Concurrent validity of the short-form Family Impact Scale (FIS-8) in 4-year-old US children.

BACKGROUND: US data on the validity and reliability of the short-form Family Impact Scale (FIS-8; a scale for measuring the impact of a child's oral condition on his/her family) are lacking. METHODS: Cross-sectional analysis of data on four-year-old US children taking part in a multi-center cohort study. For child-caregiver dyads recruited at child age 12 months, the impact of the child's oral condition on the family was assessed at age 48 months using the FIS-8, with a subsample of 422 caregivers (from 686 who were approached). Internal consistency reliability was assessed using Cronbach's α, with concurrent validity assessed against a global family impact item ("How much are your family's daily lives affected by your child's teeth, lips, jaws or mouth?") and a global oral health item ("How would you describe the health of your child's teeth and mouth?"). RESULTS: Cronbach's alpha was 0.83. Although gradients in mean scores across ordinal response categories of the global family impact item were inconsistent, there were marked, consistent gradients across the ordinal categories of the global item on the child's oral health, with scores highest for those rating their child's oral health as 'Poor'. CONCLUSIONS: While the findings provide some evidence for the utility of the FIS in a US child sample, the study's replication in samples of preschoolers with greater disease experience would be useful.

Caries-preventive efficacy of a supervised school toothbrushing programme in Northland, New Zealand.

BACKGROUND: Toothbrushing with fluoride toothpaste reduces the incidence of dental caries. OBJECTIVE: To evaluate a supervised school toothbrushing programme to reduce dental caries experience in children. BASIC RESEARCH DESIGN: Quasi-experimental study. All children had routine dental examinations at baseline using the ICDAS to record dental caries, along with bitewing radiographs. Half of the children were involved in a supervised toothbrushing programme. Examinations were repeated at the end of the school year. CLINICAL SETTING: Northland, New Zealand. PARTICIPANTS: 335 10-13-year-old New Zealand children with high caries experience. INTERVENTIONS: Half of the children participated in the supervised toothbrushing session each school day; the other half had no intervention. MAIN OUTCOME MEASURES: Caries increment, determined by comparing the baseline and follow-up status of each tooth surface. RESULTS: At baseline, there were 335 children, of whom 240 (71.6%) were followed up. The ICDAS net caries increment for those in the toothbrushing group was a mean of 11.7 surfaces improved; the control group had a mean of 8.6 surfaces which had deteriorated. Caries incidence for those in the toothbrushing group was 7.3%; that for the control group was 71.5%. Multivariate analysis showed that membership of the brushing group was the only statistically significant predictor of a lower net caries increment. CONCLUSION: A supervised school toothbrushing programme can reduce caries increment in a population experiencing high levels of dental disease.

The effect of bitewing radiography on estimates of dental caries experience among children differs according to their disease experience.

BACKGROUND: Radiography is a regularly used and accepted adjunct to visual examination in the diagnosis of dental caries. It is assumed that not using radiographs can lead to underestimation of dental caries experience with most reports having involved studies of young adults or adolescents, and been focused on the permanent dentition. The aim of this study was to determine the relative contributions of bitewing radiography and clinical examination in the detection of dental caries in primary molars and to determine whether those contributions differ according to caries experience. METHODS: A cross-sectional study was conducted, involving examinations undertaken in dental clinics. Bitewing radiographs taken at the time of the clinical examination were developed and read later, with the data from those used at the analysis stage to adjust the caries diagnosis for the mesial, occlusal and distal surfaces of the primary molar teeth. Children's clinically determined dmfs score was used to allocate them to one of three caries experience groups (0 dmfs, 1-8 dmfs, or 9+ dmfs). RESULTS: Of the 501 three-to-eight-year-old children examined, nearly three-quarters were younger than six. Caries prevalence and mean dmfs after clinical examination alone and following radiographs were 63.1% and 4.6 (sd, 6.2), and 74.7% and 5.8 (sd, 6.5) respectively. Among children with a dmfs of 1-8, the number of lesions missed during the clinical examination was greater than the number of 106 (25.6%) in children with a dmfs of 9+. In the 185 children with no apparent caries at clinical examination, 124 lesions were detected radiographically, among 58 (46.8%) of those. CONCLUSIONS: Taking bitewing radiographs in young children is not without challenges or risks, and it must be undertaken with these in mind. Diagnostic yields from bitewing radiographs are greater for children with greater caries experience. The findings of this study further support the need to consider using bitewing radiographs in young children to enhance the management of lesions not detected by a simple visual examination alone. TRIAL REGISTRATION: ACTRN12614000844640 .

Composite reflective/absorptive IR-blocking filters embedded in metamaterial antireflection-coated silicon.

Infrared (IR)-blocking filters are crucial for controlling the radiative loading on cryogenic systems and for optimizing the sensitivity of bolometric detectors in the far-IR. We present a new IR filter approach based on a combination of patterned frequency-selective structures on silicon and a thin (25-75 µm thick) absorptive composite based on powdered reststrahlen absorbing materials. For a 300 K blackbody, this combination reflects ∼50% of the incoming light and blocks >99.8% of the total power with negligible thermal gradients and excellent low-frequency transmission. This allows a reduction in the IR thermal loading to negligible levels in a single cold filter. These composite filters are fabricated on silicon substrates, which provide excellent thermal transport laterally through the filter and ensure that the entire area of the absorptive filter stays near the bath temperature. A metamaterial antireflection coating cut into these substrates reduces in-band reflections to below 1%, and the in-band absorption of the powder mix is below 1% for signal bands below 750 GHz. This type of filter can be directly incorporated into silicon refractive optical elements.

Self-report of temporomandibular joint clicking and psychological factors: is there an association?

The objectives of this study were to test the hypothesis that self-reported TMJ clicking sounds in adolescents are positively associated with non-specific somatic symptoms, self-perception of body image and care-seeking behaviour. A cross-sectional study was carried out in 353 young adolescents (48·4% females) recruited from community (N = 272) and orthodontic clinic (N = 81) settings. Assessments included self-reported TMJ clicking, non-specific physical symptoms, body image concerns and for the clinic sample only, the source of motivation for treatment. TMJ sounds were self-reported by 19% of the sample and were associated with higher scores for non-specific physical symptoms and body image concerns (P < 0·001). Adolescents who were self-motivated to seek orthodontic treatment had greater scores for non-specific physical symptoms, more body image concerns and tended to report TMJ sounds more often (26·3% and 7·7% respectively; P = 0·41) than those who were solely parent/family-motivated to seek treatment. Self-reported TMJ sounds in adolescents were associated with a propensity to somatisation and concerns with body image. Care-seeking adolescents have greater non-specific physical symptoms and body image concerns and tend to report more frequent TMJ sounds.

Overcoming structural inequalities in oral health: the role of dental curricula.

To date the role of health professional schools in addressing oral health inequalities have been minimal, as attempts have focused principally upon systemic reform and broader societal obligations. Professionalism is a broad competency that is taught throughout dental schools and encompasses a range of attributes. Professionalism as a competency draws some debate and appears to be a shifting phenomenon. We may ask if professionalism in the dental curricula may be better addressed by social accountability? Social accountability directs oral health professional curricula (education, research, and service activities) towards addressing the priority health concerns of the community, in our case oral health inequalities. Although working toward dental schools becoming more socially accountable seems like a sensible way to address oral health inequalities, it might have limitations. We will consider some of the challenges in the dental curricula by considering some of the political, structural, social and ethical factors that influence our institutions and our graduates.

Validity of self-reported periodontal questions in a New Zealand cohort.

OBJECTIVE: This study aims to assess the validity of four self-reported questions for measuring periodontitis in a birth cohort. METHODS: Full-mouth periodontal examinations (three sites/tooth) were undertaken at age 38 in a complete birth cohort born in 1972/1973 in New Zealand. Four self-reported periodontal screening questions were included ("Do you think you have gum disease"; "Has a dental professional ever told you that you have lost bone around your teeth"; "Have you ever had scaling, root planing, surgery, or other treatment for gum disease" and "Have you ever had any teeth that have become loose by themselves without some injury"), and the sensitivity and specificity of those self-reported items were calculated for individual questions and using a multivariable binary logistic regression model. Generalised linear models were used to compare relative risks for periodontitis and smoking, using the (a) clinical measures and (b) self-reported questions. RESULTS: Among the 895 who had periodontal examinations, the prevalence of periodontitis was 43.7, 22.8 and 12.0 %, respectively, for one or more sites with ≥4, ≥5 and ≥6 mm clinical attachment loss (AL). The specificity of the four self-reported questions was high (82-94 %), but the sensitivity was low for all, except the question: "Do you think you have gum disease". The four questions' highest combined sensitivity + specificity value was 1.33 for one or more sites with ≥4 mm AL, with the area under the receiver operating characteristic (ROC) curve being greatest for one or more sites with ≥6 mm AL, at 0.84. For the smoking-periodontitis association, the estimates of relative risk for periodontitis among smokers were as follows: (a) 1.81, 2.88 and 5.79, respectively, clinically determined to have one or more sites with ≥4, ≥5 and ≥6 mm AL and (b) 2.19, 2.17, 1.23 and 1.89, respectively, for the four self-reported questions. CONCLUSION: The four self-reported periodontal screening questions performed adequately in identifying clinically determined periodontal disease, and they showed moderate validity when used together as a set. However, the strength of the association between smoking and periodontitis was underestimated when they were used instead of clinically determined periodontal disease. CLINICAL RELEVANCE: These findings suggest that clinical examinations remain to be the desired approach for periodontal surveys, but where resource constraints preclude those, self-reported methods can provide useful information; after all, some periodontal information is better than none at all.

Changes in students' perceptions of their dental education environment.

OBJECTIVES: To examine the 'Expected' and 'Actual' educational environment experienced by a cohort of Bachelor of Dental Surgery (BDS) students at the University of Otago's Faculty of Dentistry using the Dundee Ready Educational Environment Measure (DREEM). METHODS: Cohort members were asked to complete five DREEM surveys over the four-year BDS programme. Student expectations at the beginning of their first year were assessed using a modified version of the DREEM questionnaire, while following (standard) DREEM questionnaires at the end of each professional year addressed students' 'Actual' perception of the educational environment. RESULTS: Sixty-six students (99%) completed at least one questionnaire. Overall, the BDS students' perceptions of their educational environment tended to be positive and students identified both perceived strengths and weaknesses in the BDS programme. However, more negative than positive shifts were reported between the 'Expected' and 'Actual' individual DREEM individual items, suggesting that BDS students initially expected more from their educational environment than they actually experienced. Individual DREEM outcomes undergoing negative and positive shifts differed over the years and varied in number. These may be explained, in part, by changes in the curriculum focus from year to year. CONCLUSION: The students' changing DREEM responses over time revealed anticipated and perceived strengths and weaknesses of the BDS curriculum, as well as shifts in students' perceptions in response to curricular changes. However, our findings highlight the potential usefulness for dental education of a measure for use that takes the unique aspects of the dental education environment into account.

The Simons Observatory: Cryogenic half wave plate rotation mechanism for the small aperture telescopes.

We present the requirements, design, and evaluation of the cryogenic continuously rotating half-wave plate (CHWP) for the Simons Observatory (SO). SO is a cosmic microwave background polarization experiment at Parque Astronómico de Atacama in northern Chile that covers a wide range of angular scales using both small (⌀0.42 m) and large (⌀6 m) aperture telescopes. In particular, the small aperture telescopes (SATs) focus on large angular scales for primordial B-mode polarization. To this end, the SATs employ a CHWP to modulate the polarization of the incident light at 8 Hz, suppressing atmospheric 1/f noise and mitigating systematic uncertainties that would otherwise arise due to the differential response of detectors sensitive to orthogonal polarizations. The CHWP consists of a 505 mm diameter achromatic sapphire HWP and a cryogenic rotation mechanism, both of which are cooled down to ∼50 K to reduce detector thermal loading. Under normal operation, the HWP is suspended by a superconducting magnetic bearing and rotates with a constant 2 Hz frequency, controlled by an electromagnetic synchronous motor. We find that the number of superconductors and the number of magnets that make up the superconducting magnetic bearing are important design parameters, especially for the rotation mechanism's vibration performance. The rotation angle is detected through an angular encoder with a noise level of 0.07 µrad s. During a cooldown process, the rotor is held in place by a grip-and-release mechanism that serves as both an alignment device and a thermal path. In this paper, we provide an overview of the SO SAT CHWP: its requirements, hardware design, and laboratory performance.

Antecedents and associations of root surface caries experience among 38-year-olds.

OBJECTIVE: To determine whether coronal caries experience through to the 30s predicts root surface caries experience by age 38. METHOD: Prospective study of a complete birth cohort (n = 1,037) born in 1972/73 in Dunedin, New Zealand. Dental examinations were conducted at ages 5, 9, 15, 18, 26, 32 and 38. Root surface caries data were first collected at age 38. Data from ages 5 through 32 were used previously to identify low, medium and high life course trajectories of caries experience and plaque accumulation. RESULTS: Of the 916 dentate individuals examined at age 38, 23.0% had 1+ root DFS, 17.2% had 1+ root DS and 11.4% had 1+ root FS. The mean root DS, FS and DFS were 0.6 (SD 3.5), 0.3 (SD 1.1) and 0.9 (SD 3.8), respectively. The mean Root Caries Index (RCI) score was 7.2% (SD 18.0). Age 38 coronal DMFS and root surface caries DFS were only weakly correlated (r = 0.32), but root surface caries experience was strongly associated with coronal caries trajectory, with the mean RCI in the low, medium and high caries trajectory groups being 4.4, 8.0 and 13.5%, respectively (p < 0.0001); their prevalence of 1+ root DFS was 14.5, 25.9 and 42.2% (p < 0.0001). Those in the high coronal caries trajectory were more likely to have 1+ root surface DFS (odds ratio = 3.83; 95% CI = 2.33-6.30); for the medium trajectory, the odds ratio was 1.86 (95% CI = 1.25-2.75). CONCLUSION: Lifelong coronal caries experience (represented by discrete longitudinal trajectories of caries experience) is indeed a risk factor for root surface caries experience by age 38.

Impact of malocclusion on quality of life among New Zealand adolescents.

OBJECTIVES: To determine whether malocclusion is associated with oral-health-related quality of life (OHRQoL) in New Zealand adolescents. METHODS: Data from two cross-sectional epidemiological studies of adolescents in Taranaki and Otago were used. Each participant completed a self-administered questionnaire and underwent a clinical examination. Information collected included sociodemographic characteristics (sex, ethnicity and household deprivation), and clinical measures (caries and malocclusion, the latter measured with the Dental Aesthetic Index, or DAI). OHRQoL was measured using the validated 16-item impact short-form Child Perceptions Questionnaire (CPQ11-14). Linear regression was used to model the CPQ11-14 score. RESULTS: 783 adolescents (52.6% male) took part. One-fifth had a handicapping malocclusion and one-third had a minor malocclusion or none. The overall mean DMFS was 2.3 (SD, 3.8), with slightly more than 50% being caries-free. With the exception of the oral symptoms domain, females presented with higher mean CPQ11-14 and domain scores, while Mãori had lower scores. There was a distinct gradient in mean CPQ11-14 and domain scores across the categories of malocclusion severity, whereby those in the 'handicapping' category of the DAI had the highest CPQ11-14 score. Linear regression modeling of the CPQ11-14 score showed that, after controlling for DMFS and socio-demographic characteristics, malocclusion category and being female were positively associated with higher CPQ11-14 scores. CONCLUSION: A severe malocclusion appears to have a negative impact on the OHRQoL of New Zealand adolescents.

Changes in Bachelor of Oral Health students' perceptions of their dental education environment.

This study used the Dundee Ready Educational Environment Measure (DREEM) to examine how a cohort of Bachelor of Oral Health (BOH) students at the University of Otago's Faculty of Dentistry perceived their educational environment. Four DREEM questionnaires were administered over the three-year programme; a modified version at the beginning of the first year asked students what they expected their year would be like, while questionnaires at the end of each subsequent year surveyed students on their actual experiences within the BOH programme. All four questionnaires were completed by 78% of students (N=31). Overall, the students' perceptions of their educational environment were more positive than negative, and they identified both strengths and weaknesses in the BOH programme. Both positive and negative shifts occurred between the 'Expected' and 'Actual' individual DREEM outcomes. The difference between students' 'Expected' and 'Actual' DREEM responses indicates, in some areas, that BOH students expected more from their educational environment than what they actually experienced. The changes in BOH students' perception of their educational environment over the three years can be explained, in part, by changes in the curriculum from year to year.

Second and third year oral health and dental student perceptions of future professional work.

OBJECTIVES: To explore and compare the ways dental and oral health students characterise their future professional work (FPW) at the end of their second and third professional years. MATERIALS AND METHODS: Questionnaires were given to a cohort group of 48 dental students and 31 oral health students at the end of their second and third professional years at the University of Otago. Students' characterisations of their FPW were identified using an inductive approach, and the emphasis on each characterisation was confirmed using a 'weighted' table. RESULTS: Dental student response rates were 92% (in 2010) and 85% (in 2011); and oral health student response rates were 100% (in 2011) and 97% (in 2011). Students characterised their FPW in ten broad ways: in reference to treatment-related concerns, patient-related concerns, oral health promotion, oral health education, disease prevention and monitoring, communication, teamwork, maintaining an ideal clinical environment, maintaining a sense of self and improving quality of life. In both years, dental students emphasised treatment-related concerns as central to their FPW and dealing with patient-related concerns as a primary source of difficulty. Oral health students emphasised oral health promotion, oral health education, disease prevention and monitoring and restorative tasks as central to their FPW and dealing with patient-related concerns as a primary source of difficulty. CONCLUSION: Students' broad perceptions of their FPW changed little as they progressed through their programmes; however, their responses suggested the need for greater attention within their programmes to patient management and teamwork.

Oral Health Status of New Zealand Defence Force Recruits.

INTRODUCTION: The demands of operational deployment mean that defense force personnel must be dentally fit. Although medical evacuation for dental causes should be avoided, dental emergencies are a major non-combat-related contributor to withdrawal from deployment. Information on the oral health status of recruits and officer cadets entering the New Zealand Defence Force (NZDF) is scarce, yet it is useful for service and workforce planning. We investigated oral health status and its associations in new recruits and officer cadets entering the NZDF over a 13-month period. MATERIALS AND METHODS: This study used data from recruits' initial dental examination (including baseline forensic charting), posterior bitewing radiographs, orthopantomograph radiograph, and a socio-dental questionnaire. The impaction status of third molar teeth was evaluated. Ethical approval was obtained from the University of Otago Ethics Committee (reference number D18/200) and the NZDF Organisational Research Committee. RESULTS: Of the 874 (83%) of the 1,053 recruits (age range 17-59 years) who participated, one in five were Maori. Nearly two-thirds were Army recruits. Caries prevalence was almost 70%. Mean Decayed, Missing, and Filled Teeth (DMFT) (3.0 overall) was higher among females and Maori. Few teeth were missing due to caries. Third molars were common, seen in 745 (88.3%). One in four maxillary third molars (but only one in six mandibular ones) had fully erupted. The most common type of impaction among mandibular third molars was the mesioangular type, followed by vertical, horizontal, and distoangular. Almost 60% of recruits had one or more potentially problematic third molars. The prevalence was highest in the youngest age groups, those of medium or low socioeconomic status and in Army or Navy recruits. CONCLUSIONS: Recruits' oral health was acceptable, but potentially problematic third molars were common, indicating a need for careful assessment (and their possible removal) before operational deployment.

Appraisal of the Dundee Ready Educational Environment Measure in the New Zealand dental educational environment.

AIMS: To examine the reliability and validity of the Dundee Ready Educational Environment Measure (DREEM) amongst New Zealand students in the first professional year of the Bachelor of Dental Surgery (BDS) and Bachelor of Oral Health (BOH) programmes. METHOD: In 2009 and 2010, students' perceptions of the educational environment were evaluated using a modified version of the 50-item DREEM, completed on the first and last day of their first professional year. Individual DREEM items' strengths and weaknesses were identified. The difference or dissonance between students' expectations and actual experience was determined by subtracting the Actual DREEM score (for each item or subscale) from the Expected DREEM score. Effect-size statistics were calculated, and internal consistency was tested using Cronbach's alpha. RESULTS: Overall, 82% of 2009 and 2010 BDS and BOH students in their first professional year completed the Expected and Actual DREEM (N = 176). Both groups identified the 'overemphasis of factual learning' as an Expected and Actual aspect and 'memorising all I need to know' as an Actual aspect of the educational environment. Internal consistency was high for the overall DREEM and the BDS and BOH Expected DREEM (0.89 and 0.88, respectively) and excellent for both the BDS and BOH Actual DREEM (0.92 and 0.90, respectively). CONCLUSION: Overall, students entering the courses anticipated a number of strengths and weaknesses and those expectations were relatively similar in the different programmes (BDS and BOH). The DREEM showed excellent internal consistency for the overall scores, and that for the subscale scores was generally acceptable. The study confirms the DREEM's utility for the NZ dental education environment.

Self-reported oral health, dental self-care and dental service use among New Zealand secondary school students: findings from the Youth 07 study.

AIM: The primary aim was to describe New Zealand secondary school students' use of dental services and determine the nature and extent of any inequities by deprivation status and ethnicity. A secondary aim was to to describe their toothbrushing practices and self-reported dental pain experience, past restorative treatment and tooth loss. METHOD: Secondary analysis of data from the cross-sectional Youth 07: National Survey of the Health and Wellbeing of New Zealand Secondary School Students. A representative sample of 9,098 secondary school students aged 13-17 years from 96 secondary schools across New Zealand took part, with a response rate of 73%. Self-report information about oral health care behaviour, past dental experiences and dental visiting pattern was collected. Data analysis took the complex survey design into account, and multivariate analysis was undertaken to examine the associations of dental service-use. RESULTS: A dental visit in the previous 12 months was reported by 72% of participants. The odds of having done so were higher among females, those who brushed at least twice daily, and those who had been kept awake at night by dental pain. Lower odds were seen among students identifying with Maori, Pacific or Asian people (and those in the 'Other' ethnic category) than among European students, and among those residing in medium- or high-deprivation areas than those in lo-deprivation areas. One in seven participants reported having lost a tooth due to oral disease. Having had a tooth filled was reported by almost three-quarters of the sample, and having been kept awake by dental pain at night was reported by just over one in five. Almost two-thirds reported brushing their teeth twice or more in the previous 24 hours, and a small minority had not brushed at all. CONCLUSION: Ethnic and socio-economic inequities in the use of dental services are apparent among New Zealand adolescents.

A Primary Care Randomized Controlled Trial of Hall and Conventional Restorative Techniques.

OBJECTIVES: To investigate treatment outcomes of different restorative techniques undertaken by dental therapists for primary molar carious lesions in a sample of children in New Zealand primary care. METHODS: This was a randomized controlled trial with children aged 3 to 8 y in New Zealand's Whanganui region. Children meeting inclusion criteria were randomly allocated to treatment with either the Hall technique (HT), in which a stainless-steel crown (SSC) is placed without any carious tissue removal or tooth preparation, or a non-Hall conventional restorative approach (NHT), including tooth preparation with selective carious tissue removal; this included SSC, amalgam, composite, or glass ionomer cement (GIC) restorations. Restorative outcomes after 12 and 24 mo were categorized as success, minor failure, or major failure. RESULTS: Of the 295 eligible children, 149 and 146 were allocated to the HT and NHT groups, respectively, with a total of 570 carious primary molars treated by 13 dental therapists. The participant follow-up rates at 12 and 24 mo were 95% and 91%. SSCs were the most commonly used restoration in the NHT group (60%), followed by GIC (28%). SSCs were the most successful restorations regardless of whether they were placed with the HT or NHT, with success rates of 89% and 92% at 12 mo and 85% and 86% at 24 mo. In the NHT group, the treatment material was a predictor of minor failure at 12 and 24 mo, with significantly more failures with GICs. CONCLUSIONS: SSCs placed by dental therapists are a highly successful restoration for the primary dentition, regardless of whether they are placed with the HT or conventionally. The high failure rate of glass ionomer restorations means that they cannot be recommended for widespread use in New Zealand primary care (Australian New Zealand Clinical Trials Registry, ACTRN12614000844640). KNOWLEDGE TRANSFER STATEMENT: The findings of this study can be used by policy makers and clinicians when deciding on which materials and which approach to use to maximize success and to minimize retreatment rates when providing restorative treatment for carious primary molars in children's primary oral health care. Results also suggest that undertaking research in the primary care setting may enhance translation of new knowledge and techniques into clinicians' hands.

The impact of climate change on mental health (but will mental health be discussed at Copenhagen?).

Climate change will shortly be assuming centre stage when Copenhagen hosts the United Nations Climate Change Conference in early December 2009. In Copenhagen, delegates will discuss the international response to climate change (i.e. the ongoing increase in the Earth's average surface temperature) and the meeting is widely viewed as the most important of its kind ever held (http://en.cop15.dk/). International agreement will be sought on a treaty to replace the 1997 Kyoto Protocol. At the time of writing it is not known whether agreement will be reached on the main issues of reducing greenhouse gas emissions and financing the impacts of climate change, and it appears that the impact of climate change on mental health is unlikely to be on the agenda. We discuss here how climate change could have consequences for global mental health and consider the implications for future research and policy.

Dental trauma experience and oral-health-related quality of life among university students.

BACKGROUND: This study aimed to investigate the impact of self-reported dental trauma on oral-heath-related quality of life (OHRQoL) of young adults and determine whether personality characteristics influenced how it was reported. METHOD: A cross-sectional study was carried out using a sample of 435 university students. A questionnaire sought data on previous dental trauma. OHRQoL was assessed using the short-form of the oral health impact profile (OHIP-14); the outcome being one or more impacts occurring 'fairly often'/'very often'. Personality was assessed using the Positive and Negative Affect Scale (PANAS). RESULTS: The participation rate was 87.2%. Dental trauma experience was reported by 110 participants (25.3%), and 242 (55.6 %) indicated previous dental caries experience. Among those with dental trauma history, one or more OHIP-14 impacts was reported by 29.1% (with 21.2% among those with no history). Impact prevalence was higher among those who had previous dental caries experience (29.8%) than among those who had not (14.7%; P < 0.001). Higher PANAS negative affect scores were observed among those reporting one or more OHIP-14 impacts (P < 0.001). CONCLUSION: While dental trauma does not appear to have a negative impact on OHRQoL in young adults, past dental caries experience does. Negative emotionality influences self-reported oral health.