Cork University Dental School and Hospital - Journal Articles

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    Consumption frequency of added sugars and UK children's dental caries
    (John Wiley & Sons, Inc., 2018-08-20) Hong, Jialan; Whelton, Helen; Douglas, Gail; Kang, Jing
    Objectives: To examine the association between consumption frequency of foods and drinks with added sugar and dental caries experience in the permanent teeth of 12- and 15-year-old children in England, Wales and Northern Ireland, using the Children's Dental Health Survey 2013 (CDHS) data. Methods: Four thousand nine hundred and fifty children aged 12 and 15 have the following information available: daily consumption frequency of foods and drinks with added sugar, tooth-brushing frequency, dental attendance, and water-drinking frequency. The children's dental caries experience was available as a DMFT score (number of decayed, missing, filled permanent teeth). A zero-inflated negative binomial model (ZINB) was used to fit the DMFT score. Results: Lower socioeconomic status (SES), nonregular dental check-ups, and low water-drinking frequency were associated with higher consumption frequency of added sugar (all P < 0.05). The consumption frequency of both drinks and foods with added sugar also differed by region (P < 0.001), and children who more frequently consumed foods with added sugars also consumed drinks with added sugars more often (P < 0.001). Using the Zero-Inflated Negative Binomial model, DMFT scores were not associated with consumption frequency of added sugars for children with caries (DMFT > 0), but the chance of being free of obvious caries (DMFT = 0) was lower for children with high frequency (≥4) of sugar-added foods than for children reported to have a sugar-free diet (OR = 0.5, 95% CI [0.3, 0.8]). Conclusions: Consumption frequency of added sugars was associated with dental caries and a number of child demographic and lifestyle characteristics. Children who consume foods and drinks with added sugar more frequently are more likely to develop dental caries, but higher consumption frequency of drinking water in fluoridated areas might reduce dental caries. The findings add to the evidence for the association between children's dental caries and added sugar consumption.
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    Resin-modified glass ionomer cement vs composite for orthodontic bonding: A multicenter, single-blind, randomized controlled trial
    (Elsevier Inc., 2019-01) Benson, Philip E.; Alexander-Abt, Jonathan; Cotter, Stephen; Dyer, Fiona M. V.; Fenesha, Fatma; Patel, Anjli; Campbell, Ciara; Crowley, Niamh; Millett, Declan T.; Sheffield Hospitals Charity
    Introduction: In this study, we aimed to compare the incidence of new demineralized lesions and bond failures between 2 groups of participants wearing fixed orthodontic appliances bonded with either light-cured resin-modified glass ionomer cement or light-cured composite. Methods: This trial was a multicenter (6 centers: 2 teaching hospitals, 4 specialist orthodontic practices), single-blinded, randomized controlled trial with 2 parallel groups. Patients aged 11 years or older, in the permanent dentition, and about to start fixed orthodontic treatment in these 6 centers were randomly allocated to have either resin-modified glass ionomer cement or light-cured composite for bonding brackets, forward of the first molars. Pretreatment and day-of-debond digital photographic images were taken of the teeth and assessed by up to 5 clinical and 3 lay assessors for the presence or absence of new demineralized lesions and the esthetic impact. The assessors were masked as to group allocation. Results: We randomized 210 participants, and 197 completed the trial. There were 173 with complete before-and after-digital images of the teeth. The incidence of new demineralized lesions was 24%; but when the esthetic impact was taken into account, this was considerably lower (9%). There was no statistically significant difference between the bracket adhesives in the numbers with at least 1 new demineralized lesion (risk ratio,1.25; 95% confidence interval, 0.74-2.13; P = 0.403) or first-time bracket failure (risk ratio,0.88; 95% confidence interval, 0.67-1.16; P = 0.35). There were no adverse effects. Conclusions: There is no evidence that the use of resin modified glass ionomer cement over light-cured composite for bonding brackets reduces the incidence of new demineralized lesions or bond failures. There might be other reasons for using resin modified glass ionomer cement.
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    Tooth replacement for partially dentate elders: A willingness-to-pay analysis
    (Elsevier B.V., 2016-09-15) McKenna, G.; Tada, S.; Woods, N.; Hayes, M.; DaMata, Cristiane; Allen, P. Finbarr; Health Research Board
    Objectives: The primary aim of this study was to investigate partially dentate elders’ willingness-to-pay (WTP) for two different tooth replacement strategies: Removable Partial Dentures (RPDs) and, functionally orientated treatment according to the principles of the Shortened Dental Arch (SDA). The secondary aim was to measure the same patient groups’ WTP for dental implant treatment. Methods: 55 patients who had completed a previous RCT comparing two tooth replacement strategies (RPDs (n = 27) and SDA (n = 28)) were recruited (Trial Registration no. ISRCTN26302774). Patients were asked to indicate their WTP for treatment to replace missing teeth in a number of hypothetical scenarios using the payment card method of contingency evaluation coupled to different costs. Data were collected on patients’ social class, income levels and other social circumstances. A Mann-Whitney U Test was used to compare differences in WTP between the two treatment groups. To investigate predictive factors for WTP, multiple linear regression analyses were conducted. Results: The median age for the patient sample was 72.0 years (IQR: 71–75 years). Patients who had been provided with RPDs indicated that their WTP for this treatment strategy was significantly higher (€550; IQR: 500–650) than those patients who had received SDA treatment (€500; IQR: 450–550) (p = 0.003). However patients provided with RPDs indicated that their WTP for SDA treatment (€650; IQR: 600–650) was also significantly higher than those patients who had actually received functionally orientated treatment (€550; IQR: 500–600) (p < 0.001). The results indicated that both current income levels and previous treatment allocation were significantly correlated to WTP for both the RPD and the SDA groups. Patients in both treatment groups exhibited little WTP for dental implant treatment with a median value recorded which was half the market value for this treatment (€1000; IQR: 500–1000). Conclusions: Amongst this patient cohort previous treatment experience had a strong influence on WTP as did current income levels. Both treatment groups indicated a very strong WTP for simpler, functionally orientated care using adhesive fixed prostheses (SDA) over conventional RPDs. Clinical significance: Partially dentate older patients expressed a strong preference for functionally orientated tooth replacement as an alternative to conventional RPDs.
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    Tooth replacement options for partially dentate older adults: a survival analysis
    (Elsevier Ltd., 2020-12-06) McKenna, Gerald; Tada, Sayaka; McLister, Conor; DaMata, Cristiane; Hayes, Martina; Cronin, Michael; Moore, Ciaran; Allen, Finbarr; Health Research Board; Royal College of Surgeons of Edinburgh
    Objectives: To compare the success of two different tooth replacement strategies for partially dentate older adults; namely resin bonded bridgework (RBB) provided to restore patients according to the principles of the shortened dental arch concept (SDA) and conventional full-arch rehabilitation with removable dental prostheses (RDPs). Methods: A randomised controlled clinical trial (RCT) was conducted with partially dentate adults aged 65 years or older. Each patient from the RDP group had all missing natural teeth replaced with cobalt–chromium framework RDPs. Each patient from the SDA group was restored to 10 occluding pairs of natural and replacement teeth using RBB. Patients were followed-up at 6, 12, 24, 36 months. Success rates were generated according to defined success criteria. Log-rank tests and Cox’s proportional hazard models were used to compare the success of the two treatment strategies. Results: After 36 months, 89 patients completed the RCT; n = 45 in the RDP group and n = 44 in the SDA group. The overall success rate of the SDA treatment was 90.4% compared to 73.0% for RDPs (p = 0.005). In the upper arch SDA treatment was 100% successful compared to 86.4% for RDPs (p = 0.019). In the lower arch, lower success rates were reported for both the SDA treatment (80.0%) and RDPs (60.0%) (p = 0.054). Further analyses with cox’s proportional hazard models demonstrated that SDA treatment was significantly more successful than RDPs (Hazard Ratio: 2.47, p = 0.04). Conclusions: After 36 months SDA treatment using RBB was significantly more successful than RDPs used for conventional full-arch rehabilitation in partially dentate older adults. Clinical significance: Functionally orientated treatment according to the principles of the SDA is a feasible alternative to RDPs for partially dentate older patients. SDA treatment using RBB can achieve higher success rates compared to RDPs in this patient group.
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    Oral care considerations for people with cystic fibrosis: a cross-sectional qualitative study
    (Springer Nature Switzerland AG, 2023-03-11) Coffey, Niamh; O'Leary, Fiona; Burke, Francis; Plant, Barry; Roberts, Anthony; Hayes, Martina
    Objectives: To investigate the attitudes of adults with Cystic Fibrosis (CF) towards dental attendance and any perceived barriers to treatment. Methods: A cross sectional survey in the form of a structured, anonymous questionnaire was used to obtain information regarding adults with CF’s feelings towards dentists and dental treatment. The final version of the questionnaire was based on a collaborative effort between researchers at Cork University Dental School and Hospital and Cystic Fibrosis (CF) patient advocates from CF Ireland. Participants were recruited via CF Ireland’s mailing list and social media channels. The responses underwent descriptive statistical analysis and inductive thematic analysis. Results: A total of 71 people (33 Male: 38 Female) over the age of 18 living with CF in the Republic of Ireland responded to the survey. 54.9% of respondents were unhappy with their teeth. 63.4% felt that CF had an impact on oral health. 33.8% were anxious about attending their dentist. Respondents believed that CF has impacted on their oral health due to the medications and dietary requirements involved, as well as tiredness and other side effects of CF. Reasons for being anxious about attending the dentist included cross infection concerns, issues with the dentist, with tolerating treatment, and with the teeth themselves. Respondents wanted dentists to be aware of the practicalities of dental treatment for people with CF, especially their discomfort with lying back. They also want the dentist to be aware of the impact that their medication, treatment and diet has on their oral health. Conclusions: Over one third of adults with CF reported anxiety about attending the dentist. Reasons for this included fear, embarrassment, cross infection concerns and problems with treatment, especially being in the supine position. Adults with CF want dentists to be aware of the impact that CF can have upon dental treatment and oral health care.