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Kettle J, Marshman Z. Powered toothbrushes and toothbrushing resistance in young children: a qualitative content analysis of an online parenting forum. Community Dent Health 2024; 41:60-64. [PMID: 38205813 DOI: 10.1922/cdh_00180kettle05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 11/13/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND Powered toothbrushes are an effective alternative to manual toothbrushes. Previous research found parents view powered toothbrushes as fun and motivating, although are less confident using them when children demonstrate resistant behaviour. Resistant child behaviour is a recognised barrier to achieving parental supervised brushing. Parents discuss strategies to address toothbrushing resistance on online parenting forums. OBJECTIVE To explore how those posting on an online parenting forum discuss powered toothbrushes as a potential solution to toothbrushing resistance in young children. DESIGN Qualitative content analysis of threads retrieved from the UK parenting forum Mumsnet. RESULTS The Mumsnet sub-forums 'Behaviour/Development', 'Parenting' and 'Children's Health' were searched in April 2022. 204 relevant threads on toothbrushing resistance were identified and analysed. A further search of these threads identified posts on powered toothbrushes, yielding a sub-sample of 245 posts from 111 threads (of which 97 focused on resistant behaviour from a child/children aged under three). A coding frame was developed and included six categories: use of powered toothbrushes, descriptions of toothbrushes, positive aspects, reasons for not using, approaches to using, and discussions on Mumsnet. Posters suggested powered toothbrushes as a solution to toothbrushing resistance. Posters use Mumsnet to discuss the appropriateness of powered toothbrushes for young children. CONCLUSIONS Powered toothbrushes offer a potential solution to toothbrushing resistance. Discussions on parenting forums can normalise the use of powered toothbrushes with under-threes. Further research on how parents and dental professionals use and recommend using powered toothbrushes with under-threes would be useful.
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Affiliation(s)
- J Kettle
- School of Clinical Dentistry, University of Sheffield, UK
| | - Z Marshman
- School of Clinical Dentistry, University of Sheffield, UK
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Bird J, Marshman Z, Jones K, Baker SR. The oral health of adults with learning disabilities: A secondary analysis of the Adult Dental Health Survey 2009. Community Dent Health 2024. [PMID: 38373221 DOI: 10.1922/cdh_00251bird06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 12/16/2023] [Indexed: 02/21/2024]
Abstract
OBJECTIVES Adults who have learning disabilities are a vulnerable group, little is known about their oral health and how this affects their quality of life. The aims of this secondary analysis of data from the 2009 Adult Dental Health Survey (ADHS) were to describe the oral health status of adults with learning disabilities, determine if severity of learning disability is associated with oral health and identify some of the methodological complexities of working with this population. The survey yields the most recent representative data on the oral health of adults with learning disabilities in England and importantly, contains information about oral health related quality of life (OHRQoL). BASIC RESEARCH DESIGN Secondary analysis of data from a supplemental survey of adults with learning disabilities collected alongside the 2009 ADHS. PARTICIPANTS 607 participants with a diagnosed learning disability aged 18 years and over. RESULTS Adults with learning disabilities had similar levels of active dental caries, fewer natural teeth, and fewer fillings than comparable participants from the general population. Self-reported oral and general health were worse for adults with learning disabilities than the general population. Possible associations between the severity of learning disability and the numbers of decayed, missing or filled teeth were identified. However, large amounts of missing data limited the analysis. CONCLUSIONS There are important questions relating to the accessibility of existing self-reported oral health questionnaires and the reliability of proxy-reported questions about OHRQoL that should be addressed to give a fuller picture of the oral health of adults with learning disabilities.
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Affiliation(s)
- J Bird
- Community and Special Care Dentistry, Sheffield Teaching Hospitals NHS Foundation Trust, UK
| | - Z Marshman
- School of Clinical Dentistry, University of Sheffield, UK
| | - K Jones
- Office for Health Improvement and Disparities, Department of Health & Social Care, UK
| | - S R Baker
- School of Clinical Dentistry, University of Sheffield, UK
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Dyer TA, Glenny AM, MacDonald L, Marshman Z, Jones K. Effectiveness of strategies to increase participation in school-based epidemiological surveys: a rapid review. Community Dent Health 2023; 40:53-59. [PMID: 36696488 DOI: 10.1922/cdh_00242dyer07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 11/19/2022] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Rapid review of the literature on strategies to increase participation rates in school-based epidemiological surveys. BASIC RESEARCH DESIGN Rapid review. MEDLINE and Embase databases were searched for articles written in English from 2000 onwards. Synthesised evidence and primary research were included as data sources from peer reviewed journals and reports. INTERVENTIONS Any strategy aiming to increase participation in school-based health surveys. The comparator was usual procedure or an alternative strategy to increase participation. MAIN OUTCOME MEASURES Primary outcomes included participation and consent rates. Secondary outcomes were feasibility, acceptability and adverse effects. RESULTS The search identified 591 unique records, of which 587 were excluded. Four studies were suitable for inclusion, including one systematic review, one randomised controlled trial, one cross-sectional study and one retrospective analysis. Based on very low certainty evidence, recommendations for maximising participation rates in one systematic review of US studies included: promoting the survey to school staff, parents and students; disseminating study information using direct rather than mediated methods; offering incentives to schools, staff and participants; following up non-responders; and employing a research team member to co-ordinate and monitor recruitment. However, UK studies found that different strategies did not increase participation more than that achieved by a standard approach (delivery of covering letter/consent forms via the child with no follow-up of non-responders). CONCLUSION Given the lack of evidence of effectiveness of alternative strategies in the UK, additional measures beyond existing standard approaches for active consent cannot be recommended.
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Affiliation(s)
- T A Dyer
- School of Clinical Dentistry, University of Sheffield, UK
| | - A-M Glenny
- Division of Dentistry, The University of Manchester, UK
| | - L MacDonald
- Cochrane Oral Health, Division of Dentistry, The University of Manchester UK
| | - Z Marshman
- School of Clinical Dentistry, University of Sheffield, UK
| | - K Jones
- Office for Health Improvement and Disparities, London, UK
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Giles E, Wray F, Eskyte I, Gray-Burrows KA, Owen J, Bhatti A, Zoltie T, McEachan R, Marshman Z, Pavitt S, West RM, Day PF. HABIT: Health visitors delivering Advice in Britain on Infant Toothbrushing - an early-phase feasibility study of a complex oral health intervention. BMJ Open 2022; 12:e059665. [PMID: 36216423 PMCID: PMC9557312 DOI: 10.1136/bmjopen-2021-059665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVES To conduct an early-phase feasibility study of an oral health intervention, Health visitors delivering Advice on Britain on Infant Toothbrushing (HABIT), delivered by Health Visitors to parents of children aged 9-12 months old. DESIGN A mixed-methods, early-phase, non-controlled, feasibility study. PARTICIPANTS Recruitment consisted of Group A-HABIT-trained Health Visitors (n=11) and Group B-parents of children aged 9-12 months old about to receive their universal health check (n=35). SETTING Bradford, West Yorkshire, UK. INTERVENTION A multidisciplinary team co-developed digital and paper-based training resources with health visitors and parents of young children. The intervention comprised of two components: (A) training for health visitors to deliver the HABIT intervention and (B) HABIT resources for parents, including a website, videos, toothbrushing demonstration and a paper-based leaflet with an oral health action plan. PRIMARY AND SECONDARY OUTCOME MEASURES Recruitment, retention and intervention delivery were analysed as key process outcomes for Groups A and B. Group B demographics, self-reported toothbrushing behaviours, dietary habits and three objective measures of toothbrushing including plaque scores were collected at baseline, 2 weeks and 3 months post intervention. RESULTS HABIT intervention delivery was feasible. Although the intended sample size was recruited (Group A=11 and Group B=35) it was more challenging than anticipated. Retention of Group B participants to final data collection was satisfactory (n=26). Total compliance with toothbrushing guidelines at baseline was low (30%), but significantly improved and was maintained 3 months after the intervention (68%). Plaque scores improved post intervention and participants found video recording of toothbrushing acceptable. Dietary habits remained largely unchanged. CONCLUSION This feasibility study has demonstrated that HABIT is an appropriate oral health intervention. Adaptions to the study design are recommended to maximise recruitment and data collection in a definitive study. These quantitative findings have demonstrated an early signal of impact for improved oral health behaviours for young children at high risk of decay. TRIAL REGISTRATION NUMBER ISRCTN55332414.
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Affiliation(s)
- Erin Giles
- School of Dentistry, University of Leeds, Leeds, UK
| | - Faye Wray
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Ieva Eskyte
- School of Law, University of Leeds, Leeds, UK
| | | | - Jenny Owen
- School of Dentistry, University of Leeds, Leeds, UK
| | - Amrit Bhatti
- School of Dentistry, University of Leeds, Leeds, UK
| | - Tim Zoltie
- School of Dentistry, University of Leeds, Leeds, UK
| | - Rosemary McEachan
- Born in Bradford, Bradford Institute of Health Research, Bradford, UK
| | - Z Marshman
- University of Sheffield Faculty of Medicine Dentistry and Health, Sheffield, UK
| | - Sue Pavitt
- School of Dentistry, University of Leeds, Leeds, UK
| | - Robert M West
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Peter F Day
- School of Dentistry, University of Leeds, Leeds, UK
- Community Dental Service, Bradford District Care NHS Foundation Trust, Bradford, UK
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Alshammari D, Marshman Z, El-Yousfi S. Anticipatory guidance and children's oral health: A scoping review. Community Dent Health 2022; 39:175-180. [PMID: 35605102 DOI: 10.1922/cdh_00208alshammari06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Anticipatory guidance (AG) involves providing parents with information about developmental milestones and promoting optimal development. Oral AG was first introduced as a comprehensive approach to provide age-appropriate oral health information and preventive interventions. The literature regarding this important topic has not yet been reviewed and summarised. AIM To describe the literature on AG provided to parents about their children's oral health and identify gaps in the current research. METHOD The scoping review mapped the existing peer-reviewed and guideline documents about AG and children's oral health using the framework established by Arksey and O'Malley (2005) and modified by Levac et al. (2010). Firstly, we defined our research questions and searched the literature using Medline, Web of Science and Scopus. Secondly, we selected all types of literature and then applied the inclusion and exclusion criteria, and finally, we analysed and summarised the information using thematic analysis. RESULTS Forty-three peer-reviewed articles and six guidelines were included. There was variation in how AG was described and defined. While some studies have evaluated the effectiveness of AG, most have investigated its short-term effectiveness only, with few interventional studies assessing this approach in the long-term. CONCLUSION While the concept of AG shows promise, there is no consensus within the current literature on a defined definition and there is a lack of long-term evaluation.
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Affiliation(s)
- D Alshammari
- Preventive department, College of Dentistry, The University of Hai'l, Saudi Arabia
| | - Z Marshman
- Academic Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, UK
| | - S El-Yousfi
- Academic Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, UK
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Rogers HJ, Sagabiel J, Marshman Z, Rodd HD, Rowen D. Adolescent valuation of CARIES-QC-U: a child-centred preference-based measure of dental caries. Health Qual Life Outcomes 2022; 20:18. [PMID: 35115013 PMCID: PMC8812216 DOI: 10.1186/s12955-022-01918-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 01/13/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives This study develops an adolescent value set for a child-centred dental caries-specific measure of oral health-related quality of life (OHRQoL) based upon CARIES-QC (Caries Impacts and Experiences Questionnaire for Children). This study develops a new approach to valuing child health by eliciting adolescent preferences and anchoring these onto the 1–0 full health-dead QALY (quality adjusted life year) scale using ordinal adult preferences. Methods Two online surveys were created to elicit preferences for the CARIES-QC classification system. The first comprised best–worst scaling (BWS) tasks for completion by adolescents aged 11–16 years. The second comprised discrete choice experiment tasks with a duration attribute (DCETTO) for completion by adults aged over 18 years. Preferences were modelled using the conditional logit model. Mapping regressions anchored the adolescent BWS data onto the QALY scale using adult DCETTO values, since the BWS survey data alone cannot generate anchored values. Results 723 adolescents completed the BWS survey and 626 adults completed the DCETTO survey. The samples were representative of UK adolescent and adult populations. Fully consistent and robust models were produced for both BWS and DCETTO data. BWS preferences were mapped onto DCETTO values, resulting utility estimates for each health state defined by the classification system. Conclusion This is the first measure with predetermined scoring based on preferences to be developed specifically for use in child oral health research, and uses a novel technique to generate a value set using adolescent preferences. The estimates can be used to generate QALYs in economic evaluations of interventions to improve children’s oral health. Supplementary Information The online version contains supplementary material available at 10.1186/s12955-022-01918-w.
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Affiliation(s)
- H J Rogers
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle-upon-Tyne, UK.
| | - J Sagabiel
- Department of Economics, Swedish University of Agricultural Economics, Uppsala, Sweden
| | - Z Marshman
- Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - H D Rodd
- Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - D Rowen
- Health Economics and Decision Science, School of Health and Related Research, University of Sheffield, Sheffield, UK
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Giles E, Gray-Burrows KA, Bhatti A, Rutter L, Purdy J, Zoltie T, Pavitt S, Marshman Z, West R, Day PF. "Strong Teeth": an early-phase study to assess the feasibility of an oral health intervention delivered by dental teams to parents of young children. BMC Oral Health 2021; 21:267. [PMID: 34001087 PMCID: PMC8130402 DOI: 10.1186/s12903-021-01608-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 05/04/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Tooth decay (caries) is a significant health burden in young children. There is strong evidence for the benefits of establishing appropriate home-based oral health behaviours in early childhood. Dental teams are well placed to provide this information and there is clear advice on what oral health information should be given to parents. However, research has shown that there is limited guidance, training and resources on how dental teams should deliver this advice. "Strong Teeth" is a complex oral health intervention, using evidence-based resources and training underpinned by behaviour change psychology, to support behaviour change conversations in dental practice. This early phase evaluation aims to assess the feasibility of this intervention, prior to a full-scale trial. METHODS The study recruited 15 parents of children aged 0-2-years-old and 21 parents of children aged 3-5 years old, from five NHS dental practices across West Yorkshire. Participant demographics, self-reported brushing behaviours, dietary habits, a dental examination and three objective measures of toothbrushing were collected in a home-setting at baseline, then at 2-weeks and 2-months post-intervention. Recruitment, retention and intervention delivery were analysed as key process outcomes. Brushing habits were compared to national toothbrushing guidelines - the Delivering Better Oral Health toolkit (Public Health England). RESULTS Strong Teeth was feasible to deliver in a General Dental Practice setting in 94% of cases. Feasibility of recruitment (37%) exceeded progression criterion, however retention of participants (75%) was below the progression criterion for the 0-2 age group. More than half of children recruited aged 3-5-years had caries experience (52%). Total compliance to toothbrushing guidance at baseline was low (28%) and increased after the intervention (52%), an improvement that was statistically significant. Dietary habits remained largely unchanged. Plaque scores significantly decreased in the 3-5-year-olds and toothbrushing duration increased in all age groups. CONCLUSION "Strong Teeth" intervention delivery and data collection in the home setting was feasible. There was a positive indication of impact on reported toothbrushing behaviours. Some amendments to study design, particularly relating to the inclusion of the 0-2-year-old group, should be considered before progression to a full trial. Trial registration ISRCTN Register: ISRCTN10709150. Registered retrospectively 24/7/2019.
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Affiliation(s)
- Erin Giles
- Department of Paediatric Dentistry, School of Dentistry, University of Leeds, Leeds, LS2 9LU, UK.
| | - K A Gray-Burrows
- Department of Paediatric Dentistry, School of Dentistry, University of Leeds, Leeds, LS2 9LU, UK
| | - A Bhatti
- Department of Paediatric Dentistry, School of Dentistry, University of Leeds, Leeds, LS2 9LU, UK
| | - L Rutter
- Department of Paediatric Dentistry, School of Dentistry, University of Leeds, Leeds, LS2 9LU, UK
| | - J Purdy
- Department of Paediatric Dentistry, School of Dentistry, University of Leeds, Leeds, LS2 9LU, UK
| | - T Zoltie
- Department of Paediatric Dentistry, School of Dentistry, University of Leeds, Leeds, LS2 9LU, UK
| | - S Pavitt
- Department of Paediatric Dentistry, School of Dentistry, University of Leeds, Leeds, LS2 9LU, UK
| | - Z Marshman
- School of Dentistry, University of Sheffield, Sheffield, S10 2TA, UK
| | - R West
- Department of Paediatric Dentistry, School of Dentistry, University of Leeds, Leeds, LS2 9LU, UK
| | - P F Day
- Department of Paediatric Dentistry, School of Dentistry, University of Leeds, Leeds, LS2 9LU, UK
- Bradford Community Dental Service, Bradford District Care NHS Foundation Trust, Bradford, BD18 3LD, UK
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Knapp R, Marshman Z, Gilchrist F, Rodd H. The impact of dental caries and its treatment under general anaesthetic on children and their families. Eur Arch Paediatr Dent 2020; 22:567-574. [PMID: 33280070 PMCID: PMC7719014 DOI: 10.1007/s40368-020-00591-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 11/18/2020] [Indexed: 12/03/2022]
Abstract
Objective To assess the impact of dental caries and treatment under general anaesthetic (GA) on the everyday lives of children and their families, using child-reported measures of quality of life (QoL) and oral health-related quality of life (OHRQoL).
Method Participants, aged 5–16 years old having treatment for dental caries under GA, were recruited from new patient clinics at Charles Clifford Dental Hospital, Sheffield. OHRQoL was measured before and 3-months after treatment using the Caries Impacts and Experiences Questionnaire for Children (CARIES-QC). Overall QoL was measured using the Child Health Utility 9D (CHU9D). Parents/caregivers completed the Family Impact Scale (FIS).
Results Eighty five parent–child dyads completed the study. There was statistically significant improvement in OHRQoL (mean interval score difference in CARIES-QC = 4.43, p < 0.001) and QoL (mean score difference in CHU9D = 2.48, p < 0.001) following treatment, with moderate to large effect sizes. There was statistically significant improvement in FIS scores (mean score difference = 5.48, p = 0.03). Conclusions Treatment under GA was associated with improvement in QoL and OHRQoL as reported by children, and reduced impacts on the family. This work highlights the importance of GA services in reducing the caries-related impacts experienced by children. Further work is needed investigate the impact of clinical, environmental and individual factors.
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Affiliation(s)
- R Knapp
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK.
| | - Z Marshman
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - F Gilchrist
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - H Rodd
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
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Innes N, Clarkson J, Douglas G, Ryan V, Wilson N, Homer T, Marshman Z, McColl E, Vale L, Robertson M, Abouhajar A, Holmes R, Freeman R, Chadwick B, Deery C, Wong F, Maguire A. Child Caries Management: A Randomized Controlled Trial in Dental Practice. J Dent Res 2019; 99:36-43. [DOI: 10.1177/0022034519888882] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This multicenter 3-arm, parallel-group, patient-randomized controlled trial compared clinical effectiveness of 3 treatment strategies over 3 y for managing dental caries in primary teeth in UK primary dental care. Participants aged 3 to 7 y with at least 1 primary molar with dentinal carious lesion were randomized across 3 arms (1:1:1 via centrally administered system with variable-length random permuted blocks): C+P, conventional carious lesion management (complete carious tooth tissue removal and restoration placement) with prevention; B+P, biological management (sealing in carious tooth tissue restoratively) with prevention; and PA, prevention alone (diet, plaque removal, fluorides, and fissure sealants). Parents, children, and dentists were not blind to allocated arm. Co–primary outcomes were 1) the proportion of participants with at least 1 episode of dental pain and/or infection and 2) the number of episodes of dental pain and/or infection during follow-up (minimum, 23 mo). In sum, 1,144 participants were randomized (C+P, n = 386; B+P, n = 381; PA, n = 377) by 72 general dental practitioners, of whom 1,058 (C+P, n = 352; B+P, n = 352; PA, n = 354) attended at least 1 study visit and were included in the primary analysis. The median follow-up was 33.8 mo (interquartile range, 23.8 to 36.7). Proportions of participants with at least 1 episode of dental pain and/or infection were as follows: C+P, 42%; B+P, 40%; PA, 45%. There was no evidence of a difference in incidence of dental pain and/or infection when B+P (adjusted risk difference [97.5% CI]: −2% [−10% to 6%]) or PA (4% [−4% to 12%]) was compared with C+P. The mean (SD) number of episodes of dental pain and/or infection were as follows: C+P, 0.62 (0.95); B+P, 0.58 (0.87); and PA, 0.72 (0.98). Superiority could not be concluded for number of episodes between B+P (adjusted incident rate ratio (97.5% CI): 0.95 [0.75 to 1.21]) or PA (1.18 [0.94 to 1.48]) and C+P. In conclusion, there was no evidence of a difference among the 3 treatment approaches for incidence or number of episodes of dental pain and/or infection experienced by these participants with high caries risk and established disease (trial registration: ISRCTN77044005).
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Affiliation(s)
- N.P. Innes
- School of Dentistry, University of Dundee, Dundee, UK
| | - J.E. Clarkson
- Dental Health Services Research Unit, University of Dundee, Dundee, UK
| | | | - V. Ryan
- Institute of Health and Society, Newcastle University, Newcastle, UK
| | - N. Wilson
- Institute of Health and Society, Newcastle University, Newcastle, UK
| | - T. Homer
- Institute of Health and Society, Newcastle University, Newcastle, UK
| | - Z. Marshman
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - E. McColl
- Institute of Health and Society, Newcastle University, Newcastle, UK
| | - L. Vale
- Institute of Health and Society, Newcastle University, Newcastle, UK
| | - M. Robertson
- School of Dentistry, University of Dundee, Dundee, UK
| | - A. Abouhajar
- Newcastle Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, UK
| | - R.D. Holmes
- School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - R. Freeman
- Dental Health Services Research Unit, University of Dundee, Dundee, UK
| | - B. Chadwick
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - C. Deery
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - F. Wong
- Institute of Dentistry, Queen Mary University of London, London, UK
| | - A. Maguire
- School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
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Rogers HJ, Rodd HD, Vermaire JH, Stevens K, Knapp R, El Yousfi S, Marshman Z. A systematic review of the quality and scope of economic evaluations in child oral health research. BMC Oral Health 2019; 19:132. [PMID: 31262293 PMCID: PMC6604207 DOI: 10.1186/s12903-019-0825-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 06/19/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Economic evaluations provide policy makers with information to facilitate efficient resource allocation. To date, the quality and scope of economic evaluations in the field of child oral health has not been evaluated. Furthermore, whilst the involvement of children in research has been actively encouraged in recent years, the success of this movement in dental health economics has not yet been explored. This review aimed to determine the quality and scope of published economic evaluations applied to children's oral health and to consider the extent of children's involvement. METHODS The following databases were searched: CINAHL, Cochrane Library, Econlit, EThOS, MEDLINE, NHS EED, OpenGrey, Scopus, Web of Science. Full economic evaluations, relating to any aspect of child oral health, published after 1997 were included and appraised against the Drummond checklist and the Consolidated Health Economic Evaluation Reporting Standards by a team of four calibrated reviewers. Data were also extracted regarding children's involvement and the outcome measures used. RESULTS Two thousand seven hundred fifteen studies were identified, of which 46 met the inclusion criteria. The majority (n = 38, 82%) were cost-effectiveness studies, with most focusing on the prevention or management of dental caries (n = 42, 91%). One study quantified outcomes in Quality Adjusted Life Years (QALYs), and one study utilised a child-reported outcome measure. The mean percentage of applicable Drummond checklist criteria met by the studies in this review was 48% (median = 50%, range = 0-100%) with key methodological weaknesses noted in relation to discounting of costs and outcomes. The mean percentage of applicable CHEERS criteria met by each study was 77% (median = 83%, range = 33-100%), with limited reporting of conflicts of interest. Children's engagement was largely overlooked. CONCLUSIONS There is a paucity of high-quality economic evaluations in the field of child oral health. This deficiency could be addressed through the endorsement of standardised economic evaluation guidelines by dental journals. The development of a child-centred utility measure for use in paediatric oral health would enable researchers to quantify outcomes in terms of quality adjusted life years (QALYs) whilst promoting child-centred research.
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Affiliation(s)
- H J Rogers
- Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, Sheffield, UK.
| | - H D Rodd
- Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - J H Vermaire
- Division of Child Health, TNO Institute for Applied Sciences, Leiden, The Netherlands
| | - K Stevens
- Health Economics and Decision Science, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - R Knapp
- Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - S El Yousfi
- Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Z Marshman
- Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
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Ravaghi V, Baker SR, Benson PE, Marshman Z, Morris AJ. Socioeconomic Variation in the association between Malocclusion and Oral Health Related Quality of Life. Community Dent Health 2019; 36:17-21. [PMID: 30667186 DOI: 10.1922/cdh_4388ravaghi05] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
OBJECTIVES Oral health related quality of life (OHRQoL) has been linked to malocclusion. We aimed (a) to investigate the association between malocclusion and OHRQoL among children, and (b) to examine whether this association varied by socioeconomic status. METHODS Cross-sectional analysis of data for 4,217 children aged 12 & 15 years, who participated in the 2013 Children Dental Health Survey (CDHS); a nationally representative survey of children in England, Wales, and Northern Ireland. Malocclusion was determined using the modified Index of Orthodontic Treatment Need (IOTN). OHRQoL was measured using the Child Oral Impacts on Daily Performance (Child-OIDP). For socioeconomic status, we used the pupils' eligibility for free school meals (FSM) and Index of Multiple Deprivation (IMD). Adjusted marginal effects were estimated controlling for confounding variables. Separate analyses were carried out for the two age groups. RESULTS Malocclusion was associated with 6% and 15% increases in the probability of reporting negative impact of OHRQoL for 12- and 15-year olds respectively, which was significant for 15-year olds (marginal effect=0.15, 95% CI=0.08-0.22). Malocclusion was associated with the prevalence of oral impacts for 12 year olds (marginal effect=0.1, 95% CI=0.02-0.17) and 15-year olds (marginal effect=0.2, 95% CI 95%=0.13-0.28) not eligible for FSM and for 15-year olds in the most (marginal effect=0.2, 95% CI=0.1-0.29) and least (marginal effect=0.26, 95% CI=0.13-0.4) deprived IMD quintiles. CONCLUSIONS Malocclusion was associated with impacts on OHRQoL for 15-year olds. There was evidence of a relationship between SES, malocclusion and OHRQoL.
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Affiliation(s)
- V Ravaghi
- School of Dentistry, University of Birmingham, 5 Mill Pool, Birmingham B5 7EG, UK
| | - S R Baker
- School of Clinical Dentistry, University of Sheffield, Claremont Crescent, Sheffield S10 2TA, UK
| | - P E Benson
- School of Clinical Dentistry, University of Sheffield, Claremont Crescent, Sheffield S10 2TA, UK
| | - Z Marshman
- School of Clinical Dentistry, University of Sheffield, Claremont Crescent, Sheffield S10 2TA, UK
| | - A J Morris
- School of Dentistry, University of Birmingham, 5 Mill Pool, Birmingham B5 7EG, UK
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Rodd H, Kirby J, Duffy E, Porritt J, Morgan A, Prasad S, Baker S, Marshman Z. Children's experiences following a CBT intervention to reduce dental anxiety: one year on. Br Dent J 2018; 225:247-251. [DOI: 10.1038/sj.bdj.2018.540] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2018] [Indexed: 12/28/2022]
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Gupta E, Innes N, Schuller AA, Vermaire JH, Marshman Z. A scoping review of the uses of the care index in children. Community Dent Health 2018; 34:131-136. [PMID: 28872806 DOI: 10.1922/cdh_4063gupta06] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 01/13/2017] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To conduct a scoping review of literature to describe how the care index (CI) and restorative index (RI) are used in child populations and to determine whether they are fit for purpose. BASIC RESEARCH DESIGN Scoping review conducted using the Arksey and O'Malley (2005) framework. METHOD Electronic and manual literature searches (1980-2015) were conducted. Titles and abstracts were screened, full-texts of potential studies were reviewed two reviewers extracted data independently, followed by data charting and summarising. RESULTS Out of 104 articles meeting all criteria, most were cross-sectional (92%), and 56% were conducted in UK and Brazil. Most commonly (63%) studies used CI and RI to obtain epidemiological data on dental care levels. Of the studies that defined CI and RI, most used and specified the standard definition. The CI and RI scores varied either due to patient related factors such as age, gender or dental care related factors including, cost of treatment and method of provider remuneration. CONCLUSION Overall, it is recommended that future studies should clearly state the definitions and thresholds used to obtain CI and RI, which would enable comparison between communities and allow temporal trends to be studied. Additionally, deriving separate CI and RI scores for groups based on caries extent would help to highlight inequalities in the provision of care. Further research is needed to explore the applicability of CI and RI to changing approaches to caries management with current care recommendations emphasising on minimal treatment and secondary prevention.
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Affiliation(s)
- E Gupta
- School of Medicine and Dentistry, University of Aberdeen, Cornhill Road, Aberdeen, AB25 2ZA
| | - N Innes
- Dundee Dental Hospital and School, University of Dundee, Park Place, Dundee DD1 4HN
| | - A A Schuller
- Centre of Dentistry and Oral Hygiene, University Medical Centre Groningen, Netherlands.,TNO Child health, Leiden, The Netherlands
| | | | - Z Marshman
- School of Clinical Dentistry, University of Sheffield, Claremont Crescent, Sheffield, S10 2TA
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Baker SR, Foster Page L, Thomson WM, Broomhead T, Bekes K, Benson PE, Aguilar-Diaz F, Do L, Hirsch C, Marshman Z, McGrath C, Mohamed A, Robinson PG, Traebert J, Turton B, Gibson BJ. Structural Determinants and Children's Oral Health: A Cross-National Study. J Dent Res 2018; 97:1129-1136. [PMID: 29608864 DOI: 10.1177/0022034518767401] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Much research on children's oral health has focused on proximal determinants at the expense of distal (upstream) factors. Yet, such upstream factors-the so-called structural determinants of health-play a crucial role. Children's lives, and in turn their health, are shaped by politics, economic forces, and social and public policies. The aim of this study was to examine the relationship between children's clinical (number of decayed, missing, and filled teeth) and self-reported oral health (oral health-related quality of life) and 4 key structural determinants (governance, macroeconomic policy, public policy, and social policy) as outlined in the World Health Organization's Commission for Social Determinants of Health framework. Secondary data analyses were carried out using subnational epidemiological samples of 8- to 15-y-olds in 11 countries ( N = 6,648): Australia (372), New Zealand (three samples; 352, 202, 429), Brunei (423), Cambodia (423), Hong Kong (542), Malaysia (439), Thailand (261, 506), United Kingdom (88, 374), Germany (1498), Mexico (335), and Brazil (404). The results indicated that the type of political regime, amount of governance (e.g., rule of law, accountability), gross domestic product per capita, employment ratio, income inequality, type of welfare regime, human development index, government expenditure on health, and out-of-pocket (private) health expenditure by citizens were all associated with children's oral health. The structural determinants accounted for between 5% and 21% of the variance in children's oral health quality-of-life scores. These findings bring attention to the upstream or structural determinants as an understudied area but one that could reap huge rewards for public health dentistry research and the oral health inequalities policy agenda.
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Affiliation(s)
- S R Baker
- 1 Unit of Dental Public Health, School of Clinical Dentistry, Claremont Crescent, University of Sheffield, Sheffield, UK
| | - L Foster Page
- 2 Department of Oral Sciences, Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Otago, New Zealand
| | - W M Thomson
- 2 Department of Oral Sciences, Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Otago, New Zealand
| | - T Broomhead
- 1 Unit of Dental Public Health, School of Clinical Dentistry, Claremont Crescent, University of Sheffield, Sheffield, UK
| | - K Bekes
- 3 Department of Paediatric Dentistry, School of Dentistry, Medical University of Vienna, Vienna, Austria
| | - P E Benson
- 1 Unit of Dental Public Health, School of Clinical Dentistry, Claremont Crescent, University of Sheffield, Sheffield, UK
| | - F Aguilar-Diaz
- 4 Department of Public Health, National Autonomous University of Mexico León Unit, León, Guanajuato, México
| | - L Do
- 5 Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, Australia
| | - C Hirsch
- 6 Department of Paediatric Dentistry, University of Leipzig, Leipzig, Germany
| | - Z Marshman
- 1 Unit of Dental Public Health, School of Clinical Dentistry, Claremont Crescent, University of Sheffield, Sheffield, UK
| | - C McGrath
- 7 Periodontology & Public Health, Faculty of Dentistry, University of Hong Kong, Hong Kong
| | - A Mohamed
- 8 Department of Dental Services, Ministry of Health, Brunei Darussalam
| | - P G Robinson
- 9 Bristol Dental School, The University of Bristol, Bristol, UK
| | - J Traebert
- 10 Postgraduate Program in Health Sciences, University of Southern Santa Catarina, Santa Catarina, Brazil
| | - B Turton
- 11 Department of Dentistry, University of Puthisastra, Phnom Penh, Cambodia
| | - B J Gibson
- 1 Unit of Dental Public Health, School of Clinical Dentistry, Claremont Crescent, University of Sheffield, Sheffield, UK
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15
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Worsley DJ, Jones K, Harris JC, Charlesworth J, Marshman Z. Review and action plan for oral health improvement in Sheffield special schools. Community Dent Health 2018; 35:5-8. [PMID: 29380962 DOI: 10.1922/cdh_4049worsley04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
A description of the process of a review of oral health improvement in special schools in Sheffield and the implementation of an action plan for these activities. Public health competencies encompassed: assessing the evidence on oral health and dental interventions, programmes and services; strategic leadership and collaborative working for health; oral health improvement.
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Affiliation(s)
- D J Worsley
- School of Clinical Dentistry, Sheffield, UK
- Dental Public Health, Public Health England, Yorkshire and The Humber, Sheffield, UK
| | - K Jones
- Dental Public Health, Public Health England, Yorkshire and The Humber, Sheffield, UK
| | - J C Harris
- School of Clinical Dentistry, Sheffield, UK
- Community and Special Care Dentistry, Sheffield Teaching Hospitals NHS Foundation Trust
| | - J Charlesworth
- Community and Special Care Dentistry, Sheffield Teaching Hospitals NHS Foundation Trust
| | - Z Marshman
- School of Clinical Dentistry, Sheffield, UK
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Doughty J, Lala R, Marshman Z. The dental public health implications of cosmetic dentistry: a scoping review of the literature. Community Dent Health 2017; 33:218-224. [PMID: 28509518 DOI: 10.1922/cdh_3881doughty07] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 01/11/2016] [Indexed: 11/11/2022]
Abstract
INTRODUCTION The popularity of cosmetic surgery has seen a rapid increase recently, with the trend mirrored in dentistry. The Department of Health expressed concerns about the potential for biological and psychosocial harm of these cosmetic procedures. Furthermore, the dental public health implications (DPH) of the growing uptake of cosmetic dental procedures have not been explored. OBJECTIVES Conduct a scoping review to explore the DPH implications of cosmetic dentistry and identify gaps for future research. METHODS A fivestage scoping review was conducted of studies identified using the search terms cosmetic AND dentistry. Data from the studies meeting the inclusion criteria were extracted, collated and summarised into themes. RESULTS Fifty-seven papers met the inclusion criteria (11 cross-sectional studies, 10 literature reviews and 36 opinion pieces). The DPH implications were summarised into five emergent themes: dento-legal and ethical, marketing, psychosocial, biological and workforce. These themes revealed patients' increased expectations, expanding commercialisation of the profession, psychological risks to vulnerable patients, the iatrogenic consequences of invasive cosmetic dental procedures and workforce implications of the current trends. CONCLUSIONS The scoping review found that existing literature on cosmetic dentistry is predominately anecdotal - professional opinions and discussions. Despite this, our findings demonstrated workforce training and governance implications due to increased demand for cosmetic dentistry. Further empirical research is needed to understand the DPH implications of the increasing demand and uptake of cosmetic dental procedures to guide evidence-based policy to safeguard patients and improve the quality of dental services.
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Affiliation(s)
- J Doughty
- Barts Health Community Dental Service, London. UK
| | - R Lala
- Dental Public Health, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Z Marshman
- Dental Public Health, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
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Owens J, Jones K, Marshman Z. The oral health of people with learning disabilities - a user-friendly questionnaire survey. Community Dent Health 2017; 34:4-7. [PMID: 28561550 DOI: 10.1922/cdh_3867owens04] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 05/01/2016] [Indexed: 11/11/2022]
Abstract
Impetus for action To conduct a user-friendly questionnaire survey of the oral health and service needs of adults with learning disabilities. Solution Researchers collaborated with local self-advocacy services to develop a questionnaire adapted from one used in a regional postal survey. The questionnaire, which covered dental status, oral health and dental services use, was sent to a random sample of people from the learning disability case register. Outcome Of 2,000 questionnaires mailed, 117 were returned undelivered and 625 were completed (response rate 31.3%). The self-reported dental status of people with learning disabilities appeared similar to that of the 2008 postal survey of the general population in Sheffield. The major difference in dental status was 11.5% of people with learning disabilities wore upper dentures and 7.2% wore lower dentures, compared to 21.2% and 12.1% of the general population in Sheffield. Challenges Using the case register as a recruitment instrument may have excluded people with learning disabilities not registered. Time and finances only permitted one mailing. Analysis on the basis of deprivation could not be conducted. Future implications and learning points Contrary to current practice, it is possible to include people with learning disabilities in oral health surveys. A multidisciplinary team was essential for enabling the progression and implementation of inclusive research and for people with learning disabilities and their supporters to engage meaningfully. This level of collaboration appears necessary if we are committed to ensuring that people with learning disabilities and their supporters are made visible to policy and decision-makers.
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Affiliation(s)
- J Owens
- Academic Unit of Dental Public Health, University of Sheffield, UK
| | - K Jones
- Public Health England, Sheffield, UK
| | - Z Marshman
- Academic Unit of Dental Public Health, University of Sheffield, UK
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19
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Worsley DJ, Robinson PG, Marshman Z. Access to urgent dental care: a scoping review. Community Dent Health 2017; 34:19-26. [PMID: 28561553 DOI: 10.1922/cdh_4038worsley08] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 10/10/2016] [Indexed: 11/11/2022]
Abstract
Objective To summarise the literature on urgent dental care and to identify research priorities on the organisation and delivery of urgent dental services. Basic research design Scoping review using Andersen's behavioural model of health service utilisation for a framework analysis of the data. Main outcome measures Gaps in the literature, defined as those factors and interactions identified by Andersen's model as having a contributory role in access to health services that were not evident in the source papers. Results Fifty-six papers met the inclusion criteria for the review. The factors most often considered were; demographic, socioeconomic, perceived and evaluated need, and health behaviours. Patient outcomes of evaluated health and quality of life following urgent dental care were the least studied variables, with the exception of patient satisfaction. No studies were identified on community values/norms of people accessing urgent dental care, on health economic evaluations or on studies of how urgent dental services mitigate use of other medical services. No studies were identified on urgent need for populations living in water fluoridated areas or on the relationship between service design and efficient or effective access as measured by patient outcomes. Conclusion Future research on patient outcomes and the comparison of different service models for urgent dental care through measures of equity, effectiveness and efficiency of access are needed to inform future policy and organisation of these services.
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Affiliation(s)
| | - P G Robinson
- Bristol School of Oral and Dental Sciences, Bristol, UK
| | - Z Marshman
- School of Clinical Dentistry, Sheffield, UK
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20
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Porritt J, Rodd H, Morgan A, Williams C, Gupta E, Kirby J, Creswell C, Newton T, Stevens K, Baker S, Prasad S, Marshman Z. Development and Testing of a Cognitive Behavioral Therapy Resource for Children's Dental Anxiety. JDR Clin Trans Res 2016; 2:23-37. [PMID: 28879243 DOI: 10.1177/2380084416673798] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Cognitive Behavioral Therapy (CBT) is an evidence-based treatment for dental anxiety; however, access to therapy is limited. The current study aimed to develop a self-help CBT resource for reducing dental anxiety in children, and to assess the feasibility of conducting a trial to evaluate the treatment efficacy and cost-effectiveness of such an intervention. A mixed methods design was employed. Within phase 1, a qualitative "person-based" approach informed the development of the self-help CBT resource. This also employed guidelines for the development and evaluation of complex interventions. Within phase 2, children, aged between 9 and 16 y, who had elevated self-reported dental anxiety and were attending a community dental service or dental hospital, were invited to use the CBT resource. Children completed questionnaires, which assessed their dental anxiety and health-related quality of life (HRQoL) prior to and following their use of the resource. Recruitment and completion rates were recorded. Acceptability of the CBT resource was explored using interviews and focus groups with children, parents/carers and dental professionals. For this analysis, the authors adhered to the Mixed Methods Appraisal Tool criteria. There were 24 families and 25 dental professionals participating in the development and qualitative evaluation of the CBT resource for children with dental anxiety. A total of 56 children agreed to trial the CBT resource (66% response rate) and 48 of these children completed the study (86% completion rate). There was a significant reduction in dental anxiety (mean score difference = 7.7, t = 7.9, df = 45, P < 0.001, Cohen's d ES = 1.2) and an increase in HRQoL following the use of the CBT resource (mean score difference = -0.03, t = 2.14, df = 46, P < 0.05, Cohen's d ES = 0.3). The self-help approach had high levels of acceptability to stakeholders. These findings provide preliminary evidence for the effectiveness and acceptability of the resource in reducing dental anxiety in children and support the further evaluation of this approach in a randomized control trial. Knowledge Transfer Statement: This study details the development of a guided self-help Cognitive Behavioral Therapy resource for the management of dental anxiety in children and provides preliminary evidence for the feasibility and acceptability of this approach with children aged between 9 and 16 y. The results of this study will inform the design of a definitive trial to examine the treatment- and cost-effectiveness of the resource for reducing dental anxiety in children.
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Affiliation(s)
- J Porritt
- Department of Psychology, Sociology, and Politics, Sheffield Hallam University, Collegiate Crescent, Sheffield, UK
| | - H Rodd
- School of Clinical Dentistry, University of Sheffield, Claremont Crescent, Sheffield, UK
| | - A Morgan
- Paediatric Dentistry Department, Charles Clifford Dental Hospital, Sheffield, UK
| | - C Williams
- Institute of Health and Wellbeing, Mental Health and Wellbeing, University of Glasgow, Administration Building, Gartnavel Royal Hospital, Glasgow, UK
| | - E Gupta
- School of Clinical Dentistry, University of Sheffield, Claremont Crescent, Sheffield, UK
| | - J Kirby
- School of Clinical Dentistry, University of Sheffield, Claremont Crescent, Sheffield, UK
| | - C Creswell
- School of Psychology and Clinical Language Sciences, University of Reading, Earley Gate, Whiteknights, Reading, Berkshire, UK
| | - T Newton
- Oral Health Services Research & Dental Public Health, King's College London, Denmark Hill Campus, Caldecot Road, London, UK
| | - K Stevens
- School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, Sheffield, UK
| | - S Baker
- School of Clinical Dentistry, University of Sheffield, Claremont Crescent, Sheffield, UK
| | - S Prasad
- Derbyshire Community Health Services, Long Eaton Dental Clinic, UK
| | - Z Marshman
- School of Clinical Dentistry, University of Sheffield, Claremont Crescent, Sheffield, UK
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Marshman Z, Broomhead T, Rodd HD, Jones K, Burke D, Baker SR. Who attends a Children's Hospital Emergency Department for dental reasons? A two-step cluster analysis approach. Community Dent Oral Epidemiol 2016; 45:49-58. [DOI: 10.1111/cdoe.12258] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 08/30/2016] [Indexed: 12/01/2022]
Affiliation(s)
- Z. Marshman
- School of Clinical Dentistry; University of Sheffield; Sheffield UK
| | - T. Broomhead
- School of Clinical Dentistry; University of Sheffield; Sheffield UK
| | - H. D. Rodd
- School of Clinical Dentistry; University of Sheffield; Sheffield UK
| | - K. Jones
- Public Health England; Sheffield UK
| | - D. Burke
- Sheffield Children's NHS Foundation Trust; Western Bank; Sheffield UK
| | - S. R. Baker
- School of Clinical Dentistry; University of Sheffield; Sheffield UK
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Thomson W, Foster Page L, Robinson P, Do L, Traebert J, Mohamed A, Turton B, McGrath C, Bekes K, Hirsch C, del Carmen Aguilar-Diaz F, Marshman Z, Benson P, Baker S. Psychometric assessment of the short-form Child Perceptions Questionnaire: an international collaborative study. Community Dent Oral Epidemiol 2016; 44:549-556. [DOI: 10.1111/cdoe.12248] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 06/28/2016] [Indexed: 11/29/2022]
Affiliation(s)
- W.M. Thomson
- Department of Oral Sciences; Sir John Walsh Research Institute; Faculty of Dentistry; University of Otago; Dunedin New Zealand
| | - L.A. Foster Page
- Department of Oral Sciences; Sir John Walsh Research Institute; Faculty of Dentistry; University of Otago; Dunedin New Zealand
| | - P.G. Robinson
- School of Oral and Dental Sciences; The University of Bristol; Bristol UK
| | - L.G. Do
- Australian Research Centre for Population Oral Health; The University of Adelaide; Adelaide SA Australia
| | - J. Traebert
- Postgraduate Program in Health Sciences; University of Southern Santa Catarina; Tubarao Brazil
| | - A.R. Mohamed
- Department of Dental Services; Ministry of Health; Bandar Seri Begawan Brunei Darussalam
| | - B.J. Turton
- Department of Dentistry; University of Puthisastra; Phnom Penh Cambodia
| | - C. McGrath
- Periodontology & Public Health; Faculty of Dentistry; University of Hong Kong; Hong Kong Hong Kong
| | - K. Bekes
- Department of Paediatric Dentistry; University Dental Clinic; Medical University of Vienna; Vienna Austria
| | - C. Hirsch
- Department of Paediatric Dentistry; University of Leipzig; Leipzig Germany
| | | | - Z. Marshman
- School of Clinical Dentistry; University of Sheffield; Sheffield UK
| | - P.E. Benson
- School of Clinical Dentistry; University of Sheffield; Sheffield UK
| | - S.R. Baker
- School of Clinical Dentistry; University of Sheffield; Sheffield UK
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Marshman Z, Ahern S, McEachan R, Rogers H, Gray-Burrows K, Day P. Parents' Experiences of Toothbrushing with Children: A Qualitative Study. JDR Clin Trans Res 2016; 1:122-130. [PMID: 28879241 PMCID: PMC5576048 DOI: 10.1177/2380084416647727] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Globally, dental caries is one of the most prevalent diseases and is more common in children living in deprived areas. Dental caries is preventable, and guidance in the United Kingdom recommends parental supervised brushing (PSB): a collection of behaviors-including twice-daily toothbrushing with fluoridated toothpaste-that should begin upon eruption of the first tooth (approximately 6 to 12 mo of age) and for which children need to be helped or supervised by an adult until at least 7 y of age. The aim of this study was to explore parents' experiences of toothbrushing with their young children and to establish barriers and facilitators to PSB at individual, interpersonal, and environmental levels according to the theoretical domains framework. Qualitative semistructured interviews guided by the framework were conducted with 27 parents of young children (<7 y) in 2 deprived areas of the United Kingdom. Framework analysis was used. Parents were not aware of national guidance concerning their active involvement in toothbrushing; however, they did have detailed knowledge of toothbrushing practices for children, and their intentions were to brush their children's teeth themselves twice every day as part of a family routine. Nonetheless, parents' difficulties experienced in managing their children's challenging behavior and the environmental context of their stressful lives meant that many parents adopted a role of simply reminding their children to brush or watching them brush. As such, the main barriers to PSB among parents living in deprived areas were skills in managing their children's behavior and environmental influences on family life. The results of our study have clear implications for the development of appropriate interventions to address the modifiable barriers to improve parental adoption of PSB. Knowledge Transfer Statement: The results of this study will be used to develop a behavior change intervention to encourage parental supervised brushing. The intervention-which is likely to be delivered through health practitioners rather than dental teams-will be developed to reduce dental caries among young children and will require evaluation in terms of its clinical and cost effectiveness.
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Affiliation(s)
| | - S.M. Ahern
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - R.R.C. McEachan
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - H.J. Rogers
- Department of Paediatric Dentistry, Charles Clifford Dental Hospital, Sheffield, UK
| | | | - P.F. Day
- School of Dentistry, University of Leeds, Leeds, UK
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Gray-Burrows KA, Day PF, Marshman Z, Aliakbari E, Prady SL, McEachan RRC. Using intervention mapping to develop a home-based parental-supervised toothbrushing intervention for young children. Implement Sci 2016; 11:61. [PMID: 27153832 PMCID: PMC4859968 DOI: 10.1186/s13012-016-0416-4] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Accepted: 04/01/2016] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Dental caries in young children is a major public health problem impacting on the child and their family in terms of pain, infection and substantial financial burden on healthcare funders. In the UK, national guidance on the prevention of dental caries advises parents to supervise their child's brushing with fluoride toothpaste until age 7. However, there is a dearth of evidence-based interventions to encourage this practice in parents. The current study used intervention mapping (IM) to develop a home-based parental-supervised toothbrushing intervention to reduce dental caries in young children. METHODS The intervention was developed using the six key stages of the IM protocol: (1) needs assessment, including a systematic review, qualitative interviews, and meetings with a multi-disciplinary intervention development group; (2) identification of outcomes and change objectives following identification of the barriers to parental-supervised toothbrushing (PSB), mapped alongside psychological determinants outlined in the Theoretical Domains Framework (TDF); (3) selection of methods and practical strategies; (4) production of a programme plan; (5) adoption and implementation and (6) Evaluation. RESULTS The comprehensive needs assessment highlighted key barriers to PSB, such as knowledge, skills, self-efficacy, routine setting and behaviour regulation and underlined the importance of individual, social and structural influences. Parenting skills (routine setting and the ability to manage the behaviour of a reluctant child) were emphasised as critical to the success of PSB. The multi-disciplinary intervention development group highlighted the need for both universal and targeted programmes, which could be implemented within current provision. Two intervention pathways were developed: a lower cost universal pathway utilising an existing national programme and an intensive targeted programme delivered via existing parenting programmes. A training manual was created to accompany each intervention to ensure knowledge and standardise implementation procedures. CONCLUSIONS PSB is a complex behaviour and requires intervention across individual, social and structural levels. IM, although a time-consuming process, allowed us to capture this complexity and allowed us to develop two community-based intervention pathways covering both universal and targeted approaches, which can be integrated into current provision. Further research is needed to evaluate the acceptability and sustainability of these interventions.
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Affiliation(s)
| | - P. F. Day
- School of Dentistry, Clarendon Way, Leeds, LS2 9JT UK
| | - Z. Marshman
- School of Clinical Dentistry, Claremont Crescent, Sheffield, S10 2TA UK
| | - E. Aliakbari
- School of Dentistry, Clarendon Way, Leeds, LS2 9JT UK
| | - S. L. Prady
- Department of Health Sciences, University of York, York, YO10 5DD UK
| | - R. R. C. McEachan
- Bradford Institute for Health Research, Duckworth Lane, Bradford, BD9 6RJ UK
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Rodd H, Hall M, Deery C, Gilchrist F, Gibson BJ, Marshman Z. 'I felt weird and wobbly.' Child-reported impacts associated with a dental general anaesthetic. Br Dent J 2016; 216:E17. [PMID: 24762920 DOI: 10.1038/sj.bdj.2014.333] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
AIM This qualitative study sought to obtain children's accounts of having dental extractions under general anaesthesia (GA). The aim was to gain greater understanding of the physical and psychological impacts from a child's perspective. METHOD Ten children, aged 6-11 years, maintained a video diary to document their feelings and experiences before, and following their hospital admission. Two semi-structured home interviews supplemented the video diary data and analysis was guided by narrative approaches. RESULTS This research revealed new insights into children's experiences of having teeth removed under GA. Several of the post-operative impacts correlated with those previously reported by parents/carers. These were notably nausea, bleeding and tiredness, although children used different terminology. However, additional physical and psychological outcomes, both positive and negative, emerged from the children's narratives. Negative aspects included hunger, disturbed eating, being scared/worried and experiencing discomfort from the IV cannula. Interestingly, pain was not a strong theme. Positive outcomes were also reported, such as satisfaction with the resolution of their dental problem and receipt of rewards and attention from family members. CONCLUSION These accounts have implications for improving patient experiences and outcomes throughout the dental GA care pathway. A review of pre-operative fasting protocols should be a priority.
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Affiliation(s)
- H Rodd
- University of Sheffield, School of Clinical Dentistry, Claremont Crescent, Sheffield, S10 2TA
| | - M Hall
- University of Sheffield, School of Clinical Dentistry, Claremont Crescent, Sheffield, S10 2TA
| | - C Deery
- University of Sheffield, School of Clinical Dentistry, Claremont Crescent, Sheffield, S10 2TA
| | - F Gilchrist
- University of Sheffield, School of Clinical Dentistry, Claremont Crescent, Sheffield, S10 2TA
| | - B J Gibson
- University of Sheffield, School of Clinical Dentistry, Claremont Crescent, Sheffield, S10 2TA
| | - Z Marshman
- University of Sheffield, School of Clinical Dentistry, Claremont Crescent, Sheffield, S10 2TA
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Worsley DJ, Marshman Z, Robinson PG, Jones K. Evaluation of the telephone and clinical NHS urgent dental service in Sheffield. Community Dent Health 2016; 33:9-14. [PMID: 27149767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Evaluate an NHS in- and out-of-hours urgent dental service (UDS) including both a telephone triage provider (TTP) and a sole clinical provider (CP) using a quality framework. BASIC RESEARCH DESIGN Analysis of activity and patient experience data. MAIN OUTCOME MEASURES Ratio of volume of services to activity provided; distance and time travelled; appropriateness of referrals and treatments; equity of utilisation; patient experience; cost per patient. RESULTS Almost all calls (96.6%) to the TTP were answered within 60 seconds and of people referred to the CP 96.0% needed treatment. Proportionately more people from deprived areas used the TTP. Highest utilisation of the TTP was by people aged 20 to 44 years and lowest was by people over 54 years. Cost per patient utilising the TTP was £5.06. Of the available appointments provided by the CP, 90.9% were booked the TTP. Travel time to the CP was less than 30 minutes for 78.0% of patients. Of treatments provided, 77.9% were clinical interventions and 18.1% were prescription only. Proportionately more people from deprived areas attended the CP. Highest utilisation was by people aged 20 to 44 years and lowest by people over 54 years. Nearly half (47.0%) of those attending reported they did not have a dentist. There was a high level of patient satisfaction. Cost per course of treatment at the CP was £67.41. CONCLUSION Overall the UDS provided a high quality service in line with Maxwell's dimensions of quality. Timely advice and treatment was provided with high levels of patient satisfaction with the CP. Comparison with other urgent dental service models would determine the relative efficiency of the UDS.
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Broomhead T, Baker SR, Jones K, Richardson A, Marshman Z. What are the most accurate predictors of caries in children aged 5 years in the UK? Community Dent Health 2014; 31:111-116. [PMID: 25055609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To find the most accurate indicators of the distribution of dental caries in 5-year-olds in the city of Sheffield, UK, using a conceptual framework based on the social determinants of health. METHOD A list of structural and intermediary indicators was compiled based on the Commission on the Social Determinants of Health's (CSDH) conceptual framework. To quantify these indicators, existing data on dental caries were obtained from the NHS Dental Epidemiology Programme, while data on social position, education, employment, income, material circumstances, social cohesion, psychosocial factors and individual behaviours were obtained from the Public Health Intelligence Team at Sheffield City Council. These data were mapped onto a simplified framework of the social determinants of dental caries. Regression analysis was conducted on this simplified framework to determine the amount of variance each indicator contributed to the distribution of dental caries at neighbourhood level. RESULTS The total score for the 2010 Index of Multiple Deprivation contributed a significant amount of variance (60.4%) compared to the combined variance of the other 13 indicators (70.5%). CONCLUSION The total IMD score has the potential to be used as an indicator for the targeting of oral health improvement programmes where survey data are not available. A large prospective study is required in the UK to investigate the full range of factors in the CSDH model to develop a new index which might better predict dental caries experience than IMD.
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Rodd HD, Hall M, Deery C, Gilchrist F, Gibson B, Marshman Z. Video diaries to capture children's participation in the dental GA pathway. Eur Arch Paediatr Dent 2013; 14:325-30. [PMID: 23784710 DOI: 10.1007/s40368-013-0061-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2010] [Accepted: 01/24/2013] [Indexed: 11/26/2022]
Abstract
AIM To explore children's experiences of having teeth extracted under general anaesthetic, with a focus on opportunities to participate in their care pathway. STUDY DESIGN Qualitative study where analysis was informed by a narrative approach. METHODS Ten fit and healthy children, aged 6-11 years, who required multiple dental extractions under general anaesthesia at a UK Children's Hospital, participated in the study. Participants were invited to keep a video diary of their thoughts and experiences leading up to, and following, their hospital admission. Data collection was supported by two semi-structured home interviews. RESULTS Three themes emerged relating to participation: (i) children's prior knowledge and expectations of the dental general anaesthetic (DGA); (ii) their role in decision-making about the DGA and (iii) opportunities identified by children to actively participate in their care pathway. Children's feedback suggested that they did not feel fully informed or involved in decisions about the procedure and were upset about not being able to keep their extracted teeth. CONCLUSIONS Child-centred resources and decision-aids may be helpful in providing greater opportunities for children to participate in their DGA pathway. However, considerable challenges lie in engaging children without increasing pre-DGA anxiety or conflicting with parents' views about what is best for their child.
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Affiliation(s)
- H D Rodd
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK,
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29
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Csikar J, Wyborn C, Dyer T, Godson J, Marshman Z. The self-reported oral health status and dental attendance of smokers and non-smokers. Community Dent Health 2013; 30:26-29. [PMID: 23550503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
AIM To report the oral health status and dental attendance of smokers and non-smokers. METHODS A postal survey enquiring about smoking status, stop smoking advice, dental attendance and perceptions of oral health was conducted in Yorkshire and the Humber, U.K., in 2008. To address potential biases data were weighted to account for variations in gender, age and deprivation. Data were analysed using descriptive statistics, chi-square tests and binary logistic regression. RESULTS A response rate of 43.1% was achieved (n=10,864). Across all deprivation quintiles, smokers (17.5% of respondents) were more likely than non-smokers to report fair, poor or very poor oral health (p<0.001). Smokers in the least deprived areas were more likely than non-smokers to attend the dentist symptomatically (p<0.001). Advice to quit was most frequently gained from GP services followed by NHS Stop Smoking Services and dental teams. CONCLUSIONS Smokers were more likely than non-smokers to have a poor self-rated oral health status and attend the dentist symptomatically, irrespective of deprivation.
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Affiliation(s)
- J Csikar
- Dental Public Health, Leeds Dental Institute, UK.
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30
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Porritt J, Baker SR, Marshman Z. A service evaluation of patient pathways and care experiences of dentally anxious adult patients. Community Dent Health 2012; 29:198-202. [PMID: 23038934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To investigate the current patient pathways used by dentally anxious adults in Sheffield and identify how the patient experience could be improved. DESIGN Questionnaires gathered stakeholder perceptions of referral pathways and services for dentally anxious adult patients. Completed questionnaires were returned by 113 dentally anxious patients who had engaged with specialised dental services and 111 general dental practitioners (GDPs) (28% and 52% response rates). RESULTS The recommendations for improving dental care experience of the anxious were: increased guidance and information to GDPs regarding available care pathways; improved availability of psychological services; and more opportunities and choice for patients in the long-term management of dental anxiety. CONCLUSIONS The findings from the service evaluation suggest ways in which dental services could be developed to improve the care experiences of dentally anxious adult patients.
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Affiliation(s)
- J Porritt
- Unit of Dental Public Health, University of Sheffield, Sheffield, UK.
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Abstract
AIM To undertake a child-centred evaluation of treatment provision for visible enamel defects. DESIGN Postal questionnaires, developed with children, were sent to 88 patients, aged 7-16 years, with visible enamel defects of permanent incisors and who had received microabrasion, with/without additional composite restoration at Sheffield Dental Hospital, UK. The questionnaires sought children's perceptions about their teeth before and after the intervention, as well as their evaluation of how they had been treated. Anonymised responses were graded using a 10 cm visual analogue scale (VAS) where a score of 10 indicated the most negative response, and zero the most positive response. RESULTS Sixty three questionnaires were returned (72% response). Prior to treatment, children reported high levels of worry (VAS=6.8), embarrassment (VAS=6.9) and a perception that their teeth looked yellow and discoloured (VAS=7.3). Following treatment, children thought their teeth looked much better (VAS=1.6), felt happier (VAS=2.2) and more confident (VAS=1.6). They also felt very positive about their clinical experiences, rating the staff as extremely friendly and kind (VAS=0.4) and reporting that procedures were clearly explained (VAS=0.6). CONCLUSIONS Simple non-invasive dental treatment can have a positive effect on appearance-related satisfaction. The use of child-centred approaches offers an invaluable insight into patient perspectives.
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Affiliation(s)
- H D Rodd
- Department of Oral Health and Development, School of Dentistry, University of Sheffield, Sheffield, UK.
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Marshman Z, Farid F. The quality of reporting of randomised controlled trials in dental public health. Community Dent Health 2010; 27:253-256. [PMID: 21473363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To assess the quality of the reporting of randomised controlled trials (RCTs) in dental public health journals. METHOD Electronic and hand searches were used to search for RCTs published in the following three journals over the period 1993 - 2008: Community Dental Health, Community Dentistry & Oral Epidemiology and the Journal of Public Health Dentistry. Exclusion criteria were applied. Each of the resulting papers was reviewed and scored, according to 56 criteria, based on the CONSORT statement. RESULTS The search identified 48 papers. The average number of criteria present per article was 27.0 (SD = 6.9), with variation between journals as follows: Community Dental Health (27.7); Community Dentistry & Oral Epidemiology (27.4); Journal of Public Health Dentistry (23.2). The average number of criteria present per article increased over the time period used. CONCLUSION There were inadequacies in the reporting of trials in dental public health journals. The quality of the reporting could be improved if the CONSORT statement was followed more closely.
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Affiliation(s)
- Z Marshman
- Department of Oral Health and Development, School of Clinical Dentistry, Claremont Crescent, Sheffield, UK.
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Marshman Z, Baker SR, Bradbury J, Hall MJ, Rodd HD. The psychosocial impact of oral conditions during transition to secondary education. Eur J Paediatr Dent 2009; 10:176-180. [PMID: 20073542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
AIM Transition to secondary education is a significant life event. Little is known about the impact of oro-facial conditions during this time and how concerns may contribute as a risk factor to negative adaptation. The aim of the study was to explore experiences of young people with oro-facial conditions as they undergo the transition to secondary education. STUDY DESIGN Qualitative interview and diary study. METHODS Participants were children aged 11-12 years with a range of clinical conditions who attended a dental hospital. Participants completed a two-week diary during the transition and were interviewed about the diary and their experiences. The interviews were audio-taped and transcribed verbatim. RESULTS Seventeen participants returned the diary and were interviewed; they described both changes in school environment and social interactions. A key finding was the concerns about aspects of themselves that children developed during this time. For some young people these concerns were about their oro-facial condition. No links between gender, severity of condition and experiences of school were apparent. CONCLUSION Transition to secondary education affected young people to varying degrees. Timely treatment for those concerned about the condition of their teeth may improve the likelihood of positive adaptation.
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Affiliation(s)
- Z Marshman
- Department of Oral Health and Development, School of Clinical Dentistry, Sheffield, UK.
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Morgan AG, Owens J, Marshman Z, Rodd HD. The case report in 21st century child dental literature. Eur J Paediatr Dent 2008; 9:145-148. [PMID: 18844444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
AIM To review recent dental child case reports to determine: 1 the main focus of the paper; 2 perceived contribution to the dental literature and, 3 involvement of the child. STUDY DESIGN Systematic review. METHODS Case reports published between 2000 and 2005 were identified using Medline via Ovid and Embase databases. Papers were reviewed to determine: their perceived value; whether they related to a single case or case series; the main dental condition; how the child was referred to, and inclusion of any child-centred input within the report. RESULTS AND STATISTICS 663 case reports, from 82 journal titles, were subject to review. The majority presented a single patient (82%) and discussed a type of intervention or treatment (58%). The most common themes related to oral pathology/medicine (28%), and orthodontics (26%). Most children were referred to as 'patients' (74%) with little use of personalised terms (4%). Few reports included any child-centred input or contribution from a proxy (10% and 2% respectively). Inter- and intra-examiner repeatability for categorisation was excellent. CONCLUSIONS The majority of child-related reports described a treatment or intervention which is surprising given the low level of case reports in the hierarchy of evidence. The child's perspective in the presenting complaint or outcome needs greater consideration.
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Affiliation(s)
- A G Morgan
- Department of Oral Health and Development, School of Clinical Dentistry, University of Sheffield, UK.
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Marshman Z. Summary of: Oral health-related quality of life and the IOTN index as predictors of children's perceived needs and acceptance for orthodontic treatment. Br Dent J 2008. [DOI: 10.1038/sj.bdj.2008.266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Marshman Z, Rodd H, Stem M, Mitchell C, Robinson PG. Evaluation of the Parental Perceptions Questionnaire, a component of the COHQoL, for use in the UK. Community Dent Health 2007; 24:198-204. [PMID: 18246836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
OBJECTIVE To assess the reliability and validity of the Parental Perceptions Questionnaire (PPQ) for use in the UK and to investigate whether different approaches to the treatment of 'don't know' (DK) responses have any effect on the psychometric properties. METHODS The parents of 89 children attending for an examination at a dental teaching hospital and a general dental practice completed the Parental-Caregiver Perceptions Questionnaire (PPQ), global oral health and global impact ratings. Clinical data were also collected. Four approaches were taken to the management of DK responses, one approach involved exclusion of DK responses and three approaches involved adjustment of DK responses (item mean, mean items answered and replacement of DK responses with zero). RESULTS All four approaches demonstrated acceptable internal consistency and test-retest reliability of the total scale. The mean items answered and replacement approaches had optimal internal consistency of the subscales of the PPQ. Assessments of criterion validity in relation to global oral health rating were similar when the DK responses were adjusted, but the exclusion of DK responses had a detrimental effect. Construct validity of PPQ in relation to global impact rating and clinical data was acceptable only when responses were adjusted. CONCLUSION These data suggest that if DK responses are adjusted, the reliability and validity of this measure are acceptable for use in the UK.
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Affiliation(s)
- Z Marshman
- Department of Oral Health and Development, School of Clinical Dentistry, Claremont Crescent, Sheffield, UK.
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Abstract
OBJECTIVE To explore the validity and reliability of the child perception questionnaire as an oral-health-related quality of life (OHRQoL) measure in adolescents with malocclusion. DESIGN A cross-sectional study comparing two groups of individuals. SETTING One group of children with malocclusion was recruited from the orthodontic departments at the Charles Clifford Dental Hospital (CCDH), Sheffield and Chesterfield Royal Hospital (CRH), Chesterfield. A second group with no malocclusion was recruited from the Paediatric Department at CCDH and one General Dental Practice in Sheffield. SUBJECTS AND METHODS The malocclusion group consisted of 116 patients aged 11-14 years about to commence orthodontic treatment. The non-malocclusion group consisted of 31 11-14-year-old patients with index of orthodontic treatment need (IOTN) 1 and 2, and DMFT <or=2, with no history of orthodontic treatment. The children completed the child perception questionnaire (CPQ), including global ratings of oral health and satisfaction. Each child rated their own IOTN aesthetic component (AC) score. OUTCOME MEASURES Total CPQ scores and responses in the four domains. Self-perceived AC scores and responses to global rating of oral health, life overall and satisfaction rating were recorded. RESULTS There was a statistically significant difference between the malocclusion and non-malocclusion total CPQ scores (P = 0.012). These differences were significant for the emotional (P = 0.006) and social well-being (P = 0.001) health domains, and not significant for the oral symptoms and functional limitations health domains. There were significant correlations between the total CPQ score and overall well-being (R(s) = 0.397) and patient satisfaction (Rs = 0.362). CONCLUSIONS Malocclusion has a negative impact on the OHRQoL of an adolescent. A shortened version of this form, specifically for prospective orthodontic patients, may be beneficial as an additional measure to assess need for treatment especially as some of the questions in the oral symptoms and functional limitations subscales of the current questionnaire are not relevant to orthodontic patients.
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Affiliation(s)
- C O'Brien
- Charles Clifford Dental Hospital, Sheffield, UK
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Marshman Z, Rodd H, Stern M, Mitchell C, Locker D, Jokovic A, Robinson PG. An evaluation of the Child Perceptions Questionnaire in the UK. Community Dent Health 2005; 22:151-5. [PMID: 16161878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
OBJECTIVE To assess the reliability and validity of the Child Perceptions Questionnaire (CPQ11-14), an oral health related quality of life measure for 11-14 year old children, for use in the UK. BASIC RESEARCH DESIGN Cross-sectional questionnaire and clinical analytical study. CLINICAL SETTING Orthodontic and paediatric dentistry clinics at a dental hospital and one general dental practice. PARTICIPANTS Eighty-nine children between 11 and 14 years of age attending for an examination. MAIN OUTCOMES MEASURES The children were invited to complete the CPQ11-14, global oral health and impact on life overall ratings. Clinical data on caries status, malocclusion and presence of dental opacities and gingivitis were collected. CPQ11-14 was summarised as the total score (sum of the item codes) and the number of impacts reported often or every day. RESULTS The Cronbach's alpha for the total scale was 0.87 and ranged from 0.59 to 0.83 for the subscales indicating acceptable internal consistency. The intraclass correlation coefficient on repeated application of the measure was 0.83 (95% CI = 0.76-0.90) suggesting almost perfect agreement. Summary measures of CPQ11-14 correlated with the global oral health rating indicating acceptable criterion validity. Impact on life overall was related to all summary measures of CPQ11-14. Number of impacts correlated with the total number of missing teeth and missing teeth due to caries. No other relationships between clinical and CPQ11-14 data were apparent. CONCLUSION The CPQ11-14 shows acceptable reliability, criterion and construct validity in relation to life overall. Relationships with clinical data were more tenuous. If this measure is to be used to compare the impacts of oral diseases in similar settings in the UK a large sample will be required.
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Affiliation(s)
- Z Marshman
- Department of Oral Health and Development, School of Clinical Dentistry, Sheffield, UK.
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