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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. Source

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. Source

O'Sullivan E.M.,Cork University Dental School and Hospital | Higginson I.J.,Kings 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. Source

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. Source

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. Source

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