Papers by Elizabeth Treasure
The New Zealand dental journal
This paper has summarised data showing that inequities in oral health and the receipt of oral hea... more This paper has summarised data showing that inequities in oral health and the receipt of oral health care exist in New Zealand. We submit that these inequities, and the consequences of oral ill-health, are of such seriousness that they cannot be ignored. Overcoming barriers to oral ill health and barriers to dental care will be a complex task. Although much can be done by the dental providers and their organisations, there is need for oral ill health to be viewed within the overall context of inequity and disadvantage within society.
The New Zealand dental journal
Changing disease patterns is one of the effects on dental practice. Although the amount of simple... more Changing disease patterns is one of the effects on dental practice. Although the amount of simple treatment is declining, the amount of complex treatment required is increasing. Important social changes influencing dental practice include the gross inequalities in oral health that are seen in New Zealand. Regional health authorities are the bodies which will have to assess the need for treatment and allocate funding, but private practitioners will have the opportunity to enter into contracts with purchasing bodies to provide care. In comparison with other countries, the number of dentists in New Zealand is correct provided fluoridation and the School Dental Service continue.
Community dental health
To observe patterns of fluoride preparation dispensing by primary care practitioners in a health ... more To observe patterns of fluoride preparation dispensing by primary care practitioners in a health authority. Observational study. The Prescription Pricing Agency of the Welsh Health Common Services Authority (WHCSA). Individuals who had exchanged a prescription for a fluoride preparation at a pharmacy in Bro Taf Health Authority in the six months from 1 January 1997 to 30 June 1997. Information from each prescription including a fluoride preparation, passed to WHCSA from pharmacists during the study, was entered onto a database, including the prescriber's postcode and profession, the recipient's postcode and product information. Numbers of dental prescriptions were correlated to local levels of NHS primary dental care provision and caries prevalence data. Comparisons were made with a similar study undertaken in 1993. 415 dentists' prescriptions were dispensed within the area, of which 38.8% originated from five dentists. At least one prescription had been made by 89 of the 253 local primary dental care providers (35%). Within the area monitored in both 1993 and 1997, dental prescribing rates had almost halved. Of the 122 doctors' prescriptions that were dispensed over the six-month period, 98 were mouthwash preparations for adult patients and four were for children. NHS provision of fluoride supplementation was low and remained related to prescribing patterns of individuals rather than to evidence on local variations in dental caries prevalence.
Evidence Based Dentistry, 2003
Objective: Improved mouthcare is reportedly needed in hospitals to prevent Ventilator Associated ... more Objective: Improved mouthcare is reportedly needed in hospitals to prevent Ventilator Associated Pneumonia. Subconscious attitudes and emotions can influence behaviour but the influence of subconscious responses on nurses’ mouthcare provision has received little attention. The aim of this study was to explore subconscious responses to mouthcare image stimuli in a population of student nurses. This involved comparing subconscious responses to oral care stimuli between those who did and did not intend to provide mouthcare for patients and those who expressed stronger or weaker attitudes and emotions towards mouthcare scenarios. Method: Following a pilot study, 41 student nurse participants completed a questionnaire for mouthcare attitudes, emotions and intentions. They then undertook 90 computerised Stroop image trials using neutral, clean and unclean mouth images in blocks of 10, delivered in random order. The response time to identify the lateral position of each image on screen was...
Objective: Poor quality oral care in hospitals is well documented. Emotional disgust has been ass... more Objective: Poor quality oral care in hospitals is well documented. Emotional disgust has been associated with hygiene behaviours. This study was conducted to investigate the relationship between student nurses' experiences of disgust, their attitudes towards oral care and intended oral care behaviours for patients in hospital. Method: The study was conducted in two stages. Firstly, student nurse participants (n=248) completed a self-report questionnaire for emotions and intended behaviours towards seven oral care scenarios. The questionnaire was developed and tested in advance of the study. Participants also completed established disgust sensitivity questionnaires and attitudinal questions. Secondly, a subset of participants (n=38) completed computer administered Implicit Association Tests. These measured response times for sorting emotional words and oral care images. Data were analysed in SPSS with Spearman’s rank-order correlation and Mann-Whitney U tests. Result: Participant...
Community dental health
To investigate the use of mapping in targeting water fluoridation to areas of high need in lechyd... more To investigate the use of mapping in targeting water fluoridation to areas of high need in lechyd Morgannwg Health Authority, as defined by the upper quintile of the distribution of the percentage with dmft > 0 in dental planning areas. Data from the 1997/98 childhood dental epidemiological survey and the Welsh Water Company water supply zones (as at 1997) were plotted. Maps were generated to identify the relationship between water supply areas, water supply sources and areas of high caries prevalence. Maps focussed upon one Welsh health authority, Iechyd Morgannwg Health Authority. Examinations for the childhood epidemiology programme took place in schools. 5-year-old children examined in the 1997/98 survey. Data presented by very different geographical boundaries were compared without having to carry out complex mathematical transformations. It was possible to quickly identify areas of Iechyd Morgannwg Health Authority with high levels of oral disease, the associated water supply zones and their water treatment centres with a view to possible future targeting of fluoridation. The maps identify the possibility of dilution, when a particular water supply zone was served by more than one treatment works. This technique enables disparate and complex data bases to be combined enabling visual analysis of the results. The maps facilitate decision making as to the most beneficial areas to fluoridate. The results will be of value in determining the feasibility and targeting of water fluoridation in Wales.
Objective: To compare the population prevalence as measured by the ADHS tooth wear criteria with ... more Objective: To compare the population prevalence as measured by the ADHS tooth wear criteria with that measured by the BEWE criteria. Method: The 2009 decennial national Adult Dental Health Survey (ADHS) includes a clinical examination of dentate subjects. To allow comparison over time the examination criteria are consistent between surveys and in 1998 criteria on tooth wear were first included. Since then the Basic Erosive Wear Examination (BEWE), an internationally agreed classification of tooth surface loss (wear) has been developed which differs from the ADHS criteria.In 2009 a stratified sample of all addresses in England, Wales and Northern Ireland formed the basis of the survey. In one geographic area, West Midlands, dentate subjects had tooth wear assessed by trained examiners using both ADHS and BEWE criteria. Derived variables for levels of tooth wear were used to compare the two indices. Result: In the West Midlands 876 adults completed a questionnaire, 490 were examined a...
Objectives: Emotions are linked to behaviour and an earlier study indicated that nurses' emot... more Objectives: Emotions are linked to behaviour and an earlier study indicated that nurses' emotions may motivate or inhibit the provision of oral care. The current investigation is to explore these emotional motivators and barriers to answer the question, How do nurses' emotions influence oral care for patients? Methods: Focus groups conducted with a purposively selected sample of 41 student nurses, hygienists and qualified nurses were used to identify the emotional experiences involved. Ten one-to-one semi-structured interviews were conducted with 3 existing and 7 new nursing participants to verify individual experiences of these emotions. Data were transcribed verbatim. Textual data were analysed through the constant comparison of data in order to develop the themes. Results: The sight and smell of patients' unclean oral conditions can attract nurses' attention by eliciting disgust. Hygiene related disgust and anxiety towards harm from contamination can be experience...
Key findings • Eighty four per cent of dentate adults had at least one filled tooth, and for thos... more Key findings • Eighty four per cent of dentate adults had at least one filled tooth, and for those with a filling the mean number of teeth affected was 7.2 with an average of 2.1 surfaces affected per restored tooth. • Adults aged under 45 years were less likely to have any fillings, and those who did had relatively low numbers of filled teeth. By contrast, 97 per cent of dentate adults aged 45 to 54 had a filled tooth and they had 9.1 teeth affected on average. • In 2009, 37 per cent of dentate adults had artificial crowns. There was significant variation with age; only 5 per cent of the 16 to 24 year olds had crowns compared to between 55 and 59 per cent of those aged 45 to 74. • For those with crowns, on average there were three per person, amounting to an estimated 47.6 million crowns across England, Wales and Northern Ireland. • The majority of dentate adults (85 per cent) had a tooth affected by restoration • Among people with at least one restoration, 9 per cent had some seco...
Community dental health, 2004
To determine the reasons for referral for dental general anaesthesia (DGA) in children in North W... more To determine the reasons for referral for dental general anaesthesia (DGA) in children in North Wales and to ascertain the level of repeat DGA. Retrospective study of the clinical records for a random sample of 10-year-old children who had a DGA before November 1998. DGAs carried out at two centres within the Community Dental Service (CDS) in the former county of Clwyd, North Wales. A random sample of children who had a DGA between April 1995 and November 1998 from whose records data was collected regarding the reason for referral and outcome. It was found that 26.6% of children had received an additional DGA, but the total of 203 additional episodes (including third and fourth DGAs) represents a true rate of 31.8%. The General Dental Service (GDS) referred more than double the numbers of children than the CDS but the referral rate per dentist was reversed with the GDS referring an average of 5.2 subjects and the CDS 11.9 subjects. Around half of all referrals did not include a medi...
Community dental health, 2005
This investigation compared the Significant Caries Index (SiC) with alternative summary measures ... more This investigation compared the Significant Caries Index (SiC) with alternative summary measures of caries prevalence, designed to highlight high-risk communities and examined the implications of their use in health policy and planning in Wales. Data from the 2001 BASCD survey of 7,412, 12-year-old Welsh children were used in this analysis. As an alternative to the 33% cut-off value utilised in the SiC, the mean DMFT of children with the 10, 20 and 25% highest caries scores were calculated for 22 local health board areas, as was the mean DMFT for the whole population, %DMFT >0, and the mean for those with DMFT >0, >1, >2, and >3. Examinations for the childhood epidemiology programme took place in Welsh secondary schools. 12-year-old children examined in the 2000/01 survey. The mean DMFT for the whole population was 1.31, and the mean DMFT of those with caries was 2.56. The mean DMFT for SiC 33%, 25%, 20% and 10% was: 3.39, 3.85, 4.28, and 5.31 respectively. When local...
International journal of paediatric dentistry / the British Paedodontic Society [and] the International Association of Dentistry for Children, 2005
The aims of the present study were to report difficulties experienced recruiting preschool childr... more The aims of the present study were to report difficulties experienced recruiting preschool children to a clinical trial and to report the acceptability of a dental intervention to their parents. The study was a randomized controlled trial (RCT). The study took place in community dental clinics, health centres and patient homes. Health visitors were used to recruit 508 children aged between 18 and 30 months from high caries areas of South Wales. Children with caries-free first primary molars were entered into a placebo-controlled individual RCT of fissure sealants. All children received a standard package of dental health education. Children in the test group had their first primary molars sealed with glass ionomer. All children were reviewed once. Families were asked to rate the acceptability of procedures. Health visitors referred 1228 children for screening, but only 547 were seen (44.5%) and 508 subjects were recruited to the trial. Of these, 449 (88.4%) were seen at follow-up. S...
International Journal of Health Promotion and Education, 2002
International Journal of Oral and Maxillofacial Surgery, 1992
The incidence and aetiology of facial fractures resulting in admission to public hospitals in New... more The incidence and aetiology of facial fractures resulting in admission to public hospitals in New Zealand in 1987 were investigated retrospectively from data collected by the Health Statistical Services. Data were analysed by the age group, ethnic origin and gender of those affected. During 1987 the overall incidence of facial fractures was 47.9/100 000 of the population. The highest incidence was for Maori males at 152/100 000. A comparison with data for the period 1979 to 1988 showed a decrease for the population as a whole but an increase for those who declared themselves to be Maori. Assault was the most common cause of facial fractures resulting in hospitalisation for both males and females. Sport was the second most common cause of facial fractures with rugby football contributing two-thirds of these. These results indicate where future preventive measures should be targeted.
Community Dentistry and Oral Epidemiology, 2001
Increasing emphasis is now being placed upon the evaluation of health service interventions to de... more Increasing emphasis is now being placed upon the evaluation of health service interventions to demonstrate their effects. A series of effectiveness reviews of the oral health education and promotion literature has demonstrated that many of these interventions are poorly and inadequately evaluated. It is therefore difficult to determine the effectiveness of many interventions. Based upon developments from the field of health promotion research this paper explores options
Community dental health, 2001
To compare the explanatory power of four composite indices of social economic status in their abi... more To compare the explanatory power of four composite indices of social economic status in their ability to predict dental caries experience. A secondary analysis of Welsh BASCD survey data using ward aggregated dental data, census variables and composite measures of deprivation. Examinations took place in schools. All 12-year-old children examined in the 1996/97 survey. The explanatory variables were Jarman index, Welsh Underprivileged Area score (WUPA), Carstairs and Townsend indices and the outcome measure was mean DMFT. The amount of the mean DMFT explained by the explanatory variables ranged from 62.9% with Welsh Underprivileged Area score (WUPA) in Bro Taf Health Authority to 4.2% with the Jarman index in Dyfed-Powys health authority. Of the constituent parts of the composite variables only the percentage with no car appeared in the 'top three' variables in all but one of six models. The composite indices explained very different amounts of the variation in mean DMFT betw...
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Papers by Elizabeth Treasure