Evaluating denture cleanliness of patients in a regional dental hospital.

Aims To evaluate the quality of clinical record keeping and determine quality of denture cleanliness; record baseline denture cleanliness for 60 patients; introduce denture hygiene instruction (DHI); and then re-assess the patients for improvement and enhanced record keeping.Methods Analysis of patients' denture hygiene instruction record keeping (n = 60) was undertaken retrospectively. The Denture Cleanliness Index (DCI) was utilised to assess denture cleanliness (best score 0, worst score 4). Baseline DCI scores were taken and individual DHI was delivered. After one month, patients were reviewed and scored, with record keeping quality analysed.Results At baseline, 11.7% (n = 7) of patients had DCI scores of ≤2, improving to 93.8% (n = 45) after one month, demonstrating short-term improvement in denture cleanliness. Only 63% (n = 38) of patients had evidence of a record of DHI within their notes at baseline, improving to 100% at recall.Conclusions New patient information leaflet and clinical guidelines on denture hygiene have been written and implemented. The results of this study suggest that this may be a relatively straightforward method to achieve a short-term improvement in denture cleanliness. The implementation of a DCI score is helpful in allowing patients to improve denture hygiene and its wider use is supported.

A clinical audit of denture cleanliness in general dental practice undertaken in the West Midlands.

The aims of the study were to develop a method of quantifying denture cleanliness and evaluate the quality of clinical record keeping; record baseline denture cleanliness for 30 patients; introduce denture hygiene instruction (DHI); and then re-assess the patients for improvement and enhanced record keeping. A retrospective analysis of denture hygiene instruction record keeping was undertaken (n = 30). A bespoke denture cleanliness index (DCI) was developed for assessing denture cleanliness (best score 0, worst score 4). Baseline DCI scores were taken and individual DHI was delivered. Patients were reviewed and scored after 1 month, together with a further analysis of record keeping. At baseline, 16% (n = 5) of patients had DCI scores of ≤2, improving to 90% (n = 27) after 1 month, demonstrating short term improvement in denture cleanliness. Only 20% (n = 6) of patients had evidence of a record of DHI within their notes at baseline, improving to 100% at recall. The bespoke denture cleanliness index (DCI) worked well as a simple objective clinical measurement and patient education tool. Provision of tailored DHI resulted in the general improvement of denture cleanliness after 1 month. The authors recommend that where denture hygiene has been issued, this should be recorded in the records as 'DHI' within the clinical notes, in a manner analogous to the recording of oral hygiene.

A hinged two-part partial denture used in conjunction with severely tilted teeth: a case report.

A two-part sectional denture can be a useful treatment option when the presence of severe hard tissue undercuts compromises the provision of a satisfactory conventional prosthesis. This article presents a case report illustrating the effective use of a hinged two-part denture in restoring a mandibular Kennedy Class IV edentulous area. A sectional denture approach was selected because of severe proximal and lingual undercuts.

Thermal effects of the Er:YAG laser on a simulated dental pulp: a quantitative evaluation of the effects of a water spray.

OBJECTIVES: To quantify the temperature increments in a simulated dental pulp following irradiation with an Er:YAG laser, and to compare those increments when the laser is applied with and without water spray. METHODS: Two cavities were prepared on either the buccal or lingual aspect of sound extracted teeth using the laser. One cavity was prepared with water spray, the other without and the order of preparation randomised. Identical preparation parameters were used for both cavities. Temperature increments were measured in the pulp chamber using a calibrated thermocouple and a novel pulp simulant. RESULTS: Maximum increments were 4.0 degrees C (water) and 24.7 degrees C (no water). Water was shown to be highly significant in reducing the overall temperature increments in all cases (p<0.001; paired t-test). None of the samples prepared up to a maximum of 135 J cumulative energy prepared with water spray exceeded that threshold at which pulpal damage can be considered to occur. Only 25% of those prepared without water spray remained below this threshold. DISCUSSION: Extrapolation of the figures suggests probably tolerable limits of continuous laser irradiation with water in excess to 160 J. With the incorporation of small breaks in the continuity of laser irradiation that occur in the in vivo situation, the cumulative energy dose tolerated by the pulp should far exceed these figures. CONCLUSIONS: The Er:YAG laser must be used in conjunction with water during cavity preparation. As such it should be considered as an effective tool for clinical use based on predicted pulpal responses to thermal stimuli.

Occlusal caries detection in primary teeth: a comparison of DIAGNOdent with conventional methods.

OBJECTIVE: To compare the accuracy and repeatability of three diagnostic systems (DIAGNOdent, visual and radiographic) for occlusal caries diagnosis in primary molars. DESIGN: Two examiner, in vitro, blinded study. Histological gold standard. MATERIALS AND METHODS: 58 occlusal surfaces of primary molars examined in turn by two examiners using each of three diagnostic systems (DIAGNOdent, visual and radiographic). These results were compared with a histological gold standard. Sensitivity and specificity were calculated for each diagnostic system at a range of thresholds. Inter- and intra- examiner repeatability were calculated for each diagnostic system using the kappa statistic. MAIN OUTCOME MEASURES: Sensitivity, specificity, inter and intra examiner repeatability for each diagnostic system. RESULTS: The highest sensitivity values were provided by DIAGNOdent (0.77 and 0.80, examiners 1 and 2 respectively) however this was offset by a lower specificity (0.82 and 0.85) than all other systems with the exception of examiner 1 at V1 visual threshold. The DIAGNOdent gave the highest values of kappa for intra- and inter-examiner repeatability with the exception of intra-examiner repeatability for examiner 2 where visual diagnosis had the highest value of kappa. CONCLUSION: The DIAGNOdent was the most accurate system tested for the detection of occlusal dentine caries in primary molars. The performance of the DIAGNOdent systems was not statistically significantly better than that achieved using visual examination for non-cavitated teeth (V1 and V2 threshold). DIAGNOdent may prove useful as a predictive clinical tool, however with appropriate training visual examination may offer similar results without the need for additional equipment.