IntroductionThe Scottish Dental Clinical Effectiveness Programme (SDCEP) is developing guidance f... more IntroductionThe Scottish Dental Clinical Effectiveness Programme (SDCEP) is developing guidance for oral health assessment and review that is intended for use in National Health Service (NHS) general dental practice. One section of this guidance is assessment of the teeth, including their caries status. The detailed caries assessment method identified by the guidance group is the International Caries Detection and Assessment System (ICDAS).AimThe aim of this study was to investigate the implications of using the ICDAS in an NHS general practice and, in particular, the time taken to use the system.MethodAfter online and in-practice training and calibration, 50 adult and 50 child patients were randomly allocated for assessment using the ICDAS detection codes. The ICDAS protocol states that the teeth should be clean and dry. For this study, all patients had their teeth brushed by the dentist before the assessment and the results were recorded on draft ICDAS clinical pro forma sheets. The time taken for the assessment was assessed with a stopwatch and recorded in a spreadsheet program.ResultsThe results showed that the mean time for the assessment of an adult was 3.80 minutes, or 4.99 minutes if the time for pre-examination cleaning and drying was included. For a child, the mean time was 2.53 minutes, or 3.99 minutes if pre-examination brushing time was included.ConclusionsThese results indicate that with training and experience, it is possible to carry out an ICDAS assessment in a time that is practical in general dental practice.
International Journal of Paediatric Dentistry, 2006
This review offers a brief summary of three of the more commonly surveyed and reported oral mucos... more This review offers a brief summary of three of the more commonly surveyed and reported oral mucosal conditions found in children, and an appraisal of the variation between selected elements of prevalence study methodologies. Searches of electronic databases (i.e. MEDLINE, CINAHL, EMBASE and EBM Reviews) were conducted to find publications related to oral mucosal conditions in children. Studies were included and reviewed if they contained data on the prevalence of any of the following oral mucosal conditions: geographical tongue, oral ulceration and herpes labialis in children or adolescents (up to the age of 19 years). A total of 29 articles out of 333 met the inclusion criteria and were reviewed. Of these 29 reports, 18 considered geographical tongue, 12 herpes labialis and 10 oral ulceration, although a number of the surveys reported on more than one condition. The approaches used in these studies varied on a number of the potentially important areas associated with validity, comparability, and whether or not the findings may be extrapolated beyond the study population, such as the sampling frame, diagnostic criteria, training and calibration, and examination features. Although there were a number of surveys relating to the prevalence of geographical tongue, herpes labialis and oral ulcers in children and adolescents, reported prevalences varied and few studies were directly comparable in terms of the methodology applied. In particular, there was substantial variation between surveys in terms of the diagnostic criteria and method of detection employed although, in many instances, there was inadequate detail to allow full appraisal of the methodology. There is a need for more good-quality epidemiological studies in this area.
ABSTRACT This interactive package, being evaluated across the EU, is designed to assist in shorte... more ABSTRACT This interactive package, being evaluated across the EU, is designed to assist in shortening the standardisation of large numbers of dentists to validly and reliably collect epidemiological data within practices, impacting on quality improvement and efficiency.
The aim of this chapter is to present the clinician a guide to the visual-tactile detection and a... more 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.
Journal of Evidence Based Dental Practice, Mar 1, 2009
Article Title and Bibliographic Information Low-fluoride dentifrice and caries lesion control in ... more Article Title and Bibliographic Information Low-fluoride dentifrice and caries lesion control in children with different caries experience: a randomized clinical trial. Lima TJ, Ribeiro CC, Tenuta LM, Cury JA. Caries Res 2008;42(1):46-50. Level of Evidence Level 2: Limited-quality, patient-oriented evidence. Strength of Recommendation Grade Not applicable. Purpose/Question How does caries status compare in caries-active and caries-inactive children aged 2 to 4 after using low-fluoride (500 μg F/g) or conventional fluoride (1100 μg F/g) toothpaste for 12 months in an area with low levels of fluoride in the water Source of Funding Not stated but toothpaste and brushes for the study provided by Colgate-Palmolive. Type of Study/Design Randomized controlled trial.
The reliable and reproducible detection of dental caries by clinical examination has been recogni... more The reliable and reproducible detection of dental caries by clinical examination has been recognized as a problem for decades with very variable approaches being taken to recognize and stage lesions along the continuum of caries--from very small initial lesions, just visible to the human eye, through more established white- and brown-spot lesions, to shadowing beneath the enamel and different extents of cavitation. Clinical caries lesion detection implies some objective method of determining whether or not disease is present, and many systems have been developed to improve the objectivity of examiners. The existence of a large number of different systems, using different definitions of caries detection thresholds, lesion staging and examination conditions has led to problems in comparing between studies and communicating across different dental domains. The International Caries Detection and Assessment System (ICDAS) has been developed from the best elements of previously published systems and is based upon the most robust evidence currently available to address the incompatibility of the systems currently used across the full breadth of cariology. The inherently visual ICDAS lesion detection codes are outlined for use with primary coronal caries, caries adjacent to restorations and sealants and for root surface caries. The ICDAS detection codes for primary coronal caries have been demonstrated to have the capability to record both enamel and dentinal caries in a reliable, valid and reproducible manner in both permanent and deciduous teeth and are being adopted increasingly in the domains of research, epidemiology, clinical practice and education.
IntroductionThe Scottish Dental Clinical Effectiveness Programme (SDCEP) is developing guidance f... more IntroductionThe Scottish Dental Clinical Effectiveness Programme (SDCEP) is developing guidance for oral health assessment and review that is intended for use in National Health Service (NHS) general dental practice. One section of this guidance is assessment of the teeth, including their caries status. The detailed caries assessment method identified by the guidance group is the International Caries Detection and Assessment System (ICDAS).AimThe aim of this study was to investigate the implications of using the ICDAS in an NHS general practice and, in particular, the time taken to use the system.MethodAfter online and in-practice training and calibration, 50 adult and 50 child patients were randomly allocated for assessment using the ICDAS detection codes. The ICDAS protocol states that the teeth should be clean and dry. For this study, all patients had their teeth brushed by the dentist before the assessment and the results were recorded on draft ICDAS clinical pro forma sheets. The time taken for the assessment was assessed with a stopwatch and recorded in a spreadsheet program.ResultsThe results showed that the mean time for the assessment of an adult was 3.80 minutes, or 4.99 minutes if the time for pre-examination cleaning and drying was included. For a child, the mean time was 2.53 minutes, or 3.99 minutes if pre-examination brushing time was included.ConclusionsThese results indicate that with training and experience, it is possible to carry out an ICDAS assessment in a time that is practical in general dental practice.
International Journal of Paediatric Dentistry, 2006
This review offers a brief summary of three of the more commonly surveyed and reported oral mucos... more This review offers a brief summary of three of the more commonly surveyed and reported oral mucosal conditions found in children, and an appraisal of the variation between selected elements of prevalence study methodologies. Searches of electronic databases (i.e. MEDLINE, CINAHL, EMBASE and EBM Reviews) were conducted to find publications related to oral mucosal conditions in children. Studies were included and reviewed if they contained data on the prevalence of any of the following oral mucosal conditions: geographical tongue, oral ulceration and herpes labialis in children or adolescents (up to the age of 19 years). A total of 29 articles out of 333 met the inclusion criteria and were reviewed. Of these 29 reports, 18 considered geographical tongue, 12 herpes labialis and 10 oral ulceration, although a number of the surveys reported on more than one condition. The approaches used in these studies varied on a number of the potentially important areas associated with validity, comparability, and whether or not the findings may be extrapolated beyond the study population, such as the sampling frame, diagnostic criteria, training and calibration, and examination features. Although there were a number of surveys relating to the prevalence of geographical tongue, herpes labialis and oral ulcers in children and adolescents, reported prevalences varied and few studies were directly comparable in terms of the methodology applied. In particular, there was substantial variation between surveys in terms of the diagnostic criteria and method of detection employed although, in many instances, there was inadequate detail to allow full appraisal of the methodology. There is a need for more good-quality epidemiological studies in this area.
ABSTRACT This interactive package, being evaluated across the EU, is designed to assist in shorte... more ABSTRACT This interactive package, being evaluated across the EU, is designed to assist in shortening the standardisation of large numbers of dentists to validly and reliably collect epidemiological data within practices, impacting on quality improvement and efficiency.
The aim of this chapter is to present the clinician a guide to the visual-tactile detection and a... more 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.
Journal of Evidence Based Dental Practice, Mar 1, 2009
Article Title and Bibliographic Information Low-fluoride dentifrice and caries lesion control in ... more Article Title and Bibliographic Information Low-fluoride dentifrice and caries lesion control in children with different caries experience: a randomized clinical trial. Lima TJ, Ribeiro CC, Tenuta LM, Cury JA. Caries Res 2008;42(1):46-50. Level of Evidence Level 2: Limited-quality, patient-oriented evidence. Strength of Recommendation Grade Not applicable. Purpose/Question How does caries status compare in caries-active and caries-inactive children aged 2 to 4 after using low-fluoride (500 μg F/g) or conventional fluoride (1100 μg F/g) toothpaste for 12 months in an area with low levels of fluoride in the water Source of Funding Not stated but toothpaste and brushes for the study provided by Colgate-Palmolive. Type of Study/Design Randomized controlled trial.
The reliable and reproducible detection of dental caries by clinical examination has been recogni... more The reliable and reproducible detection of dental caries by clinical examination has been recognized as a problem for decades with very variable approaches being taken to recognize and stage lesions along the continuum of caries--from very small initial lesions, just visible to the human eye, through more established white- and brown-spot lesions, to shadowing beneath the enamel and different extents of cavitation. Clinical caries lesion detection implies some objective method of determining whether or not disease is present, and many systems have been developed to improve the objectivity of examiners. The existence of a large number of different systems, using different definitions of caries detection thresholds, lesion staging and examination conditions has led to problems in comparing between studies and communicating across different dental domains. The International Caries Detection and Assessment System (ICDAS) has been developed from the best elements of previously published systems and is based upon the most robust evidence currently available to address the incompatibility of the systems currently used across the full breadth of cariology. The inherently visual ICDAS lesion detection codes are outlined for use with primary coronal caries, caries adjacent to restorations and sealants and for root surface caries. The ICDAS detection codes for primary coronal caries have been demonstrated to have the capability to record both enamel and dentinal caries in a reliable, valid and reproducible manner in both permanent and deciduous teeth and are being adopted increasingly in the domains of research, epidemiology, clinical practice and education.
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Papers by Gail V A Douglas