Cork University Dental School and Hospital - Journal Articles
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Item World Workshop on Oral Medicine VIII: Development of a core outcome set for dry mouth: a systematic review of outcome domains for salivary hypofunction(Elsevier Inc., 2023-03-02) Simms, Melanie Louise; Kuten-Shorrer, Michal; Wiriyakijja, Paswach; Niklander, Sven Eric; Santos-Silva, Alan Roger; Sankar, Vidya; Kerr, Alexander Ross; Beier Jensen, Siri; Ni Riordain, Richeal; Delli, Konstantina; Villa, Alessandro; American Academy of Oral Medicine; European Association of Oral Medicine; Church and Dwight; Colgate-Palmolive CompanyObjective: To identify all outcome measures used to assess salivary gland hypofunction (i.e., objective measures used to determine actual changes in saliva quantity or to assess response to treatment of salivary gland hypofunction) and to group these into domains. Study Design: A systematic review including clinical trials and prospective or retrospective observational studies involving human participants with dry mouth, with any type of intervention where the objective assessment of salivary gland hypofunction was described. Results: Five hundred fifty-three studies involving 31,507 participants were identified. Most assessed salivary gland hypofunction and xerostomia (68.7%), whereas 31.3% assessed salivary gland hypofunction alone. Most studies investigated the “amount of saliva,” and the highest number of outcome measures were within the domain of “clinical/objective signs of salivary gland hypofunction.” Conclusions: Seven domains encompassing 30 outcome measures were identified, confirming the diversity in outcomes and outcome measures used in research regarding salivary gland hypofunction. Identified items will be used in conjunction with those identified regarding xerostomia to create a core outcome set for dry mouth quantification for use in future clinical trials, with the overall goal of improving the standardization of reporting, leading to the establishment of more robust evidence for the management of dry mouth and improving patient care.Item Reasons for placement and replacement of crowns in general dental practice(Springer Nature, 2018-08-10) Lynch, Christopher D.; Hale, R.; Chestnutt, I. G.; Wilson, N. H. F.; PRIME Centre, WalesObjectives: The aim of this study was to investigate the reasons for placement and replacement of crowns in general dental practice. Methods: Forty general dental practitioners recorded the principal reason for the provision of new (initial) and replacement crowns for a maximum of up to 20 patients over a 20-week period. Results: A total of 664 patients received 783 crowns during the period of this study. Of these, 69% (n = 542) were new (initial) placements and 31% (n = 241) were replacements. Overall, tooth fracture (45%, n = 241) was the most frequently reported reason for new/ initial crown placements. Aesthetics (21%, n = 53) and secondary/recurrent caries (20%; n = 47) were the most frequent reasons for crown replacement. Maxillary premolars (27%, n = 145) and mandibular molars (25%, n = 137) were the teeth that received most initial crown placements. In contrast, maxillary incisors (50%, n = 115) were the most common teeth to receive a replacement crown. Dentists were more likely to replace a crown if they had not placed the original crown: 74% of replacement crowns (n = 178) were placed by a different dentist. Most patients had only one crown placed or replaced per course of treatment (n = 611; 90%). Conclusions: The results of this study reveal the prescribing habits of dentists in relation to provision of initial and replacement crowns. The vast majority of patients had only one crown provided per course of treatment, which is probably a reflection of funding schemes and changing patterns of oral health. This sample reported fewer replacement crowns than previous studies. In keeping with existing literature, crowns were more frequently replaced when the treating dentist had not placed the initial crown. However, against this, more replacements were provided for more long-standing patients (5+ years attendance) compared to those with shorter attendance history (<5 years). In an area where high quality evidence is lacking, further consensus on the need for placement and replacement crowns is needed. Such information would assist dentists to provide high-quality care and commissioners in developing an evidence-based service.Item Teaching of implant dentistry in undergraduate dental schools in the UK and Ireland(Springer Nature, 2018-10-19) Chin, J. S.; Lynch, Christopher D.; Rees, J.; Locke, M.; Thomas, M. B. M.; Addy, L. D.Objective: The aim of this study was to assess the current status of implant teaching within dental undergraduate schools in the UK and Ireland. Methods: An online questionnaire relating to current and future possible trends in dental implantology education was developed and distributed to heads of departments of restorative dentistry, in each of the 18 dental schools with undergraduate dental programmes in the UK and Ireland. Results: Responses were received from 16 schools. All responding schools provided implant training for their students. The majority of schools offered students direct clinical experience in treatment planning (n = 13) however, direct clinical experience in restoring implants (n = 5) and implant placement (n = 1) was low. Barriers to implementing and developing the dental undergraduate implant programme include funding and lack of available time in the curriculum. Conclusion: There has been a significant improvement in the amount of implant teaching in the UK and Ireland since previous surveys. Further development and improvement of implant teaching in dental undergraduate schools are required, particularly with respect to the amount of direct clinical experience provided. This will ensure that newly qualified dentists will enter practice with a greater level of knowledge in this field and are best prepared for independent clinical practice.Item The relationship between oral‐health‐related quality of life and general health in an elderly population: A cross‐sectional study(John Wiley & Sons, Inc., 2019-02-19) da Mata, Cristiane; Allen, Patrick Finbar; McKenna, Gerald John; Hayes, Martina; Kashan, AliObjective: To assess the oral-health-related quality of life (OHRQoL) in a cohort of Irish older patients and explore associations with overall health status. Background: The impact of oral health conditions on older individuals’ quality of life may be influenced by patients’ general health status. Materials and Methods: This paper reports a cross-sectional study, which analysed baseline data from patients aged over 60 years. Patients were recruited from two different environments, namely Cork University Dental Hospital and St. Finbarr's Hospital, to take part in two research studies. All patients completed the Oral Health Impact Profile (OHIP-14) and EuroQol-5D (EQ-5D) questionnaires. All patients provided a comprehensive overview of their general medical status. Data from the Quality of Life questionnaires were analysed to check for differences between healthy and frail elders and explore associations between OHRQoL and general health. Results: The patient sample comprised 146 (44.6%) male and 181 (55.4%) female participants, with a mean (SD) age of 73.96 (6.9). Frail patients reported a higher mean OHIP-14 score compared to non-frail patients (P < 0.001). Pearson's correlation analysis showed a negative association between OHIP-14 and EQ-5D scores. Regression analysis showed that among frail individuals, better general health corresponded to poorer OHRQoL. In the non-frail cohort, better general health was related to better OHRQoL, although these results were not statistically significant. Conclusions: General health was not significantly associated with the way that patients perceive their oral health within this patient cohort. However, factors such as objective oral health, denture wear and patient's expectations may play a role in this association.Item No more amalgams: Use of amalgam and amalgam alternative materials in primary dental care(Springer Nature, 2018-07-27) Lynch, Christopher D.; Farnell, D. J. J.; Stanton, H.; Chestnutt, I. G.; Brunton, P. A.; Wilson, N. H. F.; PRIME Centre WalesObjectives: The aim of this study was to investigate the use of dental amalgam and amalgam alternate materials in primary dental care in Wales. Methods: Following pre-piloting, a questionnaire was distributed to 667 dentists registered as working in primary dental care in Wales. The questionnaire sought to determine the current use of amalgam, and amalgam alternative materials in primary dental care services in Wales. In addition, the questionnaire sought to determine the attitudes and confidence of dentists in respect of placement of resin composites as alternatives to dental amalgam. Results: A response rate of 40.4% was achieved (n = 270). High levels of reported confidence were seen in relation to placing resin composites in posterior teeth, but these levels reduced as the complexity of the cavity increased (while 82% of respondents 'strongly agreed' that they felt confident in placing resin composites in occlusal cavities, this reduced to 52.6% for three-surface occlusoproximal cavities). Patterns of care suggested that 73.3% of respondents often, or always, place amalgam restorations for NHS-funded dentistry in adults, where two or more posterior restorations are required. This proportion drops to 27% for the same scenario in children, and 19.4% in privately-funded care for adults. Sixty-seven percent of respondents reported that restoring posterior teeth with resin composite is too expensive for NHS-funded dentistry. A similar proportion of respondents (65.9%) agreed, or strongly agreed, that having to place resin composite routinely in posterior teeth would cause appointment delays. Respondents estimated that it would take them 1.61 times as long on average to place a resin composite, compared to an amalgam, in a moderately deep two-surface proximal-occlusal cavity in a lower first permanent molar. Respondents felt that the NHS fees would have to increase by 55–60% to support the restoration of posterior teeth with resin composite, rather than dental amalgam. Conclusions: This study provided insight into current practising arrangements of primary dental care practitioners in relation to the use of dental amalgam and resin composites in the restoration of posterior teeth. Based on a sample of mainly UK-trained dentists, it would seem that amalgam remains the material typically selected for restoring posterior teeth in adults for NHS-funded care. While dentists are knowledgeable and embracing of new techniques for posterior resin composite placement, funding arrangements in NHS dentistry appear to be a barrier to the increasing use of resin composite-based, minimum intervention approaches to the restoration of posterior teeth.