Children's dental anxiety in the United Kingdom in 2003.

BACKGROUND: The prevalence of dental anxiety among a representative sample of children in the UK was determined in the Children's Dental Health survey of 2003. AIMS: This paper is concerned with the extent to which children in the United Kingdom are judged by a parent or carer to be behaviourally affected by dental anxiety and the factors associated with this. METHOD: The information was gathered by self-completion questionnaire distributed to the parents of half of the sample of children who were also clinically examined in the dental survey. RESULTS: Dental anxiety that was sufficient to disrupt dental attendance was reported for around 3-4% of the four age groups surveyed (5, 8, 12 and 15 years of age). Children's dental anxiety was associated with parental dental anxiety; a greater experience of invasive dental treatment and general anaesthetic; receipt of free school meals and social class. CONCLUSIONS: Whilst these findings do not necessarily indicate causal relationships, they do confirm a number of co-factors associated with dental anxiety perhaps most importantly that of anxiety with the experience of general anaesthetic for tooth extractions.

Effect of a 1-month vs. a 12-month reference period on responses to the 14-item Oral Health Impact Profile.

The length of the reference period used in surveys of subjective oral health may have a marked influence on the responses obtained. We aimed to evaluate the effect of a 1-month (RP-1) vs. a 12-month (RP-12) reference period in the Oral Health Impact Profile (OHIP-14) questionnaire. Using a randomized cross-over design, RP-1 and RP-12 OHIP-14 questionnaires were administered, 1 month apart, to two samples of Finnish adults, namely people awaiting orthognathic surgery (n = 104) and non-patient workers (n = 111). The effect of the reference period was computed by subtracting RP-1 OHIP-14 severity scores from RP-12 OHIP-14 severity scores (DeltaRP). Potential order effects were assessed by comparing DeltaRP between groups completing the RP-1 vs. the RP-12 questionnaire first. Mean OHIP-14 severity scores were slightly higher when the RP-12 questionnaire was administered first, but mean DeltaRP values were below the value of 2.5 considered clinically meaningful, and all 95% confidence intervals for DeltaRP included zero. No order effects in the OHIP-14 severity scores were observed. Therefore, although a standardized reference period of 12 months is recommended, in population surveys the use of a shorter reference period does not appear to influence responses.

Patients' experiences with partial dentures: a qualitative study.

OBJECTIVE: The aim of the study was to gain insight into people's experiences of being given and using partial dentures. METHODS: In-depth semi-structured interviews were carried out with 23 people of varied age, social background and denture wearing experience in Tayside, Scotland. Participants were encouraged to discuss how they came to have partial dentures, their day-to-day denture use and their interactions with dentists. The interview data were systematically coded using key theme headings, and summary charts were constructed to facilitate analysis. RESULTS: The initial decision that a partial denture was needed was generally difficult to accept. People perceived the main benefits of partial dentures to be improved appearance and confidence, but experienced a variety of difficulties with their dentures and often coped with these by only wearing them on social occasions. Participants had not always told their dentists about the difficulties they experienced. Barriers to seeking help with denture problems included financial constraints, previous experience of rushed appointments or poor communication from dentists and a perceived lack of entitlement to help when partial dentures were issued free. CONCLUSIONS: Partial dentures can be difficult to cope with. People experience a range of difficulties in wearing them, not all of which have been discussed with dentists. Informative and supportive communication when partial dentures are first needed, and subsequently, can improve the quality of patients' experiences and may help promote effective use and appropriate help-seeking by partial denture wearers.

Can dental epidemiological information be gathered during routine dental examinations by general dental practitioners?

OBJECTIVE: To assess the feasibility of gathering dental epidemiological information by General Dental Practitioners during routine dental examinations. DESIGN AND SAMPLE: Ten General Dental Practitioners (GDPs) and five Community Dental Officers (previously trained as dental examiners for epidemiological purposes) performed dental examinations of the same 10 volunteer adult patients in order to record decayed, missing and filled teeth. RESULTS: Agreement assessed by the kappa statistic showed that both the previously trained dental examiners and the GDPs assessed tooth conditions other than tooth decay consistently. Furthermore, all of the GDPs were within the range of findings of the previously trained dental examiners for missing teeth and total DMFT score. Eight of the 10 GDPs were within the range of findings for the previously trained dental examiners' assessments of which teeth were filled and seven were within the range for decayed teeth. However, the previously trained dental examiners were more consistent in classifying teeth as decayed than the GDPs. CONCLUSION: Obtaining adult oral health data during elective dental consultations in General Dental Practice as a means to gather dental epidemiological information for adults is feasible.

How do age and tooth loss affect oral health impacts and quality of life? A study comparing two national samples.

Age and loss of teeth can be expected to have a complex relationship with oral health-related quality of life. This study aimed to explain how age and tooth loss affect the impact of oral health on daily living using the short form, 14-item Oral Health Impact Profile (OHIP-14) on national population samples of dentate adults from the UK (1998 UK Adult Dental Health Survey) and Australia (1999 National Dental Telephone Interview Survey). After correcting for key covariables, increasing age was associated with better mean impact scores in both populations. Those aged 30-49 years in Australia showed the worst (highest) scores. In the UK, those aged under 30 showed the highest scores. In both countries, adults aged 70+ showed much better scores than the rest (P < 0.001). When corrected for age, the independent effect of tooth loss was that the worst scores were found where there were fewer than 17 natural teeth in the UK and fewer than 21 teeth in Australia. People with 25 or more teeth averaged much better scores than all other groups (P < 0.001), although there were differences in pattern between countries. When Australians were analysed by region of birth, the pattern of scores by tooth loss for British/Irish immigrants was strikingly similar to that for the UK sample. First-generation immigrants from elsewhere showed much worse overall scores and a profoundly different pattern to the Australian- and British-born groups. Age, number of teeth and cultural background are important variables influencing oral health-related quality of life.

Predicting the experience of dentinal caries or restorative dental treatment in adolescents using D1 and D3 visual caries assessments.

Standardised epidemiological caries assessments used in oral health surveys have been shown to be poor at predicting whether a tooth surface will be treated restoratively when a patient visits a dentist. However, it has been argued that oral health surveys may be more relevant in determining needs at the level of an individual or groups of individuals. The objective of this study was to determine the discriminatory power of visual caries assessments at two thresholds (D1 & D3) in adolescents of average age 12.1 years to predict experience of dentinal caries 3 years later or the experience of restorative treatment (not re-treatment) during the 3-year period. The data was derived from a prospective 3-year longitudinal study in which the dental care provided by 41 dentists for 403 adolescents was monitored. Dental caries experience was monitored by annual standardised assessments of caries undertaken by a single trained examiner. ROC analysis showed that caries assessed visually at the D1 threshold in 12-year-olds was a better predictor (P < 0.001) of experiencing some dentinal caries after 3 years (Az = 0.781) than was caries assessed visually at D3 threshold in 12-year-olds (Az = 0.670). Assessing caries visually at either the D1 or the D3 threshold had no discriminatory power for predicting whether an individual would experience some restorative treatment during the ensuing 3-year period (Az for D1 = 0.507; Az for D3 = 0.518).