptoms (33.6%) and apathy (31.6%) while few reported fear as a barrier (4.5%). [ABSTRACT FROM AUTHOR]

Objectives: To study barrier formation in nonvital, immature permanent incisors being treated using the apexification technique in two centres, and to establish the effect of the frequency of change of calcium hydroxide (CaOH) on barrier detection times., Design: A retrospective study of the time of detection and the position of barriers., Results: There were no significant differences between the two centres in terms of the average frequency of change of each CaOH dressing, the distribution of barrier detection times or the position of barriers (P > 0.05). There was a total of 107 teeth and the time of barrier detection was significantly earlier in more frequently dressed teeth (P = 0.013). Of the teeth with a barrier detection time of less than 9 months, 60.7% were dressed more frequently than every 3 months, as opposed to 39.1% of teeth with longer barrier times (P = 0.027). The mean time of barrier detection for all cases was 43.3 weeks. The majority of barriers were located at or near the apex., Conclusion: The frequency of change of CaOH can increase the speed of barrier detection but does not appear to affect the position.

The object of the present study was to determine the relationship between dental attendance and the levels of untreated caries in a sample of 11-12 year old pupils attending first form of second level schools in the South Belfast area of Northern Ireland. A sample of 199 first form pupils attending second level schools in the area was obtained. The diagnosis of caries depended mainly on visual evidence following removal of debris and moisture. Blunted probes were used to confirm or reject doubtful lesions and no radiographs were taken. Details of parental employment status were obtained by a questionnaire to the parents. The data were entered on to an N.C.S.S. data analysis system for stepwise regression and analysis of variance. Overall there was a significant difference in the untreated caries status of those with different attendance patterns, the major difference being that a much higher proportion of those who had not attended within the previous 12 months had active caries. Almost half of the children had attended in the previous six months and only 16 (8 per cent) had not attended in the previous 12 months. Independent analysis indicated that parental employment status was significantly related to the level of untreated caries (p > or = 0.05). Independent variables entered in the stepwise regression were attendance, employment status and DMFT. The strongest predictors of untreated caries were previous caries experience and period since dental attendance, while employment status was a significant but weaker factor in the analysis. These findings may be relevant when planning the frequency of school dental screenings and managing the frequency of dental recalls and examinations.

Objective: To determine the sources of learning and the levels of support concerning sugar-free medicines by doctors and pharmacists, to examine the provision of choice from the viewpoints of professionals and the parents, and to test the sugar-free status of medication in tests of prescribing., Design: Samples of health professionals comprising 47 general medical practitioners, (87% response rate) 29 pharmacists (94%) and 25 general dental practitioners (100%) completed closed questionnaires as did 209 parents (72%) of 4-year-old children., Setting: Newry and Mourne Health Trust Area, Northern Ireland., Outcome Measures: Proportions of respondents citing various learning sources and the levels of support for the use of sugar-free medicines were obtained and the proportions of doctors and pharmacists claiming to offer various frequencies of choice were compared to the proportions of parents recalling receiving such choices. Test prescriptions were examined and the sugar-free status of the prescribed medication was determined., Results: Markedly different sources of learning were cited by different groups. Ninety per cent of pharmacists and 88% of dentists believed that medication should be in sugar-free form in all cases, while only 66% of doctors thought so. Forty three per cent of doctors claimed to always offer a choice while 17% of parents recalled receiving this. The equivalent figures for pharmacists and parents were 69% and 11%. The majority of test prescriptions by doctors and dentists were for sugar containing medicines.

Sugar in liquid medicines is a factor in dental caries for many children. There has been an increase in the availability of sugar-free medicines in recent years, but they need to be prescribed specifically, because most generic liquid medicines still contain sugar. The object of the present study was to examine parental and child factors which may be linked to the provision of sugar-free alternatives by their medical practitioner. A random sample of 291 parents of children aged four years was obtained. A questionnaire was used to ascertain the extent of their knowledge concerning liquid medicines and their effect on dental health and the frequency with which such medicines are requested by them was assessed. The levels of provision of sugar-free medication and the frequency of used common types of medication were recorded and long term users identified. There was a total of 212 children in the study representing an inclusion rate of 73 per cent of the original sample. Just more than 17 per cent were always provided with a sugar-free liquid medicine, 58.3 per cent sometimes received this form of medication and 24.6 per cent never received it. The strongest individual predictor of a high frequency of provision of the medication in sugar-free form was the frequency of parents requesting this type of medication from their medical doctor and the next strongest predictor was the frequency of use of antibiotics. Parental awareness or knowledge of the importance of the issue for dental health did not affect the outcome in the present study. It is concluded that there is a need for specific campaigns to promote the use of sugar-free medications and further increases in their availability should be sought from manufacturers.

It is generally agreed that persons suffering from haemophilia from a priority group for dental care. The present study compares the prevalence of dental caries in haemophilic children in Northern Ireland with the reported values for similarly aged children in the population. The prevalence of caries experience and of untreated caries were low in the haemophiliacs in both the primary and permanent dentitions. No teeth had been extracted due to caries and a high level of fluoride usage was claimed. The dental care of these patients is carried out at the regional treatment centre and forms an integral part of their medical care.

The study examined the dental caries treatment profile of 186 14-15-year-old children in schools known previously to have a high overall caries experience, the schools being located in a high caries area of Northern Ireland. The children had a high mean number of decayed and untreated teeth. The majority of children who had untreated decay were unaware of this status and had a mean D value of 3.85. There was a significantly higher number of untreated carious teeth for children who had not attended a dentist within the past year when compared with those who had attended (mean values 4.08 and 2.54 respectively). While there were high levels of unmet needs overall it is concluded that children who had not attended the dentist for the past year had very high levels of untreated decay.

Factors which influence the prescribing of sugar-free medicines by 47 general medical practitioners were examined by means of questionnaire. The doctors all practise in the Newry and Mourne district of the Southern Health and Social Services Board, Northern Ireland. Twenty-six (55%) of the doctors stated that they support the principle of prescribing sugar-free medicines for children; the same number stated that they oblige parental requests and 14 (30%) stated that they frequently prescribe a common group of sugar-free medicines. However, only 14 (30%) of the doctors considered that their knowledge of sugar-free medicines was up-to-date. The main sources of information about sugar-free preparations were drug company travelling representatives and professional journals, but a few doctors learned of this issue from other professionals, including dental practitioners. The majority of doctors (especially those with a practice policy of prescribing sugar-free medicines) felt it was important to prescribe sugar-free preparations for all children, not only for those requiring long-term medication. The results show that there is a reasonable level of interest in this issue among the doctors in the area, but that there is an on-going need for further encouragement and provision of information for them, in order to increase as far as possible the use of sugar-free preparations for children.

The views of community dental officers working in Northern Ireland were obtained concerning the difficulties they experience in treating disabled people. A closed questionnaire was used and a response rate of 84 per cent was achieved (60 officers). Thirty-seven per cent of the officers had received postgraduate training in this area. Lack of experience and knowledge concerning the treatment of the disabled was the commonest reason for not offering comprehensive dental care. Emotional upset and embarrassment or the length of time for treatment were the least cited. One-fifth perceived no barriers, a slight majority indicated two or less and only two officers indicated more than five. Those who were qualified ten years or longer, had greater difficulty than the more recently qualified in providing treatment for mentally and physically disabled children and medically compromised patients.

The dental health of 54 children in remission from acute lymphoblastic leukaemia was compared with a similar number of matched healthy control subjects. Frequency of dental attendance was similar in both groups but most children in remission from leukaemia attended a hospital dentist, whereas children in the control group visited a dentist in general practice or in the public health service. Children in remission from leukaemia used fluoride supplements significantly more frequently than their controls. There was no difference in plaque or gingivitis scores between groups. Children in remission from leukaemia had a significantly lower number of decayed primary teeth (d) than their matched controls but there were no significant differences between study and control groups of m, f or dmft values. There was a significantly greater number of extracted teeth (M) and a significantly greater overall decay experience (DMFT) in the permanent dentition of children in remission from leukaemia compared to their controls. There were no significant differences between study and control groups for D or F values. The mean number of sealed teeth per patient was significantly higher in the study than in the control group.

The activities of the Community Dental Service still remain something of a mystery to many dental practitioners and recent developments broadening the remit of the community service are not universally known. There have been some schemes to introduce dental students to the care of patients by the CDS, but its role continues to develop with responsibilities which take community dental officers into a wide variety of settings in the community in order to reach priority groups such as the elderly and disabled.

The study examined the potential barriers to dental care for a selected sample of 57 adults suffering from cerebral palsy. The majority (60 per cent) were regular dental attenders and they received dental care in general dental practice and community dental practice in almost equal numbers. Those with mobility or communication difficulties were significantly more likely to attend the community or hospital dental services (P < 0.05). Their most common perceived barriers to dental care were fear, the need to be accompanied and negative attitudes, while cost was a rarely stated barrier. A dislike of dental treatment was significantly related to irregular attendance (P < 0.05) but neither anxiety nor the need to be accompanied were significantly related to attendance pattern.

This study examined the relationship between antibiotic usage and plaque, gingivitis and dental caries experience in a group of children suffering from cystic fibrosis. Their scores for plaque, gingivitis and dental caries were compared with those of healthy control children who were individually matched on the basis of age, sex and social class. Significant negative relationships were noted between (i) antibiotic usage during the 4 weeks prior to examination and plaque and gingivitis scores, and (ii) antibiotic usage since the age of 6 years and DMFT. It is suggested that antibiotic therapy may be a major cause of the lower levels of dental disease observed in cystic fibrosis children.

The present study was undertaken to establish the dental disease and treatment levels in 101 young insulin dependent diabetic patients in Northern Ireland. There was a significantly greater proportion of children from the higher social classes in the diabetic group. Their dental caries experience was lower than that reported for the general population and the restorative indices were high. However, those whose diabetes was diagnosed at a late stage had a higher caries experience. There was significantly more gingivitis detected in older diabetic patients, but oral hygiene status did not significantly differ with age. There was a pattern of regular dental attendance in the majority of diabetic subjects.

131 patients suffering from cystic fibrosis were compared with a similar number of matched healthy control subjects. The cystic fibrosis patients had significantly lower levels of gingivitis and plaque and a significantly higher prevalence of calculus. They had significantly less caries in the deciduous dentition than their controls. There was also a lower experience of caries in the permanent dentition although the difference between the two groups was not so marked in this case.