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1.
Appl Ergon ; 68: 294-303, 2018 Apr.
Article in English | MEDLINE | ID: mdl-29409648

ABSTRACT

BACKGROUND: All children attending General Dental Practice in Scotland are recommended to receive twice-yearly applications of sodium fluoride varnish to prevent childhood caries, yet application is variable. Development of complex interventions requires theorizing and modelling to understand context. This study applies the Functional Resonance Analysis Method (FRAM) to produce a sociotechnical systems model and identify opportunities for intervention to support application. METHODS: The FRAM was used to synthesise data which were: routine monitoring of fluoride varnish application in 2015/16; a longitudinal survey with practitioners (n = 1090); in-depth practitioner and key informant interviews (n = 43); and a 'world café' workshop (n = 56). RESULTS: We describe a detailed model of functions linked to application, and use this to make recommendations for system-wide intervention. CONCLUSIONS: Rigorous research is required to produce accessible models of complex systems in healthcare. This novel paper shows how careful articulation of the functions associated with fluoride varnish application can support future improvement efforts.


Subject(s)
General Practice, Dental/statistics & numerical data , Guideline Adherence/statistics & numerical data , Practice Guidelines as Topic/standards , Practice Patterns, Dentists'/statistics & numerical data , Systems Analysis , Cariostatic Agents/standards , Child , Dental Caries/prevention & control , Female , Humans , Male , Scotland , Sodium Fluoride/standards
2.
Eur J Paediatr Dent ; 15(1): 39-44, 2014 Mar.
Article in English | MEDLINE | ID: mdl-24745591

ABSTRACT

AIM: Resin infiltration of proximal lesions is a new approach to stop caries progression. The aim of this clinical trial was to assess its safety and quality, as well as the therapeutic effect. MATERIALS AND METHODS: In 47 children, adolescents and young adults, ten dentists applied the infiltration material ICON (DMG, Germany) on initial proximal lesions according to the manufacturer's instruction. One lesion with radiographic extension into enamel or the outer third of dentin per participant was allocated for the treatment. The clinical safety and quality of resin infiltration were assessed 1 week, 6 months and 12 months after the treatment and the evaluation of the therapeutic effect was analysed by pair-wise radiographs. RESULTS: The clinical safety and quality of the infiltration were assessed in 45 individuals after 12 months. The test surfaces showed no relevant changes in clinical status, plaque accumulation or gingival status (p > 0.05). A high quality of infiltration was found for the marginal adaptation. In contrast to the improvement of colour at the one-week recall (p = 0.005), the infiltrated surfaces showed a statistically significant increase in the discoloration within the following year (p = 0.014). Out of the 43 lesions which could be assessed radiographically, only two lesions showed progression to a different score (4.7%). CONCLUSION: Resin infiltration can be considered a safe and effective treatment to reduce progression of initial proximal caries.


Subject(s)
Cariostatic Agents/therapeutic use , Dental Caries/prevention & control , Pit and Fissure Sealants/therapeutic use , Resins, Synthetic/therapeutic use , Adolescent , Adult , Cariostatic Agents/standards , Child , Child, Preschool , Color , DMF Index , Dental Caries/diagnostic imaging , Dental Enamel/diagnostic imaging , Dental Enamel/drug effects , Dental Marginal Adaptation , Dental Plaque Index , Dental Pulp Test , Dentin/diagnostic imaging , Dentin/drug effects , Disease Progression , Female , Follow-Up Studies , Humans , Male , Oral Hygiene , Periodontal Index , Pit and Fissure Sealants/standards , Radiography, Bitewing , Resins, Synthetic/standards , Safety , Surface Properties , Young Adult
3.
Int Dent J ; 62(4): 213-21, 2012 Aug.
Article in English | MEDLINE | ID: mdl-23017004

ABSTRACT

OBJECTIVES: This study assessed total and free fluoride concentrations in samples of toothpaste from Brunei, Cambodia, Laos, the Netherlands and Suriname, and investigated the labelling practices of the respective manufacturers. MATERIALS AND METHODS: Convenience samples were bought in the five countries and sent for analysis to the Netherlands. Levels of total and free available fluoride were measured. Details of the information declared on the packaging about type of fluoride and abrasives were recorded, and manufacturing and expiry dates were noted. RESULTS: A total of 119 samples of toothpaste were analysed. With one exception, all samples from the Netherlands complied with ISO (International Organisation for Standardisation) labelling requirements and there were no differences between the fluoride content declared and that found to be present on analysis. In samples purchased in the other countries, sodium monofluorophosphate (SMFP) toothpastes predominantly showed a low percentage of free available fluoride and the majority of toothpastes did not follow standard labelling guidelines. DISCUSSION: This study is not representative of any of the brands analysed, yet it highlights problematic discrepancies in products across countries. These may be related to the lack of a generally accepted methodology for analysing total and free fluoride content, absence of an agreement on the minimum concentration of fluoride required to ensure efficacy, weak regulating institutions that are unable to control labelling and consumer information, as well as a possible influx of counterfeit low-quality toothpaste. CONCLUSIONS: Renewed international focus should be directed towards closing gaps in guidelines and standards. Consumers should use only non-expired toothpaste, which should preferably be silica-based fluoride toothpaste that does not include abrasives containing calcium and that is properly labelled.


Subject(s)
Cariostatic Agents/analysis , Fluorides, Topical/analysis , Fluorides/analysis , Product Labeling/standards , Toothpastes/chemistry , Brunei , Cambodia , Cariostatic Agents/standards , Fluorides/standards , Fluorides, Topical/standards , Laos , Netherlands , Suriname , Toothpastes/standards
4.
J Am Dent Assoc ; 141(12): 1480-9, 2010 Dec.
Article in English | MEDLINE | ID: mdl-21158195

ABSTRACT

BACKGROUND: This article presents evidence-based clinical recommendations for the prescription of dietary fluoride supplements. The recommendations were developed by an expert panel convened by the American Dental Association (ADA) Council on Scientific Affairs (CSA). The panel addressed the following questions: when and for whom should fluoride supplements be prescribed, and what should be the recommended dosage schedule for dietary fluoride supplements? TYPES OF STUDIES REVIEWED: A panel of experts convened by the ADA CSA, in collaboration with staff of the ADA Center for Evidence-based Dentistry, conducted a MEDLINE search to identify publications that addressed the research questions: systematic reviews as well as clinical studies published since the systematic reviews were conducted (June 1, 2006). RESULTS: The panel concluded that dietary fluoride supplements should be prescribed only for children who are at high risk of developing caries and whose primary source of drinking water is deficient in fluoride. CLINICAL IMPLICATIONS: These recommendations are a resource for practitioners to consider in the clinical decision-making process. As part of the evidence-based approach to care, these clinical recommendations should be integrated with the practitioner's professional judgment and the patient's needs and preferences. Providers should carefully monitor the patient's adherence to the fluoride dosing schedule to maximize the potential therapeutic benefit.


Subject(s)
Cariostatic Agents/therapeutic use , Dental Caries/prevention & control , Dietary Supplements/standards , Evidence-Based Dentistry , Fluorides/therapeutic use , Practice Guidelines as Topic , American Dental Association , Cariostatic Agents/administration & dosage , Cariostatic Agents/standards , Child , Dental Care/methods , Drug Prescriptions , Environmental Exposure , Fluorides/administration & dosage , Fluorides/standards , Fluorosis, Dental/epidemiology , Humans , United States , Water Supply/statistics & numerical data
8.
Braz. oral res ; 18(4): 317-321, Oct.-Dec. 2004. tab
Article in English | LILACS | ID: lil-398751

ABSTRACT

Este estudo avaliou a capacidade de selamento do agregado trióxido mineral (MTA Angelus), de um cimento de óxido de zinco e eugenol reforçado (Super EBA), de um cimento de ionômero de vidro reforçado por resina (Vitremer) e de um amálgama sem zinco (GS-80) (controle). Os canais radiculares de oitenta molares inferiores humanos foram acessados, limpos, modelados e obturados. Os ápices foram seccionados, e as cavidades, preparadas. Os dentes foram divididos em 4 grupos de 40 cavidades, retrobturados com os materiais e imersos em azul de metileno por 72 h a 37ºC. As raízes foram então seccionadas transversalmente a cada milímetro e avaliadas sob aumento, observando-se a penetração de corante a cada corte. Os dados foram avaliados usando-se o teste de Kruskal-Wallis (5%), que mostrou diferenças entre todos os materiais (p < 0,001). A ordem crescente de infiltração marginal foi MTA < Vitremer < Super EBA < amálgama. Níveis mais altos de infiltração foram observados nos cortes de primeiro milímetro de amálgama, Vitremer e MTA, quando comparados com o terceiro milímetro (p < 0,05).


Subject(s)
Humans , Bismuth/pharmacology , Cariostatic Agents/pharmacology , Composite Resins/pharmacology , Dental Cements/pharmacology , Dental Pulp Cavity/drug effects , Dentin-Bonding Agents/pharmacology , Glass Ionomer Cements/pharmacology , Oxides/pharmacology , Root Canal Filling Materials/pharmacology , Bismuth/standards , Cariostatic Agents/standards , Composite Resins/standards , Dental Leakage , Dental Bonding/standards , Dental Cements/standards , Dentin-Bonding Agents/standards , Coloring Agents , Glass Ionomer Cements/standards , Oxides/standards , Root Canal Filling Materials/standards , Statistics, Nonparametric
9.
Caries Res ; 35 Suppl 1: 22-5, 2001.
Article in English | MEDLINE | ID: mdl-11359053

ABSTRACT

The 1,500 ppm fluoride (F(-)) concentration limit set up for European cosmetic toothpaste needs to be considered in terms of effectiveness and toxicity. There is clear evidence for a dose-response relationship between F(-) concentration and caries-preventive effect (25-30% caries reduction achieved with a 1,000 ppm F(-) dentifrice). Clinical significance of higher F(-) concentration has not been totally proven. Low F(-) toothpastes (<500 ppm F(-)) have been marketed to reduce F(-) ingestion by young children in order to minimize the risk of dental fluorosis. Their effectiveness is, however, unclear. Fluoride intake and caries risk assessment should be performed by dental professionals and prescription of topical fluoride should be adjusted individually.


Subject(s)
Cariostatic Agents/administration & dosage , Cosmetics/standards , European Union , Fluorides/administration & dosage , Legislation, Drug , Cariostatic Agents/adverse effects , Cariostatic Agents/standards , Child , Child, Preschool , Dental Caries/prevention & control , Dental Caries Susceptibility , Dentifrices , Dose-Response Relationship, Drug , Europe , Fluorides/adverse effects , Fluorides/standards , Fluorosis, Dental/prevention & control , Humans , Risk Assessment , Risk Factors
13.
Int Dent J ; 45(3): 185-96, 1995 Jun.
Article in English | MEDLINE | ID: mdl-7558357

ABSTRACT

The prevention of caries, gingivitis and periodontal diseases has been, and still is, a major objective for the dental profession. A large number of products are available to the general public, either over the counter or on prescription, formulated to prevent these diseases. Formulations are also used by professionals for the prevention and treatment of dental diseases. In recommending or using agents for prevention or therapy it is necessary for the practitioner to appreciate whether proof of efficacy is established. Preventive or therapeutic roles of formulations are frequently confused and there is a need to define the often misleading terminology used to describe products. Guidelines are required to enable the dental professional to understand research data and what constitutes proof of efficacy for preventive and/or therapeutic formulations. The guidelines should describe the research methodologies used today, including study design and analysis, ethics, the format of research papers and the relevance of laboratory data to clinical efficacy.


Subject(s)
Clinical Trials as Topic/standards , Dental Caries/prevention & control , Dental Research/standards , Periodontal Diseases/prevention & control , Anti-Infective Agents, Local/standards , Cariostatic Agents/standards , Clinical Trials as Topic/methods , Controlled Clinical Trials as Topic/standards , Data Interpretation, Statistical , Dental Research/methods , Dentifrices/standards , Documentation/standards , Humans , Research Design
15.
J Clin Dent ; 6(3): 176-84, 1995.
Article in English | MEDLINE | ID: mdl-8615960

ABSTRACT

Comparative attributes are terms or phrases commonly employed in the vernacular of the biomedical literature to convey the results of comparative studies. Examples are such terms as "equivalent" or "superior." Recently, there has developed an increasing tendency in certain areas of application toward the institution of guidelines which provide both a uniform set of criteria for defining such attributes and a set of requirements which must be satisfied in order to demonstrate that such attributes may hold in a particular situation. The present paper provides a general discussion of comparative attributes, from which the application of the underlying concepts to any particular context might better be understood. Second, it provides an explicit and comprehensive discussion regarding the American Dental Associations's guidelines concerning the attributions of "superiority," "equivalence," and "at least as good as," as they are applied to the comparison of the clinical anticaries efficacy of fluoride dentifrices.


Subject(s)
American Dental Association , Cariostatic Agents/standards , Dental Materials/standards , Quality Assurance, Health Care/organization & administration , Dental Research/standards , Dentifrices/standards , Fluorides/standards , Guidelines as Topic , Humans , United States
16.
J Dent Res ; 71 Spec No: 949-52, 1992 Apr.
Article in English | MEDLINE | ID: mdl-1592992

ABSTRACT

Subsequent to the American Dental Association Symposium on Intra-oral Studies, held in Chicago in September, 1990, the Council on Dental Therapeutics decided that further consideration should be given to statistical issues relating to intra-oral models. The authors accepted the request of Council staff to assist in the development of Guidelines concerning the validity, reliability, and combinability of data obtained from these models. The ensuing work in this area, which began in the fall of 1990 and has continued to date, has thus far focused on the tissue of validity. The purpose of the present paper is to provide the interested community at large with an update on the progress made thus far, and to provide some perspective as to where all of the work in this area may eventually be leading. It is anticipated that a more comprehensive and definitive report will be produced at the completion of this process.


Subject(s)
American Dental Association , Cariostatic Agents/therapeutic use , Dental Caries/prevention & control , Research Design/statistics & numerical data , Cariostatic Agents/standards , Documentation , Humans , Models, Biological , Reproducibility of Results , United States
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