Dentists with extended skills: the challenge of innovation.

BACKGROUND: The aim was to obtain stakeholders' views on the former London Deanery's joint educational service development initiative to train dentists with a special interest (DwSIs) in endodontics in conjunction with the National Health Services (NHS) and examine the models of care provided. METHODS: A convergent parallel mixed methods design including audit of four different models of care, semi-structured interviews of a range of key stakeholders (including the DwSI trainees) and questionnaire surveys of patients and primary care dentists. RESULTS: Eight dentists treated over 1,600 endodontic cases of moderate complexity over a two year training period. A retrospective audit of four schemes suggested that first molars were the most commonly treated tooth (57%; n = 341). Patients who received care in the latter stages of the initiative were 'satisfied' or 'very satisfied' with the service (89%; n = 98). Most dental practitioners agreed that having access to such services would support the care of their patients (89%; n = 215) with 88%; (n = 214) supporting the view that DwSIs should accept referrals from outside of their practice. CONCLUSION: This initiative, developed to provide endodontic care of medium complexity in a primary care setting, received wide support from stakeholders including patients and primary care dentists. The implications for care pathways, commissioning and further research are discussed.

The potential benefits of sugar-free chewing gum on the oral health and quality of life of older people living in the community: a randomized controlled trial.

OBJECTIVES: To determine the effects of prescribing sugar-free chewing gum on the oral health and quality of life of dentate older people living in the community and attending for routine dental care. METHODS: A randomized controlled trial was conducted on 186 older people who were not regular chewers of gum, (aged 60 years and over with ≥ 6 teeth) recruited from primary care clinics. Participants were randomly allocated to a gum-chewing group (chewing xylitol-containing gum twice a day for 15 min; n = 95) or a control group (no gum; n = 91). Both groups were examined at baseline and at the end of the study (6 months later). The primary outcome measure for the study was increased in stimulated saliva flow rate. Secondary measures included improvements in Plaque and Gingival Indices, and self-perceived change in oral health. RESULTS: The retention rate for the study was 78.5% (n = 146 at follow-up); reported compliance with the protocol was 84% (ranged between 12% and 100%). There was no significant change in the saliva flow of the gum-chewing group (1.20-1.17 ml/min), while the control group experienced an increase in flow rate (1.06-1.32 ml/min; P = 0.001). The gum-chewing group, however, demonstrated significant improvement in Plaque and Gingival Index scores over the control group. For the Plaque Index, the mean scores (±SD) were 0.29 (±0.29) and 0.56 (±0.46) for the gum-chewing group and control groups, respectively (P < 0.001), at the second examination, which remained significant after controlling for age and saliva flow rate. For the Gingival Index, the scores were 0.73 (±0.30) and 0.92 (±0.32), respectively (P < 0.001), which persisted after controlling for age. A significantly higher proportion of participants in the gum-chewing group perceived that their oral health had improved during the study period in comparison with the control group (40% cf 21%; P = 0.016). CONCLUSIONS: Prescription of sugar-free chewing gum to dentate older people living in the community and attending routine dental services was not associated with a significant increase in stimulated saliva flow. There were, however, significant improvements in Plaque and Gingival Index scores, and in self-perceived oral health.

Oral Bifidobacteria: caries-associated bacteria in older adults.

Bifidobacteria are aciduric bacteria that might play a role in the caries process. To test the hypothesis that Bifidobacteria behave as caries-associated organisms, as predicted by the ecological plaque hypothesis, we determined salivary levels of Bifidobacteria and caries-associated organisms for 156 older adults. Salivary levels of Bifidobacteria, mutans streptococci, lactobacilli, and yeasts were correlated with each other (p < 0.001), negatively correlated with salivary flow rate (p < 0.001), and positively correlated with plaque index (p < 0.05). Salivary Bifidobacteria levels were positively associated with the number of filled (p < 0.001) and decayed (p = 0.036) tooth surfaces and negatively associated with number of teeth (p < 0.001) and salivary flow rate (p = 0.049). In regression analyses, caries experience was significantly associated with only salivary Bifidobacteria (p < 0.001) and yeast (p < 0.001) levels and the individual's age (p = 0.021). Bifidobacteria should be regarded as caries-associated organisms whose role in the caries process and as markers of caries risk requires further investigation.

Toward designing new classrooms.

This study is a work on analyzing the traditional shapes of classrooms. A model is presented that considers the rectangular classroom divided into five sections as a function of two factors: viewing distance and horizontal viewing angle. The reading time and number of errors are affected by both. This model is validated experimentally, and the shape of a trapezoid is suggested for new classrooms.

Designing a license plate.

The majority of license plates in Saudi Arabia contain a 7-digit code to represent the registration number of vehicles. This information can be difficult to read, memorize, and reproduce in a short period of time, such as in the case of recall of hit-and-run accidents. The study reported proposes a registration code composed of 3 letters and 3 digits. This alphanumeric code can be converted into a numerical value which would give close to 20 million possible permutations, which would cover the projected number of vehicles to the year 2012. The original and proposed designs would give, in addition to two other alphanumeric codes, were tested on 60 participants using computer animations at three exposure times (1, 2, and 3 s). The results of the ANOVA on the errors committed and Sheffe tests reveal a significant difference (alpha = 0.01) between the 7-digit design and the other designs at all time intervals. Validation of the laboratory experiments were conducted on 15 different participants in the field, with similar findings.

The female/male ratio of anthropometric dimensions.

A great many anthropometric studies contain the data of either males or females. Instead of presenting single-sex data, this study presents a method of using the female/male (F/M) ratio to estimate the dimensions of unknown body parts. Several studies that include the data for both sexes are used to develop the ratio. Statistical analysis is performed, including fitting to normal distribution. Stature, sitting shoulder height, shoulder breadth, and hip breadth are used in the study. The result of the analysis reveals the importance of using a different F/M ratio for each body part instead of adopting a single value for estimation.

Ergonomic design of a barber's workstation.

Long hours of work while standing have been known to cause health problems for humans. Such professions include that of the barber. A survey was conducted of barbers from different barber shops in Saudi Arabia to determine their discomfort level. A prototype workstation was then designed and constructed in which the barber sits and performs work. The workstation was tested by nine barbers in the Human Factors Laboratory in the Systems Engineering Department at King Fahd University of Petroleum and Minerals. These barbers were among those surveyed earlier in their shops. Their discomfort level was again taken and an experiment was conducted to design the shape of the footrest. The discomfort levels obtained while standing and sitting were statistically analysed. From the results, it was concluded that the mean of the discomfort levels while standing is significantly (alpha = 0.01) higher than that while sitting.

Anthropometry for a mix of different populations.

Anthropometric data available in the literature refers to certain nationalities. In a substantial number of countries, a mixture of individuals of different races live in a particular city or even a community. Anthropometrists should address the users of the intended system irrespective of their ethnic background. A case study for the community of King Fahd University for Petroleum and Minerals (KFUPM) in Saudi Arabia is presented. Nineteen body dimensions of 408 subjects affiliated with KFUPM are reported and compared with other studies. The theme to design for the user population is emphasized.