A dentist's dilemma: sharing wellbeing concerns to safeguard Scotland's children.

Introduction Over a decade ago, Getting it right for every child (GIRFEC) introduced the 'Named Person' as a central contact with whom professionals could share 'wellbeing' concerns in Scotland, aiming to promote inter-agency working to avoid potential child protection issues. The mandatory 'Named Person' scheme has since been repealed but the professional's responsibility to share concerns at wellbeing level remains.Aims To explore general dental practitioners' (GDPs') understanding of a child's 'wellbeing', along with the investigation of influencing factors on behaviour when sharing concerns at wellbeing level.Methods Qualitative one-to-one semi-structured telephone interviews with GDPs. Themes arising from transcriptions were organised into the Theoretical Domains Framework.Results In total, 11 dentists (five men and six women) participated. Risks to wellbeing included only attending in pain and dental neglect. There was good awareness of the 'Named Person' and triggers to sharing suspicions were identified, which were concern severity, multiple concerns and own intuition. Multiple barriers (eg poor knowledge, fear of consequences, environment) and enablers (eg professional responsibility and influences, positive consequences) influenced decisions to refer. GDPs struggled to differentiate between wellbeing and child protection.Conclusion Barriers and facilitators to sharing wellbeing suspicions are similar to child protection. GDPs may benefit from further training when safeguarding at a wellbeing level.

Degree of conversion of resin-based materials cured with dual-peak or single-peak LED light-curing units.

BACKGROUND: There is a lack of data on polymerization of resin-based materials (RBMs) used in paediatric dentistry, using dual-peak light-emitting diode (LED) light-curing units (LCUs). OBJECTIVE: To evaluate the degree of conversion (DC) of RBMs cured with dual-peak or single-peak LED LCUs. METHODS: Samples of Vit-l-escence (Ultradent) and Herculite XRV Ultra (Kerr) and fissure sealants Delton Clear and Delton Opaque (Dentsply) were prepared (n = 3 per group) and cured with either one of two dual-peak LCUs (bluephase(®) G2; Ivoclar Vivadent or Valo; Ultradent) or a single-peak (bluephase(®) ; Ivoclar Vivadent). High-performance liquid chromatography and nuclear magnetic resonance spectroscopy were used to confirm the presence or absence of initiators other than camphorquinone. The DC was determined using micro-Raman spectroscopy. Data were analysed using general linear model anova; α = 0.05. RESULTS: With Herculite XRV Ultra, the single-peak LCU gave higher DC values than either of the two dual-peak LCUs (P < 0.05). Both fissure sealants showed higher DC compared with the two RBMs (P < 0.05); the DC at the bottom of the clear sealant was greater than the opaque sealant, (P < 0.05). 2,4,6-trimethylbenzoyldiphenylphosphine oxide (Lucirin(®) TPO) was found only in Vit-l-escence. CONCLUSIONS: Dual-peak LED LCUs may not be best suited for curing non-Lucirin(®) TPO-containing materials. A clear sealant showed a better cure throughout the material and may be more appropriate than opaque versions in deep fissures.

The effect of interincisal opening, cavity location and operator experience on the energy delivered by a light-curing unit to a simulated dental restoration.

BACKGROUND: Curing of resin-based composites depends on the delivery of adequate total energy, which may be operator dependent. Aim To determine the effect of interincisal opening, cavity location and operator experience on the total energy delivered to simulated cavity preparation sites. DESIGN: Three cohorts were included: junior dental nurses, senior dental nurses and qualified dentists (N=5, each cohort). Each operator (participant) followed the same procedure and light-cured two simulated restorations in a MARC patient simulator using a Demi light-curing unit for 20 seconds in each of the following situations: left upper second molar (UL7), interincisal opening at both 25 mm and 45 mm; upper central incisor (UR1), interincisal opening at 45mm. The light energy delivered by each operator in each situation was recorded. Five readings for each operator were taken at each interincisal distance. Statistical comparisons of delivered energy (J/cm2) between interincisal openings, location and groups in the total energy delivered were performed using the Kruskal-Wallis nonparametric test: alpha = 0.05. RESULTS: Less total energy was delivered to the posterior cavity at 25mm (12.0 +/- 5.3 J/cm2) than at 45mm (16.9 +/- 5.6 J/cm2) by all operators (P < 0.05). At 45 mm, less total energy was delivered to the posterior cavity compared to the anterior cavity (25.1 +/- 7.4 J/cm2; P < 0.05). There was no statistically significant difference between junior nurses and qualified dentists (P > 0.05) but there was a significant difference in the total energy delivered between senior nurses (20.1 +/- 7.8 J/cm2) and junior nurses (17.5 +/- 7.6 J/cm2) and between senior nurses and qualified dentists (16.6 +/- 8.7 J/cm2) (P < 0.05). CONCLUSIONS: Interincisal mouth opening, location of the cavity and operator experience affected the total energy delivered to cavities in a simulated clinical environment.

In vitro microleakage of a fissure sealant polymerized by either a quartz tungsten halogen curing light or a plasma arc curing light.

BACKGROUND: The benefits of using plasma arc curing lights with their shorter curing times in the management of children are potentially great, provided there are no adverse effects. OBJECTIVE: The aim of this study was to investigate whether the microleakage of a resin-based sealant is influenced by polymerization with either a conventional quartz tungsten halogen or a plasma arc curing light. DESIGN: This study took the form of an in vitro randomized control trial. Seventy extracted human first and second permanent premolars and molars were randomly allocated into two groups. Their occlusal surfaces were sealed with a light-cured fissure sealant using either a quartz tungsten halogen curing light or a plasma arc curing light. The teeth were then sectioned, resulting in four surfaces per tooth, which were examined for microleakage under x 15 magnification with a light microscope. The principal unit of analysis was the tooth (worst section score) and not the section microleakage score. RESULTS: No statistical significant difference in microleakage scoring between the two groups was demonstrated. CONCLUSION: This study found no difference in the degree of microleakage of fissure sealants polymerized by either light source.