Hall technique: is it superior in success and savings to conventional restorations?

Design A cost-effectiveness analysis of caries management in primary molars using Hall technique (HT) versus conventional restoration (CR) from a pre-existing dataset from a randomised split-mouth trial, within primary care in Scotland, with a five-year follow-up.Case selection Computer-generated block randomisation was used to match asymptomatic primary molars of 3-10-year-old children recruited from primary care, to either HT or CR arms.Economic evaluation A cost-effectiveness analysis was undertaken. A five-year horizon was chosen. A societal perspective was adopted. Estimation of direct, indirect and opportunity costs were presented. Costs were discounted at 1.5%. Molar survival was chosen as the effectiveness measure.Data analysis Statistical significance of primary outcome (survival) was examined using the log-rank test. Bootstrapping produced a sampling distribution of mean cost and effectiveness with a 95% confidence interval around a mean value. An incremental cost-effectiveness ratio (ICER) was provided.Results HT molars had superior survival of 99% (95% CI: 98-100%) compared to CR at 92% (95% CI: 87-97%). Initials costs indicated HT to be more expensive than CR; however, direct costs, including retreatments, were cheaper for HT when using both NHS Scotland and NHS England cost data. Indirect/opportunity costs, including time and travel of parents, were significantly less for HT. Total cumulative costs were significantly lower in HT (32 GBP; 95% CI: 31-34) than CR (49 GBP; 34-69). HT dominated CR, being less costly and more effective with a mean ICER of 2.38 GBP spent additionally while losing 1% of molar survival with CR over HT.Conclusions HT molars are cost-effective, compared to CR, when managing asymptomatic carious primary molars after five years' follow-up.

Distraction osteogenesis versus orthognathic surgery for the treatment of maxillary hypoplasia in cleft lip and palate patients: a systematic review.

OBJECTIVE: To compare the effectiveness of distraction osteogenesis to orthognathic surgery for the treatment of maxillary hypoplasia in individuals with cleft lip and palate. METHOD: A systematic review of prospective randomized, quasi-randomized or controlled clinical trials. MEDLINE, EMBASE, Scopus, Web of Science, CINAHL, CENTRAL, trial registers and grey literature were searched. Hand searching of five relevant journals was completed. Two reviewers independently completed inclusion assessment. Data extraction and risk of bias assessment were completed by a single reviewer and checked by a second reviewer. RESULTS: Five publications all reporting different outcomes of a single randomized controlled trial are included within the review. The quality of the evidence was low with a high risk of bias. Both surgical interventions produce significant soft tissue improvement. Horizontal relapse of the maxilla was statistically significantly greater following orthognathic surgery. There was no statistically significant difference in speech and velo-pharyngeal function between the interventions. Maxillary distraction initially lowered social self-esteem, but this improved with time resulting in higher satisfaction with life in the long term. CONCLUSIONS: The low quality of evidence included within the review means there is insufficient evidence to conclude whether there is a difference in effectiveness between maxillary distraction and osteotomy for the treatment of cleft-related maxillary hypoplasia. There is a need for further high-quality randomized controlled trials to allow conclusive recommendations to be made.

Dental erosion among 12 year-old Libyan schoolchildren.

OBJECTIVE: As there are limited data on dental erosion in Libya, the aim of this study was to assess the prevalence and severity of dental erosion in a sample of 12 year-old children in Benghazi, Libya. BASIC RESEARCH DESIGN: Cross-sectional observational study. CLINICAL SETTING: Elementary schools in Benghazi, Libya. PARTICIPANTS: A random sample of 791 12 year-old children (397 boys and 394 girls) attending 36 schools. METHODS: Clinical dental examination for erosion using UK National Diet and Nutrition Survey (2000) criteria and self-completion questionnaire. MAIN OUTCOME MEASURES: The area and depth of dental erosion affecting the labial and palatal surfaces of the upper permanent incisors and occlusal surfaces of the first permanent molars. RESULTS: Dental erosion was observed in 40.8% of subjects; into enamel affecting 32.5%, into dentine affecting 8.0% and into pulp affecting 0.3% of subjects. Based on area affected, 323 subjects (40.8%) exhibited dental erosion (code > 0), with 32.6% of these subjects having erosion affecting more than two thirds of one or more surfaces examined. Mean total scores for dental erosion for all surfaces per mouth by area and by depth were both 2.69 (sd 3.81). Of the 9492 tooth surfaces examined, 2128 surfaces (22.4%) had dental erosion. Girls had more experience of erosion than boys at all levels of severity (p = 0.001). CONCLUSIONS: In a cohort of 12 year-old Libyan schoolchildren, more than one third of children examined showed dental erosion, requiring clinical preventive counselling. Significantly more erosion occurred in girls than boys.

Dental erosion and its association with diet in Libyan schoolchildren.

AIM: To investigate any association between dental erosion and its potential dietary risk factors in a group of schoolchildren in Benghazi, Libya. STUDY DESIGN: A cross-sectional observational study. METHODS: A random sample of 12-year-old schoolchildren in 36 randomly selected schools completed a questionnaire to provide dietary data and underwent dental examination. Dental erosion was assessed using UK National Diet and Nutrition Survey (2000) criteria. Associations between erosion and dietary variables under study were investigated through processes of bivariate and multivariate analyses. RESULTS: Of 791 schoolchildren dentally examined, 40.8% had dental erosion; erosion into enamel affecting 32.5%, into dentine affecting 8% and into pulp affecting 0.3% of subjects. Bivariate analysis showed frequency of fruit-based sugary drink intake was statistically significantly and positively associated with erosion (p=0.006, Odds Ratio; 1.498, 95% CI; 1.124, 1.996) as was the length of time taken to consume acidic drinks (p≠0.005, Odds Ratio; 1.593, 95%CI; 1.161, 2.186). Additionally, multivariate analysis showed frequency of consumption of fruit other than bananas, sugared tea with milk and flavoured milk to also be positively associated with erosion (p=<0.05). CONCLUSIONS: In this group of Libyan 12-year-olds, frequency of consumption of fruit-based sugary drinks and length of time taken to consume acidic drinks were the primary statistically significant positive risk factors for dental erosion.

Developing an assessment in dental public health for clinical undergraduates attending a primary dental care outreach programme.

BACKGROUND: This paper describes the development and implementation of a Dental Public Health (DPH) assessment within the Primary Dental Care Outreach (PDCO) course at Newcastle University. The assessment was piloted alongside the delivery of the Bachelor of Dental Surgery (BDS) curriculum in accordance with established learning outcomes. AIM: To design and implement a pilot summative assessment, incorporating patients' social histories obtained by undergraduate students attending primary dental care outreach clinics. METHOD: Undergraduates were tasked with obtaining a detailed social history from a patient seen during their two-year outreach attachment. Each student submitted a written account of their patient's social history and placed this in context by researching a number of demographic and social variables centred upon their patient's home residence. The final component involved writing a concise case feature for a nominated newspaper based upon the case history, where students were encouraged to identify one or more public health messages using language appropriate to a lay readership. RESULTS: Seventy one clinical undergraduates (98.6% of the year-group) subsequently submitted all components of the assessment. Eighty six per cent of the year-group was deemed to have passed the assessment with 9.9% achieving a 'Merit' grade and 76% a 'Satisfactory' grade. Following the assessment, students and clinical teachers were asked for their feedback through a focus group for staff, and a brief feedback form for students. CONCLUSION: Undergraduates subsequently reported greater awareness of the significance and importance of obtaining a detailed social history and its relevance when devising appropriate and realistic treatment plans.

Quantifying and qualifying surface changes on dental hard tissues in vitro.

INTRODUCTION: Tooth surface loss (TSL) is an increasingly recognised problem. We are therefore seeing an increase in the number and complexity of in vitro studies investigating factors that modify effects at the tooth surface. AIM: The aim of this paper is to provide a narrative review that illustrates the more commonly used in vitro methods (both historical and contemporaneous) that are available for measuring surface loss and surface change. METHOD: An initial search (March 2009) was carried out using Scopus abstract and citation database with the keywords 'dental' AND 'erosion OR abrasion' AND 'surface change OR surface loss' AND 'vitro' (1975-2009). This resulted in 69 papers which were reviewed and the methods critically appraised. Bibliographic material from the papers was then used in order to find other appropriate sources. RESULTS: It is clear that tooth surface change is a complex process that can be measured in a variety of ways. No single technique provides a comprehensive assessment of the remaining tooth surface, and each technique suffers its own limitations. What is also clear is that way in which surface change is reported by each of the techniques gives little information relating to how the surface may change in the immediate future. CONCLUSION: Despite a variety of available in vitro tests for measuring surface changes, the roughness average (R(a)) is still the main reported measurement within dental studies. Using the same set of profilometric data, it is proposed that additionally reporting bearing area parameters will allow a further and more meaningful description of the surface quality.

Developing a primary dental care outreach (PDCO) course--part 1: practical issues and evaluation of clinical activity.

BACKGROUND: The primary dental care outreach (PDCO) course in Newcastle, UK commenced in September 2004 with dental undergraduates attending outreach clinics on a fortnightly rotation over a 2 year continuous placement. OBJECTIVES: To evaluate the PDCO with respect to practical issues and clinical activity. METHODS: Clinical activity data were collected using data sheets and Access software together with data on patient attendances and Structured Clinical Operative Tests (SCOTs). Comparative clinical data were collected from the same group of students in Child Dental Health (CDH) in the School of Dental Sciences. RESULTS: In 2004/2005, 1683 clinical procedures were undertaken in PDCO and 1362 in CDH. Of the treatment undertaken in PDCO, 37.1% was examination and treatment planning, 17.1% basic intracoronal restorations and 13.1% fissure sealing, the activity representative of day to day in general practice. Completion rates for the five piloted SCOTs in cross infection control, writing a prescription, writing a referral letter, taking a valid consent and taking a radiograph ranged from 74% to 97% in 2004/2006. The practical issues and challenges of delivering a new clinical course broadly related to induction of new PDCO staff, support of staff, establishing effective communication, timetabling logistics, delivery of clinical teaching and quality assurance. CONCLUSION: Once the practical issues and challenges of setting up a new clinical course have been overcome PDCO has a valuable role to play in preparing undergraduates for their future practising careers.

Developing a primary dental care outreach (PDCO) course--part 2: perceptions of dental students.

BACKGROUND: The perspective of participating students in a primary dental care outreach (PDCO) course, with regard to clinical and educational value, has informed course development and delivery. OBJECTIVES: To evaluate students' perception of the PDCO experience including clinical experience gained, teaching and learning and the teaching environment. METHODS: Likert Scale-based questionnaires were completed: (A) prior to the start of PDCO teaching, (B1) after one term, (B2) after one year and (C) for entry year 2001 students at completion. Additionally, a cohort of entry year 2000 students with no PDCO experience was surveyed at the end of their 4th year. Factor Analysis with Crohnbach's alpha was used to investigate perception of (i) confidence and skills in treating child patients, (ii) confidence and skills in treating adult patients; (iii) general clinical skills and experience; (iv) team working. Data from entry years 2000-2003 were analysed using ANOVA and independent sample t-tests. RESULTS: For entry years 2001 and 2002, perceived confidence and skills in treating child patients and general clinical experience increased, although for entry year 2002 students the levels of perceived general confidence and skills achieved after 1 year were similar to the entry year 2000 cohort who had received no PDCO teaching. There was consistently high satisfaction with teamworking. After 2 years in PDCO, 11 of the 13 overall satisfaction scores were over 70%. CONCLUSION: The majority of students perceive PCDO as a valuable component of professional training and development. Further evaluation, including analysis of value for money, would help to inform funding decisions and further curriculum development.

A clinical guide to endodontics--update part 2.

This second update paper aims to provide a review of changes and developments that have occurred within the field of pulp therapy for primary teeth since the publication of the BDJ's series and textbook A clinical guide to endodontics. The biological basis of pulp therapy is an area where much recent research has taken place, particularly linked to the healing capacity of pulp tissue. This has lead to the adoption of treatment techniques aimed at maintaining pulp vitality. Such techniques are introduced here as a more contemporary, biological approach to pulp management in the primary dentition.

The development of a primary dental care outreach course.

The aim of this work was to develop the first north-east based primary dental care outreach (PDCO) course for clinical dental undergraduate students at Newcastle University. The process of course design will be described and involved review of the existing Bachelor of Dental Surgery (BDS) degree course in relation to previously published learning outcomes. Areas were identified where the existing BDS course did not meet fully these outcomes. This was followed by setting the PDCO course aims and objectives, intended learning outcomes, curriculum and structure. The educational strategy and methods of teaching and learning were subsequently developed together with a strategy for overall quality control of the teaching and learning experience. The newly developed curriculum was aligned with appropriate student assessment methods, including summative, formative and ipsative elements.

Nuclear gene silencing directs reception of long-distance mRNA silencing in Arabidopsis.

In plants, silencing of mRNA can be transmitted from cell to cell and also over longer distances from roots to shoots. To investigate the long-distance mechanism, WT and mutant shoots were grafted onto roots silenced for an mRNA. We show that three genes involved in a chromatin silencing pathway, NRPD1a encoding RNA polymerase IVa, RNA-dependent RNA polymerase 2 (RDR2), and DICER-like 3 (DCL3), are required for reception of long-distance mRNA silencing in the shoot. A mutant representing a fourth gene in the pathway, argonaute4 (ago4), was also partially compromised in the reception of silencing. This pathway produces 24-nt siRNAs and resulted in decapped RNA, a known substrate for amplification of dsRNA by RDR6. Activation of silencing in grafted shoots depended on RDR6, but no 24-nt siRNAs were detected in mutant rdr6 shoots, indicating that RDR6 also plays a role in initial signal perception. After amplification of decapped transcripts, DCL4 and DCL2 act hierarchically as they do in antiviral resistance to produce 21- and 22-nt siRNAs, respectively, and these guide mRNA degradation. Several dcl genotypes were also tested for their capacity to transmit the mobile silencing signal from the rootstock. dcl1-8 and a dcl2 dcl3 dcl4 triple mutant are compromised in micro-RNA and siRNA biogenesis, respectively, but were unaffected in signal transmission.

Tutor perceptions of the use of a reflective portfolio within a pastoral tutor system to facilitate undergraduate personal development planning.

All Higher Education Institutions in the UK are now required to provide transcripts of student activity and outcomes of summative assessments. In addition, the student should be able to reflect on their learning and plan their own development. This article reports on the staff evaluation of the use of a reflective portfolio facilitating the production of highly individualised personal development plans within an existing tutor system. A number of significant issues are highlighted; tutor systems adopting this approach must maintain flexibility for managing student crises when they arise, the difference between appraisal and assessment needs clear definition for both students and tutors, training in basic mentoring skills should be provided for all tutors, tutors should be aware of the difficulties many students experience with reflection and also be alert to the over reflective learner.

Factors affecting treatment outcomes following complicated crown fractures managed in primary and secondary care.

The aims of this retrospective observational study were to determine the factors which affect treatment provision and the Median Survival Time (MST) for maintenance of tooth vitality following complicated crown fracture. The survey was carried out for patients treated at Newcastle Dental Hospital (NDH) according to departmental guidelines over a 2-year period following the introduction of a new protocol for management of these types of injuries. Seventy-three cases of complicated crown fracture were identified in 69 children with a mean age of 10.3 years (SD = 2.5 years). Seventy-one percent of the fractures occurred in males (M:F ratio was 2.5:1). Fifty-one percent of the complicated crown fractures were in immature teeth. Of the 73 traumatised teeth, 45% presented initially in general dental practice (GDP), 37% at the dental hospital and 8% at local accident and emergency departments with the remaining 10% seen at other or unrecorded locations. Of the 41 fractures, which presented initially at a location other than the dental hospital, 38% were referred to the dental hospital without the provision of an emergency pulp bandage. The overall definitive treatments provided for the 37 open apex teeth included pulp cap (19%), partial pulpotomy (32%), cervical pulpotomy (8%) and pulpectomy (35%), while for the 36 closed apex teeth it was pulp cap (28%), pulpotomy (11%), and pulpectomy (61%). Of the 30 teeth, which underwent vital pulp therapy (18 open and 12 closed apex), the MST for the 15 teeth treated with pulp caps was 1460 days (95% CI: 1067, 1853) while for the 15 teeth treated with pulpotomies it was 1375 days (95% CI: 964, 1786). There was no statistically significant difference in the MST between teeth treated with pulp caps and pulpotomies. In conclusion, the proportion of patients referred to secondary care with complicated crown fractures without provision of a pulp bandage is of some concern. More conservative treatment of closed apex teeth sustaining complicated crown fractures, utilizing vital pulp therapy techniques would appear to be appropriate.

Is there life after Buckley's formocresol? Part II - Development of a protocol for the management of extensive caries in the primary molar.

OBJECTIVE: To produce a working clinical protocol for pulp therapy techniques in the extensively carious primary molar. INTRODUCTION: The International Agency for Research on Cancer has recently classified formaldehyde as carcinogenic to human beings. As such, a medicament that can be used to replace formocresol in clinical practice should be identified. METHODS: Part I of this paper explored the currently available alternative interventions and materials to formocresol in the form of a narrative review following an extensive literature search. Part II now presents the formation of a specialist group to establish an evidence-based protocol, for the management of the extensively carious primary molar. CONCLUSION: A protocol and key points document have been developed to assist clinicians in their treatment planning. Areas for further postgraduate training are identified.

Is there life after Buckley's Formocresol? Part I -- a narrative review of alternative interventions and materials.

OBJECTIVES: (1) To present a narrative review of the currently available alternative interventions and materials to formocresol pulpotomy for the management of extensive caries in the primary molar, and (2) to produce a clinical protocol for pulp therapy techniques in the extensively carious primary molar. INTRODUCTION: The International Agency for Research on Cancer has recently classified formaldehyde as carcinogenic to human beings. Since Buckley's Formocresol contains 19% formaldehyde in its full strength and, therefore, 1% in a 20% dilution, a safer alternative should be identified. METHODS: A narrative review of the published literature for primary molar pulp therapy techniques was undertaken following an extensive and appropriate literature search. A specialist group of paediatric dentists was formed to arrive at a consensus and establish an evidence-based protocol for the management of extensively carious primary molar teeth. Part I of this paper explores the currently available alternative interventions and materials to formocresol in the form of a narrative review. The second part of the paper will present the formation of a specialist group to arrive at a consensus and establish an evidence-based protocol for the management of the extensively carious primary molar. CONCLUSIONS: After consideration of a review of extensively searched literature, a protocol and key points document have been developed to assist clinicians in their treatment planning. Further long-term studies with the highest level of evidence (i.e. randomized controlled trials) are required to enable us to identify acceptable alternatives which can replace formocresol.

Management of dental trauma in primary care: a postal survey of general dental practitioners.

OBJECTIVES: To determine the self-perceived knowledge and attitudes of general dental practitioners (GDPs) concerning management of dental trauma in primary care. To identify potential barriers to the management of dental trauma in primary care. DESIGN AND SETTING: A self-completion postal questionnaire survey of 417 GDPs in six local health authority districts in northeast England. MAIN OUTCOME MEASURES: Likert scale responses to 20 statements designed to test self-perceived knowledge and attitudes. Following descriptive statistical analysis. Factor analysis with principle components analysis was undertaken to identify areas of correlation in questionnaire responses, followed by Chi squared test, Spearman's Rank Correlation and analysis of variance (ANOVA) to measure association between variables. RESULTS: The response rate was 74%. Enamel and dentine fractures were the most common injury, with 45% of GDPs responding seeing more than 10 cases of dental trauma in the preceding year and 53% of respondents seeing one to three cases of complicated crown fracture. Seventy-eight per cent believed that NHS remuneration was inadequate, but only 8% would refer patients with dental trauma to secondary care for this reason. Half of the GDPs believed that trauma could be treated more effectively in practice if NHS payments were greater. GDPs were significantly more likely to agree with this statement if they had previously undertaken a postgraduate course in the treatment of dental trauma (p=0.002). Single handed GDPs were statistically significantly more likely to agree with the statements 'I would not treat dental trauma cases at my practice because the NHS payment is inadequate' (p=0.008) and 'Treating dental trauma at my practice requires too much of my clinical time to be worthwhile' (p=0.002). Ninety-six per cent of GDPs disagreed that treatment of dental trauma rested solely within secondary care. Ninety-six per cent of GDPs agreed that they had a responsibility to provide initial emergency treatment for trauma patients prior to referral. Eighty-eight per cent of GDPs felt that aids to management would be useful. CONCLUSIONS: Although GDPs believed that financial remuneration was inadequate, this did not prevent them treating trauma cases. They strongly agreed that they had responsibility for the management of dental trauma in primary care and that they believed trauma could be treated more effectively in practice if payment was greater. Time constraints were perceived as a barrier to long-term management of complex trauma cases in primary care. GDPs would welcome the use of management aids.

The dental attitudes, knowledge and health practices of patients with Juvenile Idiopathic Arthritis.

AIM: To investigate the dental attitudes, knowledge and dental health practices of children and adults with a previous diagnosis of Juvenile Idiopathic Arthritis (JIA). STUDY DESIGN: A self-completion questionnaire. METHODS: Ninety-one children and 82 adults with JIA were age and gender matched with 152 healthy controls. For those below the age of 16 years, the parents' attitude, knowledge and dental health practices were investigated by the questionnaire. The adult subjects and controls completed an identical questionnaire assessing their own attitude, knowledge and dental health practices. RESULTS: Response rates of 84% and 75% were achieved for the subject and controls respectively. Both groups responded similarly to questions assessing perception of different medical conditions. The majority of respondents thought leukaemia was a very serious condition. Twenty-seven percent of subjects and 34% of controls felt dental decay was "slightly or not serious". Ninety percent of subjects and 93% of controls knew having sweet snacks during the day would harm teeth, but fewer were sure that eating sweet foods at mealtimes only would help reduce decay. The majority of respondents (63% and 56% respectively) did not know whether children should receive fluoride tablets but the majority of subjects in both groups had attended a dentist within the last year. STATISTICS: Descriptive analyses and chi-squared analysis were undertaken. A p-value of < or =0.01 was taken as strong evidence of a difference between groups. CONCLUSION: The perception of health and illness by both groups was appropriate. The questions investigating dental knowledge revealed understanding of the basic messages of prevention of dental disease, but finer detail appeared less well understood. Responses concerning dental health confirmed positive attitudes towards good dental health habits. The benefits of brushing with fluoride toothpaste were known, and the majority toothbrushed daily and received dental care within the previous year.

The complete nucleotide sequence of Subterranean clover mottle virus.

The complete nucleotide sequence of Subterranean clover mottle virus (SCMoV) genomic RNA has been determined. The SCMoV genome is 4,258 nucleotides in length. It shares most nucleotide and amino acid sequence identity with the genome of Lucerne transient streak virus (LTSV). SCMoV RNA encodes four overlapping open reading frames and has a genome organisation similar to that of Cocksfoot mottle virus (CfMV). ORF1 and ORF4 are predicted to encode single proteins. ORF2 is predicted to encode two proteins that are derived from a -1 translational frameshift between two overlapping reading frames (ORF2a and ORF2b). A search of amino acid databases did not find a significant match for ORF1 and the function of this protein remains unclear. ORF2a contains a motif typical of chymotrypsin-like serine proteases and ORF2b has motifs characteristically present in positive-stranded RNA-dependent RNA polymerases. ORF4 is likely to be expressed from a subgenomic RNA and encodes the viral coat protein. The ORF2a/ORF2b overlapping gene expression strategy used by SCMoV and CfMV is similar to that of the poleroviruses and differ from that of other published sobemoviruses. These results suggest that the sobemoviruses could now be divided into two distinct subgroups based on those that express the RNA-dependent RNA polymerase from a single, in-frame polyprotein, and those that express it via a -1 translational frameshifting mechanism.

Dental erosion and soft drinks: a qualitative assessment of knowledge, attitude and behaviour using focus groups of schoolchildren. A preliminary study.

OBJECTIVES: This qualitative study was designed to record the perception by Newcastle children of the influences on their choice of drinks and their knowledge of the dental health problems caused by acidic drinks. METHODS: Four focus groups, each involving 8 Newcastle schoolchildren (4 boys and 4 girls) formed the basis of the study. Two age groups, 13-14-year-olds and 8-9-year-olds, and two socio-economic groups were investigated, using state schools in Newcastle upon Tyne. A moderator guided the children to discuss their choice of drink and its dental effects amongst themselves. RESULTS: In total, 32 children participated in the focus groups and the results suggested that 8-9-year-olds preferred still, fruit-flavoured drinks whilst 13-14-year-olds preferred carbonated drinks. Taste was the most important influence on drink choice in all age groups. Parents and friends were more influential in younger children, whilst cost, availability and thirst were more important to older children. Younger children did not believe advertisements whilst older children thought they might work if seen enough times. Dental knowledge was confused in all age groups and only the 13-14-year-old-high socio-economic groups knew that acidic drinks were bad for the teeth. Different methods for addressing the problem of erosion were suggested by different age groups. There was very little difference between the socio-economic groups in the areas discussed. CONCLUSIONS: The children's knowledge of dental diseases and the effect of drinks on the teeth were confused. The factors that influence drink choice appear to change with age, rather than socio-economic status.