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Leeds, United Kingdom

Dhaliwal H.,Leeds Dental Institute
Dental update | Year: 2010

Dentinogenesis imperfecta (DI) is a hereditary condition which affects the development of dentine in both the primary and permanent dentitions. Three types of DI have been described in the literature. The presentation of DI is variable, depending on the type and severity of the disease. Early intervention in the treatment of a patient with DI is extremely important both for psycho-social and for functional reasons. This paper attempts to describe the clinical presentation and management of DI, and explores its association with certain medical conditions. CLINICAL RELEVANCE: Recognition of DI is important, so that correct treatment principles may be instituted.

Auld D.N.,Leeds Dental Institute
Dental update | Year: 2010

Dento-alveolar trauma presents commonly in general dental practice, but may prove difficult to manage for those unfamiliar with it. Timely and well-informed intervention can significantly improve the clinical outcome for the patient. This article aims to inform the clinician on best current practice for the assessment and initial management of dental traumatic injuries, incorporating current international guidelines and practical arrangements for follow-up care. Clinical Relevance: The dental trauma patient often presents to the general dental practitioner and the appropriate emergency management plays a vital role in relieving pain, protecting the dentino-pulpal complex, reducing displaced teeth and improving prognosis.

Marsh P.D.,Public Health England | Marsh P.D.,Leeds Dental Institute
Dental Clinics of North America | Year: 2010

Dental plaque is the biofilm found naturally on teeth. Dental plaque is also implicated in dental caries, which is associated with shifts in the microbial balance of the biofilm resulting in increased proportions of acid producing and acid tolerating bacteria, especially (but not exclusively) mutans streptococci and lactobacilli. The regular intake of fermentable dietary sugars, or impaired saliva flow, produces persistent conditions of low pH within the biofilm, which selects for these cariogenic bacteria. Clinicians should prevent this disruption to the natural microbial balance of the biofilm (relevant approaches are described) rather than merely treating its consequences by restoring cavities. © 2010 Elsevier Inc.

Duggal M.S.,Leeds Dental Institute
European archives of paediatric dentistry : official journal of the European Academy of Paediatric Dentistry | Year: 2010

This was to determine the presence and types of oral mucosal lesions in a sample of HIV(+)/AIDS South African children taking antiretroviral therapy and to investigate the relationship between CD4(+) lymphocyte counts, viral load, duration of taking antiretroviral therapy (DART), and age on presence of oral lesions. The samples consisted of 56 South African children aged 0-4 years (mean age =7.09 years) with HIV(+)/AID, infected at birth. Subjects were divided into two groups according to the presence of oral lesions with test group (patients with oral lesions) and control group (patients with no oral lesions). Children were also divided into two groups, those <6 years and those >6 years old to study the effect of age on presence of lesions. Oral Candidiasis was the most common lesion reported in 19/56 children, followed by Recurrent Herpetic Infection in 9 children. Other lesions such as Kaposi's sarcoma, Multifocal Epithelial Hyperplasia, Oral Hairy Leukoplakia, Linear Gingival Erythema, and oral ulceration were also present. A statistical significant difference in CD4(+) lymphocyte count (p value 0.005), and viral load (p value 0.002) was found between the oral lesion and no oral lesion groups, those with oral lesions having a significantly higher viral load and lower CD4+ count. No statisticaly significant difference between the two groups in terms of the DART effect (p value 0.811) was found. Furthermore, there was no effect of age groups on the presence of lesions in children with HIV(+)/AIDS. This study contributes to the relatively scant literature on the prevalence of oral lesions in children with HIV infection in South Africa and also the relationship of these lesions to the viral load and CD4(+) lymphocyte counts.

Balmer R.,Leeds Dental Institute
Primary dental care : journal of the Faculty of General Dental Practitioners (UK) | Year: 2010

The aim of this paper is to update the reader on the subject of dental neglect in children. Recent national guidelines produced by the National Institute for Health and Clinical Excellence and the British Society of Paediatric Dentistry have raised the profile of this condition by providing specific, evidence-based recommendations for recognition and response to dental neglect. Dental neglect may be a sign of general neglect or may be considered maltreatment in itself. The specific dental and non-dental features are described and actions secondary to a diagnosis of dental neglect are discussed. Three types of intervention are described: preventive dental team management, preventive multi-agency management, and referral to child protection services. With increasing awareness of this condition and through access to the expertise of other specialist agencies in this field, the primary care practitioner can play a key role in safeguarding the welfare of children.

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