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Publication History View all

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    ABSTRACT: Objectives The aim of this study was to establish the success in calibrating dental students in the use of the Index of Orthodontic Treatment Need (IOTN). Design Single-centre, evaluation of teaching study. Setting University department, UK, 2013. Subjects and method Third-year dental students were divided into four groups and received IOTN instruction via clinical and non-clinical teaching over a three-month period. This was followed by a calibration exercise where the whole year assessed 30 study models for orthodontic treatment need using the dental health component (DHC) and modified aesthetic component (AC) of the IOTN. Main outcome measures Student IOTN scores were compared to a gold standard using kappa statistics (κ). Results Results showed that although substantial agreement was achieved in both the DHC (κ = 0.65) and a modified AC (unweighted κ = 0.63), the year only calibrated successfully in the DHC. Conclusion Third year dental students taught at Cardiff University applied the DHC of IOTN better than the AC.
    British dental journal official journal of the British Dental Association: BDJ online 11/2013; 215(9):469-71.
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    ABSTRACT: The front covers of the current volume of the British Dental Journal (Volume 215) feature drawings by children participating in the Welsh national oral health improvement programme - Designed to Smile. This programme involves 78,350 children in the Principality, who are deemed at greatest risk of tooth decay, participating in daily toothbrushing in 1,211 nurseries and schools. It mirrors the Childsmile programme in Scotland. Since devolution in 1999, approaches to oral health improvement across the United Kingdom have diverged. This article considers the way in which population-based policies with regards to fluoride use have varied between countries.
    British dental journal official journal of the British Dental Association: BDJ online 07/2013; 215(1):11-12.
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    ABSTRACT: BACKGROUND: Despite recent improvements in oral health, dental caries remains a significant source of morbidity for young children. Research has shown that regular toothbrushing with fluoride toothpaste reduces the risk of dental caries, but the factors that influence parental decisions about whether or not to brush their infant children's teeth at home are poorly understood. AIM: To develop an in-depth understanding of the issues that parents face from socio-economically deprived areas when trying to brush their young children's teeth at home. DESIGN: Fifteen parents of children aged 3-6 years took part in semi-structured telephone interviews, discussing factors relating to brushing their child's teeth at home. Thematic analysis was used to develop three themes. RESULTS: Parents discussed the difficulty of brushing their children's teeth in the evening, due to changing day-to-day routines, and the subsequent difficulty of forming a toothbrushing habit. Motivating factors for brushing children's teeth were largely short term. Satisfaction with brushing frequency was influenced more by perceptions of how often other parents brushed children's teeth than by the 'twice a day' norm or health outcomes. CONCLUSION: Results are discussed in relation to research and theories from the psychology and behavioural economics literature, and comparisons are drawn with assumptions inherent in more traditional oral health promotion messages.
    International Journal of Paediatric Dentistry 04/2013;
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    ABSTRACT: Students looking to read dentistry can be overwhelmed by the information and requirements presented to them by dental schools, career advisors and the printed literature. In the UK, there are currently 16 dental schools which provide a dentistry degree. While there are variations in the specific aspects of the dental courses at each school, there are common principles and generic application requirements that apply. This paper provides a guide to facilitate applications and inform potential students, career advisors and dentists. The information presented has been gathered from UK dental school websites and university prospectuses and corroborated through contact with university admissions offices. CLINICAL RELEVANCE: This paper is relevant to dental practitioners who are often asked to provide advice on applications to dental schools by potential students.
    Dental update 03/2013; 40(2):129-32, 135-8, 141-2.
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    ABSTRACT: This study used Q-sort methodology to determine the views of staff involved in a national school-based daily toothbrushing programme. Q-methodology is a mixed-method approach in which participants are asked to sort a collection of statements according to degree of agreement with them. Factor analysis identified subgroups of like-minded participants and revealed areas of consensus and disagreement. 24 Community Dental Service staff managing or delivering the toothbrushing programme were asked to rank 49 statements derived from previous qualitative interviews. Varimax rotation produced a three-factor solution with five/six participants loading significantly into each group. Groups divided largely according to staff role: Factor 1, mainly support workers (assistants with no oral-health background); Factor 2, managers; and factor 3, oral health educators (dental nurses with teaching qualifications). As staff new to the area of oral-health, the views of support workers were of particular interest. Unlike others, this group saw Designed to Smile as a unique health promotion scheme and wanted to involve as many children as possible, regardless of oral-disease risk. Managers' perceptions of issues affecting the establishment of the programme differed from those staff in day-to-day contact with the 515 schools in which the toothbrushing took place. This study used a long established but little used technique to ascertain the commonality of views of staff These data may be of value not only in managing the current programme, but for anyone who may be considering developing such a toothbrushing scheme.
    Community dental health 03/2013; 30(1):45-51.
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    ABSTRACT: Objective measures of facial movement are important for interventions where surgical repositioning of facial structures can influence soft tissue mobility and include the management of patients with cleft lip, facial nerve palsy and orthognathic surgery. As such, the aim of this study is to present a method for determining the outcome of surgical procedures on lip shape during speech. A control group (CG) of 115 average subjects and 30 patients with a Class 3 malocclusion requiring bimaxillary surgery performed four reproducible verbal utterances during image capture using a non-invasive, three-dimensional (3D) motion scanner (3dMDFace™ Dynamic System). Landmark coordinates around the lips of the 3D facial shells were extracted and subjected to discriminant analysis and principal component analysis to statistically differentiate lip shapes between the CG and the patient group (PG) pre- and post-surgery. Pre-surgically, the PG showed statistically significant differences in lip shape during speech in the lateral and vertical dimensions, preferring a wider, shorter lip shape when compared with the CG for all the utterances. The shape differences normalised towards the CG post-surgery. The method presented utilises pre-existing statistical shape analyses and can be reproduced in the clinical setting to provide a diagnostic and functional outcome tool. In this example, correction of the Class 3 skeletal disproportions appeared to normalise lip shape during speech.
    Journal of Oral Rehabilitation 02/2013;
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    ABSTRACT: Objective assessments of lip movement can be beneficial in many disciplines including visual speech recognition, for surgical outcome assessment in patients with cleft lip and for the rehabilitation of patients with facial nerve impairments. The aim of this study was to develop an outcome measure for lip shape during speech using statistical shape analysis techniques. Lip movements during speech were captured from a sample of adult subjects considered as average using a three-dimensional motion capture system. Geometric Morphometrics was employed to extract three-dimensional coordinate data for lip shape during four spoken words decomposed into seven visemes (which included the resting lip shape). Canonical variate analysis was carried out in an attempt to statistically discriminate the seven visemes. The results showed that the second canonical variate discriminated the resting lip shape from articulation of the utterances and accounted for 17.2% of the total variance of the model. The first canonical variate was significant in discriminating between the utterances and accounted for 72.8% of the total variance of the model. The outcome measure was created using the 95% confidence intervals of the canonical variate scores for each subject plotted as ellipses for each viseme. The method and outcome model is proposed as reference to compare lip movement during speech in similar population groups.
    PLoS ONE 01/2013; 8(2):e57368.
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    ABSTRACT: To determine whether facial morphology is associated with fasting insulin, glucose and lipids independent of body mass index (BMI) in adolescents. Population-based cross-sectional study. Avon Longitudinal Study of Parents and Children (ALSPAC), South West of England. From the ALSPAC database of 4747 three-dimensional facial laser scans, collected during a follow-up clinic at the age of 15, 2348 white British adolescents (1127 males and 1221 females) were selected on the basis of complete data on cardiometabolic parameters, BMI and Tanner's pubertal stage. Fasting insulin, glucose and lipids (triglycerides, high-density lipoprotein cholesterol (HDLc) and low-density lipoprotein cholesterol (LDLc)). On the basis of the collection of 63 x, y and z coordinates of 21 anthropometric landmarks, 14 facial principal components (PCs) were identified. These components explained 82% of the variation in facial morphology and were used as exposure variables. With adjustment for age, gender and pubertal stage, seven PCs were associated with fasting insulin, none with glucose, three with triglycerides, three with HDLc and four with LDLc. After additional adjustment for BMI, four PCs remained associated with fasting insulin, one with triglycerides and two with LDLc. None of these associations withstood adjustment for multiple comparisons. These initial hypotheses generating analyses provide no evidence that facial morphology is importantly related to cardiometabolic outcomes. Further examination might be warranted. Facial morphology assessment may have value in identifying other areas of disease risk.
    BMJ Open 01/2013; 3(5).
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    ABSTRACT: OBJECTIVES: Three-dimensional analysis of facial shape and symmetry in twins. SETTING AND SAMPLE POPULATION: Faces of 37 twin pairs [19 monozygotic (MZ) and 18 dizygotic (DZ)] were laser scanned at the age of 15 during a follow-up of the Avon Longitudinal Study of Parents and Children (ALSPAC), South West of England. MATERIAL AND METHODS: Facial shape was analysed using two methods: 1) Procrustes analysis of landmark configurations (63 x, y and z coordinates of 21 facial landmarks) and 2) three-dimensional comparisons of facial surfaces within each twin pair. Monozygotic and DZ twins were compared using ellipsoids representing 95% of the variation in landmark configurations and surface-based average faces. Facial symmetry was analysed by superimposing the original and mirror facial images. RESULTS: Both analyses showed greater similarity of facial shape in MZ twins, with lower third being the least similar. Procrustes analysis did not reveal any significant difference in facial landmark configurations of MZ and DZ twins. The average faces of MZ and DZ males were coincident in the forehead, supraorbital and infraorbital ridges, the bridge of the nose and lower lip. In MZ and DZ females, the eyes, supraorbital and infraorbital ridges, philtrum and lower part of the cheeks were coincident. Zygosity did not seem to influence the amount of facial symmetry. Lower facial third was the most asymmetrical. CONCLUSION: Three-dimensional analyses revealed differences in facial shapes of MZ and DZ twins. The relative contribution of genetic and environmental factors is different for the upper, middle and lower facial thirds.
    Orthodontics and Craniofacial Research 12/2012;
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    ABSTRACT: summaryTo investigate the feasibility of facial laser scanning in pre-school children and to demonstrate landmark-independent three-dimensional (3D) analyses for assessment of facial deformity in 5-year-old children with repaired non-syndromic unilateral cleft lip and/or cleft palate (UCL/P).Faces of twelve 5-year-old children with UCL/P (recruited from university hospitals in Cardiff and Swansea, UK) and 35 age-matched healthy children (recruited from a primary school in Cardiff) were laser scanned. Cleft deformity was assessed by comparing individual faces against the age and gender-matched average face of healthy children. Facial asymmetry was quantified by comparing original faces with their mirror images.All facial scans had good quality. In a group of six children with isolated cleft palate coincidence with the average norm ranged from 18.8 to 26.4 per cent. There was no statistically significant difference in facial asymmetry when compared with healthy children (P > 0.05). In a group of six children with UCL with or without cleft palate coincidence with the average norm ranged from 14.8 to 29.8 per cent. Forehead, midface and mandibular deficiencies were a consistent finding, ranging from 4 to 10mm. The amount of 3D facial asymmetry was higher in this group (P < 0.05).Facial laser scanning can be a suitable method for 3D assessment of facial morphology in pre-school children, provided children are well prepared. Landmark-independent methods of 3D analyses can contribute to understanding and quantification of facial soft tissue cleft deformity and be useful in clinical practice.
    The European Journal of Orthodontics 10/2012;
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