Gail Douglas

Gail Douglas
University of Leeds · School of Dentistry

BMSc, BDS, MPH, FDS RCS(Edin), PhD, FDS(DPH)RCS(Edin)

About

112
Publications
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Publications

Publications (112)
Article
Full-text available
The aim of the present consensus paper was to provide recommendations for clinical practice on the individual etiological and modifying factors to be assessed in the individual diagnosis of caries, and the methods for their assessment, supporting personalized treatment decisions. The executive councils of the European Organisation for Caries Resear...
Article
Introduction: This consensus paper provides recommendations for oral health professionals on why and how to assess caries activity and progression with special respect to the site of a lesion. Methods: An expert panel was nominated by the executive councils of the European Organization for Caries Research (ORCA) and the European Federation of Conse...
Article
Full-text available
The aim of the present consensus paper was to provide recommendations for clinical practice considering the use of visual examination, dental radiography and adjunct methods for primary caries detection. The executive councils of the European Organisation for Caries Research (ORCA) and the European Federation of Conservative Dentistry (EFCD) nomina...
Article
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Background Oral health has an important role in the general health and well-being of individuals. Dental teams are ideally placed to support patients in preventing ill-health. Understanding the barriers and facilitators to the adoption, promotion and facilitation of preventive advice and treatment is key to improving oral health services. The Theor...
Preprint
Full-text available
Background:In 2020, CariesCare International (CCI) -derived from ICCMS- was plannedto be tested for caries-control effectiveness in children by means of a multicenter randomized clinical trial (RCT). Nevertheless, due to the pandemic, RCTs proved unfeasible and aerosol-generating procedures (AGP) were associated with a spread of COVID-19. Consequen...
Article
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A global survey among dentists was used to identify the various impacts of the COVID-19 pandemic on this professional group. Special attention was given to perception and assessment of infection risk. From May to August 2020, the questionnaire was delivered in 36 countries by respective research groups and was completed by 52,491 dental professiona...
Method
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This questionnaire was developed by The University of Leeds and should be cited: Csikar, J., Leggett, H., Vinall‐Collier, K., Whelton, H., Pavitt, S., Kang, J. and Douglas, G.V., 2022. Development and validation of an International Patient’s Attitudes to Prevention in Oral Health Questionnaire. Community Dentistry and Oral Epidemiology.
Conference Paper
Background An international study of dental practise across 36 countries during the pandemic concluded that oral health provision had not been significantly affected. This study examines the impact of COVID-19 on provision of NHS care and hours worked by dentists in the UK. Methods Dentists were surveyed in the UK in June and July 2020. 4,637 prim...
Conference Paper
Background An international study of dental practise across 36 countries during the pandemic concluded that although lockdown affected provision of service temporarily, oral health provision had not been significantly affected. This study aims to describe the impact of COVID-19 on future workforce participation in the UK and associated individual f...
Article
Full-text available
Introduction National surveys of the oral health of adults are conducted decennially. For reasons of feasibility and cost, these only provide accurate information at large geographical areas. To address this, a survey of adults attending dental practices in England was undertaken. Aim To describe and discuss the survey method and findings. Method A...
Article
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Background Despite significant progress in the control of oral diseases since the discovery of fluoride in the 1940s, dental caries and periodontal diseases continue to affect a significant proportion of the population, particularly socially disadvantaged and lower socioeconomic groups. The National Health Service in England provides preventive adv...
Article
Aims This study aimed to use electronic referral management system (eRMS) oral surgery data across multiple sites in England to evaluate the service over a 34-month period in relation to: 1) pre- and post-pandemic referral rates in oral surgery; 2) examining the data for signs of inequality in obtaining a referral for oral surgery; and 3) consideri...
Article
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Objectives: To develop a patient's attitude questionnaire regarding prevention in oral health for use internationally. Methods: Using a mixed methods approach, a questionnaire was developed and refined as part of ADVOCATE (Added Value for Oral Care) study, involving partners in six countries: Netherlands, Hungary, Denmark, Ireland, Germany, and...
Article
Aims To assess the effectiveness and acceptability of smartphone customised frame technology to improve the fit of disposable filtering facepiece class 3 (FFP3) respirators for dental staff who previously failed fit testing.Method In total, 20 volunteers who previously failed FFP3 fit testing were recruited to use smartphone technology (Bellus3D Fa...
Preprint
Full-text available
Aims: This study aimed to use the electronic Referral Management System (eRMS) oral surgery data across multiple sites in England to evaluate the service over a 34-month period in relation to: 1. Pre and post pandemic referral rates in oral surgery 2. Examining the data for signs of inequality in obtaining a referral for oral surgery. 3. The impact...
Article
Introduction Patients referred from primary dental care to hospital-based specialists in high volumes can contribute to significant NHS service pressures. Surprisingly, little is understood about what contributes to referral factors.Aims To gain new insight into the referral factors from primary dental care by interrogating the tri-speciality West...
Article
Background/Aims Children with congenital heart disease are at an increased risk of developing oral disease, which can negatively impact their general health and increase the risk of infective endocarditis. This study explored the preventive oral health advice given to parents of children with congenital heart disease and any barriers that exist to...
Article
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This research aimed to identify and explore perceived challenges and facilitators to acquiring routinely collected oral healthcare data for research in six European countries with the aim of generating practical solutions for future initiatives. Seventeen participants from the UK, Denmark, Germany, Hungary, Ireland and the Netherlands participated...
Article
Background In 2020/21, as part of the COVID-19 pandemic response and for the first time in England, newly qualified foundation dentists (FDs) were trained to participate in flu and COVID-19 vaccination programmes to offer additional workforce capacity. The largest of these efforts was in Yorkshire and the Humber where 106 FDs were trained and ready...
Article
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Background Comprehensive caries care has shown effectiveness in controlling caries progression and improving health outcomes by controlling caries risk, preventing initial-caries lesions progression, and patient satisfaction. To date, the caries-progression control effectiveness of the patient-centred risk-based CariesCare International (CCI) syste...
Article
Background Many people residing in nursing or residential care homes (also called long-term care facilities) live with physical or cognitive difficulties. Staff working in these environments often help residents (particularly those with more advanced dementia) with their personal care needs, including maintaining mouth care and health. Poor oral he...
Presentation
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Presentation discussing referral data for a 3 year period relating to primary care referrals to Oral Surgery, Oral Medicine and Oral & Maxillofacial Surgery in West Yorkshire.
Preprint
Background Gender inequalities in dental caries and periodontal diseases have been observed among adults. However, literature is scarce for children and evidence on gender inequalities regarding caries and/or periodontal diseases is vague. Our aim is to examine potential gender differences in UK children regarding caries experience and periodontal...
Article
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[This corrects the article DOI: 10.3389/fmed.2020.606242.].
Article
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Objective To compare the clinical effectiveness of different frequencies of dental recall over a four-year period. Design A multi-centre, parallel-group, randomised controlled trial with blinded clinical outcome assessment. Participants were randomised to receive a dental check-up at six-monthly, 24-monthly or risk-based recall intervals. A two-str...
Article
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Introduction Influenza is regarded by the World Health Organization (WHO) as a “serious global health threat” and is responsible for a significant number of deaths worldwide (1, 2). Influenza vaccines are usually delivered in primary care physician practices as well as in pharmacy settings. Dental practices are generally not seen as routine provide...
Article
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Background Traditionally, patients are encouraged to attend dental recall appointments at regular 6-month intervals, irrespective of their risk of developing dental disease. Stakeholders lack evidence of the relative effectiveness and cost-effectiveness of different recall strategies and the optimal recall interval for maintenance of oral health....
Article
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Operative treatment is indicated for most toothache/dental abscesses, yet antibiotics instead of procedures are often prescribed. This ethnographic study aimed to identify clinician and patient factors influencing urgent dental care for adults during actual appointments; and to identify elements sensitive to context. Appointments were observed in o...
Article
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The Centres for Disease Control and Prevention and the World Health Organization have developed preparedness and prevention checklists for healthcare professionals regarding the containment of COVID-19. The aim of the present protocol is to evaluate the impact of the COVID-19 outbreak among dentists in different countries where various prevalence o...
Article
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Introduction Dental caries, gum disease, and tooth loss are all preventable conditions. However, many dental care systems remain treatment oriented rather than prevention oriented. This promotes the treatment of oral diseases over preventive treatments and advice. Exploring barriers to prevention and understanding the requirements of a paradigm shi...
Presentation
Objectives: The associations between oral and systemic conditions are becoming increasingly important for clinicians, policy makers and patients. Periodontitis has been associated with several chronic inflammatory conditions including diabetes, cardiovascular disease and rheumatoid arthritis (RA). Most studies to date have focused on clinical outco...
Article
Full-text available
Background: The Filling Children's Teeth: Indicated Or Not? (FiCTION) randomised controlled trial (RCT) aimed to explore the clinical- and cost-effectiveness of managing dental caries in children's primary teeth. The trial compared three management strategies: conventional caries management with best practice prevention (C + P), biological managem...
Article
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Background: The lack of evidence for the effective management of carious lesions in children's primary teeth has caused uncertainty for the dental profession and patients. Possible approaches include conventional and biological management alongside best practice prevention, and best practice prevention alone. The FiCTION trial assessed the effecti...
Article
Full-text available
Background: A three-arm parallel group, randomised controlled trial set in general dental practices in England, Scotland, and Wales was undertaken to evaluate three strategies to manage dental caries in primary teeth. Children, with at least one primary molar with caries into dentine, were randomised to receive Conventional with best practice prev...
Article
Objective Attendance at accident and emergency departments (A&E) for non-traumatic dental conditions (NTDC) is increasing in high-income countries. Not all NTDC visits to A&E are inappropriate; however, those that are take up capacity with conditions which are adding to the pressure regarding cost and healthcare utilisation for A&E departments. The...
Article
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Background Historically, lack of evidence for effective management of decay in primary teeth has caused uncertainty, but there is emerging evidence to support alternative strategies to conventional fillings, which are minimally invasive and prevention orientated. Objectives The objectives were (1) to assess the clinical effectiveness and cost-effe...
Article
This multicenter 3-arm, parallel-group, patient-randomized controlled trial compared clinical effectiveness of 3 treatment strategies over 3 y for managing dental caries in primary teeth in UK primary dental care. Participants aged 3 to 7 y with at least 1 primary molar with dentinal carious lesion were randomized across 3 arms (1:1:1 via centrally...
Chapter
The aim of this chapter is to present the clinician a guide to the visual-tactile detection and assessment of caries. This chapter will give the clinicians knowledge and support to use visual-tactile diagnosis within a clinical examination.
Article
Background Excessive antibiotic prescribing is a global public health and patient safety problem. Around 10% of all antibiotic prescriptions worldwide are from primary dental care, with 80% estimated to be unnecessary. Earlier research identified 34 factors associated with dentists’ decisions on whether to prescribe antibiotics for adults with acut...
Article
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Objective To explore, through face to face interviews with a selection of General Dental Practitioners (GDPs), their views and experiences of having used the International Caries Detection and Assessment System (ICDAS) within primary care research studies for recording caries. Methods This qualitative study involved one on one interviews with eigh...
Article
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This CariesCare practice guide is derived from the International Caries Classification and Management System (ICCMS) and provides a structured update for dentists to help them deliver optimal caries care and outcomes for their patients. This '4D cycle' is a practice-building format, which both prevents and controls caries and can engage patients as...
Article
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Objective This study aimed to describe stakeholder perspectives of a new service delivery model in primary care dentistry incorporating incentives for access, quality and health outcomes. Design Data were collected through observations, interviews and focus groups. Setting This was conducted under six UK primary dental care practices, three worki...
Article
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Objective: A qualitative exploration of the barriers and facilitators for people experiencing homelessness achieving good oral health. Participants: Adults using two homeless centres in Leeds. Methods: Focus group discussions were convened with homeless people using support services. Both an inductive and deductive approach to data analysis wa...
Article
Objective To explore how parents access emergency care for their children following avulsion of a permanent tooth. Method Semi-structured qualitative interviews were undertaken with parents of children who had suffered a tooth avulsion injury in the previous two years. The interviews were recorded and transcribed verbatim. Framework analysis was us...
Poster
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Background: Excessive antibiotic prescribing in primary dental care is a global problem. 1 Much is known about use in primary medical care; less about dental care. In England, most dental antibiotics are for adults with acute conditions. 2 Aim: To develop a theory-informed complex intervention to reduce dental antibiotic prescribing. Methods: An et...
Article
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Objective: To explore barriers and facilitators to oral disease prevention in Danish dental care from a multi-stakeholder perspective. Methods: Eleven semi-structured focus groups and interviews about Danish oral healthcare were conducted with 27 stakeholders (general public, dental teams, dental policy makers) in Copenhagen. Transcripts were analy...
Poster
Oral health varies around Europe, little is known about impacts of healthcare systems on disease prevention. Information about different healthcare systems is mostly limited to contextual facts with inadequate information about how they facilitate better outcomes. The aim of the Added Value for Oral Care (ADVOCATE), EU Horizon 2020 project, which i...
Article
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Aim To compare the provision and costs at the point of delivery of dental treatments in a sample of European Union (EU) Member States. Materials and methods A questionnaire with open‐ended questions was sent to oral health policy‐makers in Denmark, England, France, Germany, Hungary, Ireland, Italy, the Netherlands, Poland, Romania, Scotland and Sp...
Article
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Antibiotics do not cure toothache. This headline message of the United Kingdom’s (UK) Dental Antimicrobial Stewardship (AMS) toolkit’s posters and leaflets is aimed at patients; clinicians are expected to know this already. Evidence based clinical guidelines exist to set clear standards for good clinical practice yet there are barriers to complianc...
Article
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Objectives: The purpose of this study was to determine knowledge, attitude, and practical behavior of health visitors regarding children's oral health in the United Kingdom (UK). Methods: A web-based self-administered survey with 18 closed and 2 open ended questions was distributed to a convenience sample of approximately 9,000 health visitors w...
Article
Birth cohort initiatives, such as 'Born in Bradford', provide a unique opportunity to study the influence of socio-economic and environmental factors acting in pregnancy, birth and infancy on the development of dental caries in later life. This paper describes a feasibility study which established the processes required, and outcomes of, successful...
Article
Objectives: To explore fear/anxiety inducing triggers associated with dental treatment, and what dentally anxious adults would like from their dental encounter. Methods: Two focus-groups and three interviews with fourteen dentally-anxious people were conducted in this qualitative study. All discussions were tape-recorded and transcribed verbatim...
Article
Increasingly more responsive and accountable health care systems are demanded, which is characterized by transparency and explicit demonstration of competence by health care providers and the systems in which they work. This study aimed to establish measures of oral health for transparent and explicit reporting of routine data to facilitate more pa...
Presentation
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Overview of the protocol for the qualitative element of FiCTION RCT.
Article
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Objective The aim of the study was to assess the occlusal caries diagnosis and treatment strategies adopted by undergraduate dental students in dental colleges in Tamil Nadu, India. Methods Randomly selected 7 dental institutions in Tamil Nadu state India were sent a pre-tested 12 items questionnaire designed to assess the opinion and strategy ado...
Article
ADVOCATE (Added Value for Oral Care) is a project funded by the European Commission?s Horizon 2020 program, which aims to develop strategies for a system transition toward more patient-centered and prevention-oriented oral health care delivery within health care systems. This system should balance the restorative and preventive approaches in dental...
Article
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Objective: To evaluate the clinical and cost-effectiveness of a new blended dental contract incentivising improved oral health compared with a traditional dental contract based on units of dental activity (UDAs). Design: Non-randomised controlled study. Setting: Six UK primary care dental practices, three working under a new blended dental con...
Conference Paper
Whilst confirming that innovative preventive focused commissioning models can improve health outcomes the study also highlights the financial impact of the contracts. There is a need to understand how best to promote and encourage appropriate dental service attendance especially amongst those with high level of need to avoid increasing health inequ...
Article
Objectives: To review the literature reporting factors that are associated with the delivery of lifestyle support in general dental practice. Methods: A systematic review of the quantitative observational studies describing activities to promote the general health of adults in primary care general dental practice. Behavior change included tobacc...
Article
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Despite improvements in dental caries levels since the widespread introduction of fluoride toothpastes, it is still a disease which is considered to be a priority in many countries around the world. Individuals at higher risk of caries can be targeted with products with a high fluoride concentration to help reduce the amount and severity of the dis...
Article
The management of carious primary teeth is a challenge for patients, parents and clinicians. Most evidence supporting different management strategies originates from a specialist setting and therefore its relevance to the primary care setting is questionable. The UK National Institute for Health Research (NIHR) Health Technology Assessment (HTA) ha...
Article
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Background Over the past decade, commissioning of primary care dentistry has seen contract currency evolving from payment for units of dental activity (UDAs) towards blended contracts that include key performance indicators such as access, quality and improved health outcome. Objectives The aim of this study was to evaluate a blended/incentive-dri...
Article
Objectives: To compare the cost-effectiveness of smoking cessation services in general dental practice (dental), general medical practice (GMP), pharmacy and NHS Stop Smoking Services (NHS SSS) from the perspective of the provider and the perspective of the NHS. Methods: Retrospective monitoring data from NHS Bradford were accessed for any clien...
Article
Introduction: An avulsed permanent tooth is one of the few true emergencies in dentistry. Children who suffer this injury require urgent dental care and prompt follow-up care. There is very limited evidence available regarding the provision of treatment for avulsion injuries in primary dental care. Objectives: To explore the experience of UK den...
Article
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Background This study examined urban–rural and socioeconomic differences in adolescent toothbrushing. Methods The data were modelled using logistic multilevel modelling and the Markov Chain Monte Carlo method of estimation. Twice-a-day toothbrushing was regressed upon age, family affluence, family structure, school type, area-level deprivation and...
Article
Background: Birth cohorts, such as Born in Bradford (BiB), provide a unique opportunity to study the influence of socio-economic and environmental factors acting in pregnancy, birth and infancy on the development of dental caries (decay) in later life. Dental epidemiology surveys (DES) are undertaken annually in Bradford for different age groups us...
Conference Paper
Objective: A new approach to commissioning English National Health dental services focuses on oral health improvement, quality and activity and was used to commission three new practices in areas with high oral health needs. This study aimed to identify stakeholder perspectives of the new contract. Method: Observation of 30 dental appointment...
Article
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In England, in 2006, new dental contracts devolved commissioning of dental services locally to Primary Care Trusts to meet the needs of their local population. The new national General Dental Services contracts (nGDS) were based on payment for Units of Dental Activity (UDAs) awarded in three treatment bands based on complexity of care. Recently, co...
Conference Paper
Objective: There is currently little information on the prevalence of early decay in the UK population except in relation to orthodontic brackets. The main objective of this study was to establish the prevalence of early decay using the International Caries Detection and Assessment System (ICDAS) in a population of staff and students at the Univers...
Conference Paper
Smoking is the biggest cause of premature death worldwide. Smoking cessation services report a four-fold increase in a smoker’s chances of stopping smoking if they access specialist support and medication. There are a plurality of providers which can give this ‘specialist’ support but identifying location where they are best placed may pose issues...
Conference Paper
Objective: This study used a qualitative approach to explore how parents access emergency care for their children following avulsion of a permanent tooth. Methods: Parents of children who had suffered tooth avulsion injuries were recruited from Leeds Dental Institute Trauma and Emergency clinics using purposive sampling. Participants’ were re...
Conference Paper
Objective: Dental amalgam has been used to restore dental cavities. Concern over mercury vapour release from the dental amalgam and its health effects had been debated continually. The objectives of this study were to conduct a systematic review for dental amalgam fillings, body tissue mercury level and their potential health effects. Method:...
Article
Full-text available
Background: There is a lack of evidence for effective management of dental caries (decay) in children's primary (baby) teeth and an apparent failure of conventional dental restorations (fillings) to prevent dental pain and infection for UK children in Primary Care. UK dental schools' teaching has been based on British Society of Paediatric Dentist...
Conference Paper
ICDAS, a standardized system (2002) based on best-available evidence for detecting early and later stage caries severity (7 codes) is applicable in epidemiology/public health, research, and clinical practice. Its implementation has required training. In Colombia 9 training courses have been conducted since 2005, by the Caries Research Unit UNICA (U...
Conference Paper
Background: In the UK, there is uncertainty over the generalisability, to a primary care setting, of evidence for different treatment strategies used to manage decay in primary teeth. The FiCTION Trial will address the research question What is the clinical and cost effectiveness of restoring primary teeth, compared to no treatment? A third app...
Conference Paper
Background: FiCTION (Filling Children's Teeth: indicated or Not) is a multi-centre three-arm parallel group, randomised design trial involving UK general dental practitioners (GDPs) comparing three approaches to managing caries in the primary dentition: 1.Conventional, 2.Biological, 3.Prevention Alone. Funding for the 3-year trial was conditional o...
Article
Full-text available
Data from the Adult Dental Survey conducted in 2009/10 have recorded some major changes in the pattern of oral conditions in British adults. The change in the number of sound and untreated teeth in recent decades has been particularly marked in younger adults. Across all ages there were 17.9 sound and untreated teeth per dentate adult, but among th...
Article
Full-text available
Background: There is a lack of evidence for the effective management of dental caries in children's primary teeth. The trial entitled 'Filling Children's Teeth: Indicated Or Not?' (FiCTION) was designed to examine the clinical and cost effectiveness, in primary dental care, of three different approaches to the management of caries in primary teeth...