bluuebunny/crossref_metadata_2025_split huggingface dataset:
A baseline study of the demographics of the oral health workforce in rural and remote Western Australia
Authors: Kruger E. , Tennant M. 
Published: March 2008

Abstract Background: A shortage of dental practitioners in Australia is predicted for the future, and the greatest effect of this will be felt in rural and remote areas. Strategies are needed to increase the recruitment and retention of dental practitioners in these areas. Part of this process is to assess the demographics of the oral health workforce. Methods: A postal questionnaire survey was undertaken in 2002, that involved all registered dentists, therapists and hygienists in rural and remote Western Australia. Results: Rural dentists are predominantly male, early middle aged, married, UWA trained, Australian born with one to two children. Rural dental therapists are predominantly female, in their mid‐thirties, married, Australian born, trained in Western Australia, with two children. Male dentists worked slightly more hours per week than female dentists. The majority of the workforce does have access to email and the internet. Taking leave is a problem for most dentists because of difficulties in finding locums. Conclusions: The rural dental workforce capacity and demographic distribution need monitoring and analysis. This will determine the dental workforce's future ability to deliver the necessary services in rural and remote regions, where currently there is a dental workforce shortage.
Developing primary health clinical teams for public oral health services in Tasmania
Authors: Cane RJ , Butler DR 
Published: March 2008

AbstractThis paper reviews the problem of socio‐economic health inequalities and highlights the relevance of these issues for the delivery of public oral health services in the Australian island State of Tasmania. It contends that unless there is reform of existing public oral health systems, inequities in oral health care linked to socio‐economic factors and geographic location will remain. The challenge is, firstly, to understand the current situation and why it has occurred. Secondly, we need to ensure that this understanding is shared across educational and professional sectors for the development of innovative approaches to the problem. Thirdly, we must carry out preliminary research and evaluation for any reforms. Using a combination of approaches, i.e., primary health care, a ‘common risk’ approach and increasing workforce numbers has been identified as a method showing the most potential to improve access to equitable oral health care. An outline of a current research project evaluating the impact of the integration of primary oral health care clinical teams into public oral health services is provided. The clinical teams combine the skills of the dentist and an expanded role for dual trained dental therapists/dental hygienists. The teams focus on the development of innovative clinical practice in the management and prevention of common oral diseases that take into account the broader determinants of oral health inequality. This project will be conducted in Tasmania, where the dominance of small rural and remote communities, adverse socio‐economic factors and shortage of oral health professionals are key issues to consider in planning public oral health services and programmes. The results of the evaluation of the Tasmanian pilot model will contribute to the evidence base that will support the introduction of new approaches to public oral health care.
The growth of the nasal septum in the 6–9 week period of foetal development—Warfarin embryopathy offers a new insight into prenatal facial development
Authors: Howe AM , Hawkins JK , Webster WS 
Published: March 2008

Abstract Background The aim of this study was to determine the role of the nasal septum in embryonic facial development. Methods Nasal septal growth and facial profile development were examined in sagittally‐sectioned 6–9 week human foetuses and compared to previously published data for later prenatal periods. To complement this data a cephalometric study of a child with untreated warfarin embryopathy was undertaken since a previous study in rats had shown warfarin exposure interferes with septal growth. Results The results showed that prenatal septal growth was maximal during the 6–9 week period and resulted in the establishment of a facial profile that was maintained until birth. This critical period of growth corresponds to the period of warfarin exposure of the human foetus that results in the warfarin embryopathy. The cephalometric examination of a child with untreated warfarin embryopathy showed a combination of short anterior cranial base and a short maxilla had contributed to a significant retrusion of the maxilla suggestive of failure of the midface to develop over the 6–9 week period. Conclusion These findings would support the hypothesis that the nasal septum plays an active role in embryonic midfacial development.
Longevity of a resin‐modified glass ionomer cement and a polyacid‐modified resin composite restoring non‐carious cervical lesions in a general dental practice
Authors: Smales RJ , Ng KKW 
Published: March 2008

Abstract Background Long‐term prospective survival studies of resin‐modified glass ionomer cements (RMGICs) and polyacid‐modified resin composites (compomers) placed in non‐carious cervical lesions (NCCLs) are lacking from general dental practice. Short‐term studies have shown an unsatisfactory clinical performance for several materials. Methods One practitioner placed 87 compomer (Compoglass, Vivadent‐Ivoclar) and 73 encapsulated RMGIC (Fuji II LC, GC Int.) restorations in NCCLs for 61 adults. Compoglass was placed using SCA primer, and Fuji II LC using GC Dentin Conditioner. No cavity preparation was undertaken. The Kaplan‐Meier method was used for estimating the cumulative survivals for those restorations that were replaced, with the probability level set at a=0.05 for statistical significance. Results Restorations were judged unsatisfactory (by the practitioner and the subjects) because of surface and marginal loss of material (68.8 per cent), dislodgement (18.8 per cent) and discoloration (12.4 per cent), these modes being similar for both materials (P=0.35). Unsatisfactory restorations were replaced in 121 (75.6 per cent) instances. After periods of up to five years, cumulative survival estimates were 14.9 (5.8 Standard Error) per cent for Compoglass and zero per cent for Fuji II LC (P=0.74). Median survivals were 30 months for Compoglass and 42 months for Fuji II LC. Conclusion Both materials had high long‐term unsatisfactory performances when placed in non‐ prepared NCCLs in a general dental practice.
Burning mouth syndrome: an update on recent findings
Authors: Barker KE , Savage NW 
Published: March 2008

AbstractBurning mouth syndrome (BMS) is characterized by a burning sensation of the oral mucosa in the absence of mucosal abnormality. Various local, systemic and psychological factors are associated with BMS, but its aetiology is not fully understood. Recently, significant inroads have been made, producing a better understanding of this complex condition. The aim of the current paper is to explore the condition of BMS in an educational context with the specific outcome of increasing awareness of the condition.
An in vitro model to measure the effect of a silver fluoride and potassium iodide treatment on the permeability of demineralized dentine to Streptococcus mutans
Authors: Knight GM , McIntyre JM , Craig GG , Mulyani  , Zilm PS , Gully NJ 
Published: March 2008

Abstract Background: Diamine silver fluoride (Ag(NH3)2F), referred to as AgF, has been used to reduce the incidence of caries in primary dentitions but has been limited by the associated staining of both teeth and restorative materials. The application of potassium iodide (KI), following AgF prevents staining but its effects on the ability of AgF to reduce caries are not known. The aim of this study was to develop an in vitro model that would provide an indication of the permeability of demineralized dentine to Streptococcus mutans after treatment of the dentine with AgF followed by KI. Methods: Forty dentine discs were bonded to the base of forty 5mL polycarbonate screw top vials (that had had their bases removed), filled with nutrient medium, sterilized and placed into a continuous culture of S. mutans. Samples were divided into four groups as follows: 10 samples of demineralized dentine as a control, 10 samples of demineralized dentine treated with AgF/KI, 10 samples of demineralized dentine treated with KI and 10 samples of demineralized dentine treated with AgF. After two weeks the optical density of the growth medium chambers was measured to determine bacterial penetration and growth. Cultures were plated out to determine migration through the discs by S. mutans. Results: S. mutans migrated through all dentine discs. However, the samples treated with AgF and AgF/KI had significantly lower optical densities than the corresponding controls. The range of optical densities was least amongst demineralized samples treated with AgF/KI. Conclusions: Under the conditions of this study, treatment of demineralized dentine discs with AgF followed by KI allowed the penetration of S. mutans. Based on optical density measurements, the treatment resulted in significantly fewer microorganisms being present subjacent to the discs treated with AgF and KI than the control discs at the end of the experimental period.
Pre‐school child oral health in rural Western Australia
Authors: Kruger E. , Dyson K. , Tennant M. 
Published: March 2008

Abstract Background: In light of the various challenges faced by public dental health services, especially when large geographical areas and isolated communities are concerned, targeting of high risk groups within these populations needs to be investigated. This study aimed to assess caries experience, dental health behaviour and dental service utilization among a sample of pre‐school children in a rural community in Western Australia. Methods: The study was a cross‐sectional oral health survey of pre‐school children between the ages of 2 and 5 in Carnarvon, Western Australia. Results: In total, 70 pre‐school children (representing approximately 15 per cent of the total 2–5 year old population of Carnarvon) were examined. Less than half of the children were caries free. Both caries prevalence and severity (mean dmft) were significantly higher among Aboriginal children than non‐Aboriginal children. Caries prevalence and severity were also significantly higher among children who often consumed carbonated drinks. Conclusions: This survey indicates that some preschool children in rural areas, and especially Aboriginal pre‐school children, are at high risk of developing dental caries. Effective oral health programmes commencing well before the usual first contact with dental services at age 5 are needed for young children at high risk of dental caries.
Drugs for pain management in dentistry
Authors: Hargreaves K. , Abbott P V 
Published: March 2008

AbstractPain is one of the most common reasons patients seek dental treatment. It may be due to many different diseases/conditions or it may occur after treatment. Dentists must be able to diagnose the source of pain and have strategies for its management. The ‘3‐D’ principle — diagnosis, dental treatment and drugs — should be used to manage pain. The first, and most important, step is to diagnose the condition causing the pain and identify what caused that condition. Appropriate dental treatment should then be undertaken to remove the cause of the condition as this usually provides rapid resolution of the symptoms. Drugs should only be used as an adjunct to the dental treatment. Most painful problems that require analgesics will be due to inflammation. Pain management drugs include non‐narcotic analgesics (e.g., non‐steroidal anti‐inflammatory drugs, paracetamol, etc) or opioids (i.e., narcotics). Non‐steroidal anti‐inflammatory drugs (NSAIDs) provide excellent pain relief due to their anti‐inflammatory and analgesic action. The most common NSAIDs are aspirin and ibuprofen. Paracetamol gives very effective analgesia but has little anti‐inflammatory action. The opioids are powerful analgesics but have significant side effects and therefore they should be reserved for severe pain only. The most commonly‐used opioid is codeine, usually in combination with paracetamol. Corticosteroids can also be used for managing inflammation but their use in dentistry is limited to a few very specific situations.
Oral candidosis and the therapeutic use of antifungal agents in dentistry
Authors: McCullough MJ , Savage NW 
Published: March 2008

AbstractThis paper reviews the current concepts of mycology and candidal infections as they relate to the oral cavity. Proposed classification for the presentation of oral candidosis is outlined as are examples of these topical infections, such as erythematous, pseudo‐membranous and hyperplastic candidosis, as well as angular chelitis and median rhomboid glossitis. The diagnosis and principles of management of oral candidosis are discussed, the therapeutic agents available for the management of these infections are presented and a treatment protocol for the management of patients with oral candidosis is given.
Topical corticosteroids in dental practice
Authors: Savage NW , McCullough MJ 
Published: March 2008

AbstractTopical corticosteroids represent an important therapeutic aid in the management of a range of oral mucosal disease conditions. Like all medications, their successful use depends upon an understanding of the disease process. This includes an appropriate diagnosis, a clear view of the desirable treatment outcomes and knowledge of whether treatment is aimed at management of a chronic disease or enhanced resolution of a short‐term condition. This paper reviews the use of topical corticosteroids and their possible roles in the management of oral disease.
Antibiotic prophylaxis for endocarditis: time to reconsider
Authors: Singh J. , Straznicky I. , Avent M. , Goss AN 
Published: March 2008

AbstractSome cardiac conditions require antibiotic prophylaxis for some types of dental treatment to reduce the risk of infective endocarditis (IE). All medical and dental practitioners are familiar with this practice but tend to use different regimens in apparently similar circumstances. Generally, the trend has been to prescribe antibiotics if in doubt. This review explores the evidence for antibiotic prophylaxis to prevent IE: does it work and is it safe? The changing nature of IE, the role of bacteraemia of oral origin and the safety of antibiotics are also reviewed. Most developed countries have national guidelines and their points of similarity and difference are discussed. One can only agree with the authority who describes antibiotic guidelines for endocarditis as being ‘like the Dead Sea Scrolls, they are fragmentary, imperfect, capable of various interpretations and (mainly) missing!’ Clinical case‐controlled studies show that the more widely antibiotics are used, the greater the risk of adverse reactions exceeding the risk of IE. However, the consensus is that antibiotic prophylaxis is mandatory for a small number of high‐risk cardiac and high‐risk dental procedures. There are a large number of low‐risk cardiac and dental procedures in which the risk of adverse reactions to the antibiotics exceeds the risk of IE, where prophylaxis should not be provided. There is an intermediate group of cardiac and dental procedures for which careful individual evaluation should be made to determine whether IE or antibiotics pose the greater risk. These categories are presented. All medical and dental practitioners need to reconsider their approach in light of these current findings.
Cardiac murmurs: echocardiography in the assessment of patients requiring antibiotic prophylaxis for dental treatment
Authors: Ching M. , Straznicky I. , Goss AN 
Published: March 2008

Abstract Background: Traditionally patients who indicate that they have a heart murmur or who indicate that they have had rheumatic fever are given antibiotic prophylaxis for dental treatment. This is commonly done without further assessment of the patient's actual endocarditis risk. Echocardiography is a non‐invasive method of assessing cardiac valve function and haemodynamics. Methods: Consecutive patients who were referred to a private practice oral and maxillofacial surgeon for dentoalveolar surgery and indicated that they had a cardiac problem and usually had antibiotic prophylaxis, were evaluated. Those with a clear indication for prophylaxis, for example had prosthetic heart valves or previous infective endocarditis, received antibiotic prophylaxis. Where there was uncertainty, they were referred for an echocardiogram, and if abnormal, a formal cardiology review. Results: Three hundred and seventy patients out of approximately 20 000 (1.85 per cent) indicated that they had a cardiac murmur and usually received antibiotic prophylaxis for dental treatment between 1 February 1997 and 1 February 2005. Two hundred and sixty‐two (71 per cent) were female and 108 (29 per cent) were male; age range 0.7 to 98 years, average 37.6 years. Two hundred and seventy (72 per cent) had normal hearts with no indication for antibiotic prophylaxis. Of the 100 (28 per cent) patients with abnormal findings, they were on average older; 49.5 years, range 0.7 to 87 years. Of these, 50 (14 per cent) met current indications for antibiotic prophylaxis. Conclusion: Patients who present for dental treatment indicating that they require antibiotic prophylaxis for cardiac condition need to be fully evaluated. In this study only 50 of 370 patients (14 per cent) required antibiotic prophylaxis. The remaining 320 (86 per cent) would have no benefit but a risk of adverse reaction to the antibiotic.
Severe odontogenic infections
Authors: Uluibau IC , Jaunay T. , Goss AN 
Published: March 2008

Abstract Background: Severe odontogenic infections are serious potentially lethal conditions. Following the death of a patient in the authors' institution this study was initiated to determine the risk factors, management and outcome of a consecutive series of patients. Methods: All patients admitted to the Royal Adelaide Hospital under the care of the Oral and Maxillofacial Surgery Unit with odontogenic infections in calendar year 2003 were investigated. Detailed information relative to their pre‐presentation history, surgical and anaesthetic management and outcome was obtained and analysed. Results: Forty‐eight patients, 32M, 16F, average age 34.5, range 19 to 88 years were treated. All presented with pain and swelling, with 21 (44 per cent) having trismus. Forty‐four (92 per cent) were as a result of dental neglect and four (8 per cent) were regular dental patients having endodontic treatment which failed. Of those known to have been treated prior to presentation, most had been on antibiotics. Most patients had aggressive surgical treatment with extraction, surgical drainage, high dose intravenous antibiotics and rehydration. The hospital stay was 3.3 (range 1–16) days. Patients requiring prolonged intubation and high dependency or intensive care (40 per cent) had longer hospitalization. No patient died and all fully recovered. Conclusion: Severe odontogenic infections are a serious risk to the patient's health and life. Management is primarily surgical with skilled anaesthetic airway management. Antibiotics are required in high intravenous doses as an adjunct and not as a primary treatment.
Cryotherapy for treatment of oral lesions
Authors: Farah CS , Savage NW 
Published: March 2008

AbstractCryotherapy is the deliberate destruction of tissue by application of extreme cold. It is well received by patients due to a relative lack of discomfort, the absence of bleeding and minimal to no scarring after healing. It has many applications in oral medicine and clinical oral pathology, and is extremely useful in patients for whom surgery is contra‐indicated due to either age or medical history. In this paper we outline the principles, mechanisms of action, and current applications of cryotherapy in the treatment of oral lesions, and present some clinical cases.
Dental therapy in Western Australia: profile and perceptions of the workforce
Authors: Kruger E. , Smith K. , Tennant M. 
Published: March 2008

Abstract Background: In 2002, the Centre for Rural and Remote Oral Health (CRROH) completed a rural oral health workforce survey which indicated that a high number of therapists, although registered, were not working as therapists. The aim of the present study was to develop a profile of the dental therapy workforce and analyse the perceptions of therapists. Methods: In 2004, a postal questionnaire survey was undertaken amongst all registered dental and school dental therapists for 1999, 2000, 2001, 2002 and 2003. Results: Valid information was obtained from 253 therapists (55 per cent response rate). The therapy workforce are almost exclusively female, have an average age of 40 years, are working in urban areas, obtained their qualification on average 20 years ago, work for the School Dental Service and qualified in Western Australia. More than a quarter no longer worked as therapists. Perceptions regarding the advantages and disadvantages of dental therapy as a career were identified. Conclusions: When trying to promote dental therapy and school dental therapy as a career, retain therapists and recruit new graduates, the opportunities identified in this survey should be embraced. A clear focus on the issues will be required to facilitate meeting the workforce objectives as outlined in Australia's National Oral Health Plan.
Epidemiological analysis of tongue cancer in South Australia for the 24‐year period, 1977–2001
Authors: Lam L. , Logan RM , Luke C. 
Published: March 2008

Abstract Background: Tongue cancer (141 ICD‐9) is the most common intra‐oral malignancy in Western countries. In recent decades, reported tongue cancer incidence and mortality rates have increased both in Europe and in the United States, whilst survival has not improved. This study aimed to determine the epidemiology and survival trends of tongue cancer in South Australia over the 24‐year period from 1977 to 2001. Methods: Population‐based data for tongue cancer were provided by the Central Cancer Registry Unit of the Epidemiology Branch of the South Australian Department of Health. Age‐standardized incidence and mortality rates for males and females were calculated. Kaplan‐Meier survival analysis was conducted according to time periods, age, sex and tongue sub‐sites. Cox regression analysis was used to determine factors that influenced survival. Results: During this 24‐year period, 611 cases of tongue cancer (398 males, 213 females) were reported, the majority of which were squamous cell carcinomas. The most common age of diagnosis was 65–69 years in males and 60–64 years in females. Fifty cases (8.18 per cent of all tongue cancer cases) occurred in patients 40 years or younger. The most common cancer sub‐sites reported were ‘unspecified site’ (48.45 per cent), lateral border (25.53 per cent) and base (18.49 per cent) of the tongue. The age‐standardized incidence and mortality rates for males and females in South Australia were relatively low and stable, and there was no significant improvement in survival of tongue cancer over this period. Significant predictors for survival were sex, age and tongue sub‐sites, with male, advanced age and base of tongue associated with poorer survival. Conclusions: Tongue cancer is an important health issue associated with poor survival. Early detection and diagnosis is important in order to improve survival rate for this malignancy.