Cork University Dental School and Hospital

Cork, Ireland

Cork University Dental School and Hospital

Cork, Ireland
SEARCH FILTERS
Time filter
Source Type

O'Sullivan E.M.,Cork University Dental School and Hospital | Higginson I.J.,King's College London
Acupuncture in Medicine | Year: 2010

Background Irradiation-induced xerostomia seriously reduces quality of life for patients with head and neck cancer (HNC). Anecdotal evidence suggests that acupuncture may be beneficial. Objective To systematically review evidence on clinical effectiveness and safety of acupuncture in irradiationinduced xerostomia in patients with HNC. Methods A detailed search was performed to identify randomised controlled trials (RCTs) and systematic reviews of RCTs on acupuncture in irradiation-induced xerostomia, using AMED, BNIA, CINAHL, Cochrane, Embase, HPSI, PsycInfo and Medline. Grey literature was explored and 11 journals hand searched. Search terms included: acupuncture, xerostomia, salivary hypofunction, hyposalivation, dry mouth, radiotherapy, irradiation, brachytherapy, external beam. Two authors independently extracted data for analysis using predefined selection criteria and quality indicators. Results 43 of the 61 articles identified were excluded on title/abstract. 18 articles underwent full-text review; three were deemed eligible for inclusion. Two trials had moderate risk of bias; one had high risk. Two trials compared acupuncture with sham acupuncture; one control arm received 'usual care'. Outcome measurements included salivary flow rates (SFRs) in two trials and subjective questionnaires in three. All three trials reported significant reduction in xerostomia versus baseline SFR (p<0.05); one reported greater effect in the intervention group for stimulated SFR (p<0.01). Subjective assessment reported significant differences between real acupuncture and control in two trials (p<0.02-0.05). Insufficient evidence was presented to undertake risk/ benefit assessment. Conclusions Limited evidence suggests that acupuncture is beneficial for irradiation-induced xerostomia. Although current evidence is insufficient to recommend this intervention, it is sufficient to justify further studies. Highlighted methodological limitations must be dealt with.


Tsakos G.,University College London | Allen P.F.,Cork University Dental School and Hospital | Steele J.G.,Northumbria University | Locker D.,University of Toronto
Community Dentistry and Oral Epidemiology | Year: 2012

The most common way of presenting data from studies using quality of life or patient-based outcome (PBO) measures is in terms of mean scores along with testing the statistical significance of differences in means. We argue that this is insufficient in and of itself and call for a more comprehensive and thoughtful approach to the reporting and interpretation of data. PBO scores (and their means for that matter) are intrinsically meaningless, and differences in means between groups mask important and potentially different patterns in response within groups. More importantly, they are difficult to interpret because of the absence of a meaningful benchmark. The minimally important difference (MID) provides that benchmark to assist interpretability. This commentary discusses different approaches (distribution-based and anchor-based) and specific methods for assessing the MID in both longitudinal and cross-sectional studies, and suggests minimum standards for reporting and interpreting PBO measures in an oral health context. © 2011 John Wiley & Sons A/S.


Riordain R.N.,University College London | McCreary C.,Cork University Dental School and Hospital
Oral Diseases | Year: 2013

This review aims to investigate the patient-reported outcomes currently used in the burning mouth syndrome literature and to explore whether any standardisation of such measures has taken place. Electronic databases were searched for all types of burning mouth syndrome studies using patient-reported outcome measures. Studies were selected by predefined inclusion criteria. Copies of the papers obtained were thoroughly reviewed. A study-specific data extraction form was used, allowing papers to be reviewed in a standardised manner. The initial literature search yielded a total of 173 citations, 43 of which were deemed suitable for inclusion in this study. Symptom severity and symptomatic relief were reported as a patient-reported outcome measure in 40 of the studies and quantified most commonly using a visual analogue scale. Quality of life was reported in 13 studies included in this review. Depression and / or anxiety was reported in 14 of the studies. As is evident from the variety of questionnaires and instruments used in the evaluation of the impact of burning mouth syndrome on patients' lives, no standardisation of patient outcomes has yet been achieved. © 2012 John Wiley & Sons A/S.


Riordain R.N.,Cork University Dental School and Hospital | McCreary C.,Cork University Dental School and Hospital
Oral Diseases | Year: 2010

Objectives: To explore the use of patient reported quality of life measures in oral medicine, to highlight the importance of use of these measures in oral medicine practice and to provide guidance for the selection of such measures in the future. Methods: A detailed literature review was undertaken to investigate the use of quality of life measures in oral medicine. The databases searched were MEDLINE (through PubMed), EMBASE, CINDHL, Web of Science Citation Index and the Cochrane Database of Systematic Reviews and randomised controlled trials. Results: The initial literature search yielded a total of 5310 citations; however, only 63 of these fulfilled the inclusion criteria. Twenty-two articles were regarding oral mucosal conditions, 14 related to orofacial pain disorders and 27 were regarding salivary gland-related conditions. Conclusions: The evaluation of quality of life in oral medicine has a broad applicability, providing information in treatment-based studies and population-based studies. A predominance of generic and oral health specific quality of life measures are being used to a limited extent in oral medicine practice. A scarcity of reports of the development, validation or use of disease specific measures is evident. © 2010 John Wiley & Sons A/S.


Harding M.A.,Cork University Dental School and Hospital
Acta medica academica | Year: 2013

Water fluoridation, is the controlled addition of fluoride to the water supply, with the aim of reducing the prevalence of dental caries. Current estimates suggest that approximately 370 million people in 27 countries consume fluoridated water, with an additional 50 million consuming water in which fluoride is naturally occurring. A pre-eruptive effect of fluoride exists in reducing caries levels in pit and fissure surfaces of permanent teeth and fluoride concentrated in plaque and saliva inhibits the demineralisation of sound enamel and enhances the remineralisation of demineralised enamel. A large number of studies conducted worldwide demonstrate the effectiveness of water fluoridation. Objections to water fluoridation have been raised since its inception and centre mainly on safety and autonomy. Systematic reviews of the safety and efficacy of water fluoridation attest to its safety and efficacy; dental fluorosis identified as the only adverse outcome. Water fluoridation is an effective safe means of preventing dental caries, reaching all populations, irrespective of the presence of other dental services. Regular monitoring of dental caries and fluorosis is essential particularly with the lifelong challenge which dental caries presents. Copyright © 2013 by Academy of Sciences and Arts of Bosnia and Herzegovina.


Ni Riordain R.,Cork University Dental School and Hospital | Mccreary C.,Cork University Dental School and Hospital
Journal of Oral Pathology and Medicine | Year: 2011

Introduction: The aims of this study were to test the validity and reliability of a newly developed discipline-specific questionnaire, the Chronic Oral Mucosal Diseases Questionnaire (COMDQ), to measure quality of life in patients with chronic oral mucosal conditions. Materials and methods: Two patient samples were recruited for the purposes of this study. First, a random sample of 160 patients attending the Oral Medicine Unit of Cork University Dental School and Hospital with the following chronic oral mucosal conditions, recurrent aphthous stomatitis, oral lichen planus, the more common vesiculobullous conditions (mucous membrane pemphigoid and pemphigus vulgaris) and orofacial granulomatosis. Second, the COMDQ was randomly distributed to a sample of 100 patients without a chronic oral mucosal condition. Convergent and discriminative validity and internal consistency of the newly developed questionnaire were assessed. Results: This study has demonstrated that the newly developed questionnaire has good convergent validity with Pearson correlation coefficient of 0.819 with Oral Health Impact Profile-14 and 0.883 with Visual Analogue Scale for pain scores. The discriminative validity was also good with statistically significant differences between patients with chronic oral mucosal conditions and without chronic oral mucosal conditions. The new instrument has also demonstrated excellent reliability with Cronbach's alpha of 0.929. Conclusions: In conclusion, this study has demonstrated that the COMDQ is a valid and reliable measure to assess quality of life in patients with chronic oral mucosal diseases and therefore will be a valuable instrument in the management of these conditions. © 2011 John Wiley & Sons A/S.


McCreary C.,Cork University Dental School and Hospital
Dental update | Year: 2010

Although systemic diseases can occur at any age, they are more common in older patients. Accurate and detailed medical and drug histories are important in dental practice as many conditions and medications can influence oral health and dental care in patients. Not only can these conditions influence patient care in the surgery and oral hygiene at home, but access to dental services may also be adversely affected. Clinical Relevance: The systemic diseases can impact upon oral care or can have oral manifestations. Many of the pharmacological interventions prescribed for chronic conditions can have multiple and diverse adverse effects on the oral environment.


O'Sullivan E.M.,Cork University Dental School and Hospital
Community Dental Health | Year: 2012

Objectives: This study examines the independent and combined impact of 'alcohol only' and 'alcohol plus drug' abuse on the dental health of Irish alcohol/drug abuse treatment centre residents, comparing their dental caries experience. Methods: Four Irish treatment centres were visited periodically over a year. Data was collected on residents' alcohol, tobacco and drug habits. Participants underwent comprehensive oral examination. Results: Of 210 participants (148 males and 62 females), 53% reported an 'alcohol plus drug' abuse; 44% had an 'alcohol-only' abuse. 'Drug-only' abusers (n=7) were excluded. Ages ranged from 18-73 with 59% aged under 40. 'Alcohol-only' abusers were significantly older than "alcohol plus drugs" abusers (p<0.001). Mean DMFT (14.4, sd 7.3) and MT scores (7.3, sd 6.8) were above the national averages. "Alcohol-only" abusers had higher DMFT scores (p<0.001), more missing teeth (p<0.001) and more filled teeth (p<0.01) than "drugs plus alcohol" abusers. DT scores did not vary significantly between study groups. Multivariate analysis confirmed the significance of gender (males OR=2.31, p=0.009) on DT scores and highly significant influence of age (age≤36, OR=0.08, p<0.001) on MT status. However, study group was not a significant influence once age was taken into consideration. Conclusions: The study reveals a high level of dental disease among Irish alcohol/drug abusers. While some authors have suggested that 'alcohol-only' abusers may experience less decay than 'alcohol plus drug' abusers, this study found no significant difference in the caries experience of the two groups once age was taken into consideration. © BASCD 2012.


Ni Riordain R.,Cork University Dental School and Hospital | Mccreary C.,Cork University Dental School and Hospital
Oral Diseases | Year: 2012

Objective: To test the reliability and responsiveness of the Chronic Oral Mucosal Diseases Questionnaire (COMDQ), in measuring the quality of life (QofL) in patients with chronic oral mucosal conditions. Methods: A random sample of 160 patients with the following chronic oral mucosal conditions, recurrent aphthous stomatitis, oral lichen planus, the more common vesiculobullous conditions (mucous membrane pemphigoid and pemphigus vulgaris) and orofacial granulomatosis received a copy of the COMDQ. A subset of 100 patients received the questionnaire on two further occasions, 2weeks and 3months later. Statistical tests were carried out to evaluate the test-retest reliability and responsiveness of this instrument. Results: This study has demonstrated that the COMDQ has good test-retest reliability with an intraclass correlation coefficient of 0.81 and is responsive to changes in the patients' overall conditions. Conclusion: In conclusion, this study has further demonstrated the reliability and responsiveness of the COMDQ in assessing QofL in patients with chronic oral mucosal diseases. © 2011 John Wiley & Sons A/S.


O'Mahony G.,Cork University Dental School and Hospital
The Angle orthodontist | Year: 2011

To determine the prevalence of tooth size discrepancies (TSDs) in an Irish orthodontic population among different malocclusion groups. From 850 pretreatment sets of orthodontic models at a university clinic, 240 were selected with 30 female and 30 male sets for each malocclusion (Class I, Class II division 1, Class II division 2, and Class III). Digital models were produced, and the mesial and distal contact points were digitized to calculate overall and anterior tooth size ratios. The differences between the male and female groups and among the malocclusion groups were analyzed using two-way analysis of variance (ANOVA) (P < .05). A clinically significant anterior TSD (more than two standard deviations from the Bolton means) existed in 37.9% of the subjects. No differences existed in the prevalence of overall TSDs between the male and female groups (P = .5913) or among the malocclusion groups (P = .0809). For the mean anterior tooth size ratios in the male group, the values for Class III and Class II division 2 were higher than in Class II division 1, and the value for Class II division 2 was higher than in Class I (P = .0184). The prevalence of anterior tooth size discrepancies in this sample of Irish orthodontic patients was 37.9%. There were no statistically significant differences in the prevalence of mean overall TSDs with regard to malocclusion or gender. In the male group, the mean anterior tooth size ratio was higher in Class III and in Class II division 2 malocclusion than in Class II division 1 and higher in Class II division 2 malocclusion than in Class I malocclusion.

Loading Cork University Dental School and Hospital collaborators
Loading Cork University Dental School and Hospital collaborators