Mervyn Turton

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Lennart Bes

Universiteit Leiden

Pedro Machado

Indiana University

Manishita Dass

Royal Holloway, University of London

Maja Vasiljevic

University of Belgrade

Dunkin Jalki

Independent Researcher

Heike A Becker

University of the Western Cape

Kerstin B Andersson

Christian Costamagna

New Europe College

Henrik Ernstson

KTH Royal Institute of Technology

Aminah Mohammad-Arif

Centre National de la Recherche Scientifique / French National Centre for Scientific Research

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Papers by Mervyn Turton

A Case Report on Symptomatic Primary Herpetic Gingivostomatitis

Journal of Dental Health, Oral Disorders & Therapy, 2017

Primary herpetic gingivostomatitis is a common paediatric infection and the causative organism in... more Primary herpetic gingivostomatitis is a common paediatric infection and the causative organism in 90% of cases is herpes simplex virus type 1, with complications that range from indolent cold sores to dehydration and even life-threatening encephalitis. A nine year old, female presented with a main complaint of difficulty eating due to pain associated with multiple shallow oval oral ulcers. PHG has to be differentiated clinically from acute necrotising ulcerative gingivitis, recurrent HSV infection, herpangia, aphtous ulcers, erythema multiforme, teething, allergic stomatitis and ulcers due to chemotherapy. Management of PHG is palliative and supportive, with symptomatic relief that primarily involves pain management and oral fluids to prevent dehydration until the viral infection subsides, prevention of dehydration, and shortening the duration of lesions even though orolabial herpetic infections are usually self-limiting. The aim of this case study was to highlight a symptomatic case of PHG which required an astute diagnosis and a comprehensive treatment plan with emphasises on the importance for oral health clinicians to have a holistic approach to management of oral disease.

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Barriers to oral health care among people living with HIV in Kwazulu Natal and the Western Cape

If the participant lived in a metropolitan area, they were 3.647 times more likely to receive car... more If the participant lived in a metropolitan area, they were 3.647 times more likely to receive care than those in a non-metropolitan area (p <0.01); if the participant had not moved recently into the area where the participant was currently residing, the participant was 0.324 times less likely to receive care compared to someone who had moved recently (p = 0.002); if the participant lived 1-5km from the clinic, the participant was 3.371 times more like to receive care (p = 0.015); if the participant had been working part-time for the past year, the participant was 0.107 times less likely to receive care (p = 0.011) and if the participant earned R5000 or less, the participant was 0.106 times less likely to receive care (p = 0.048). Conclusion This study provides evidence that people living with HIV still have unmet needs and experience barriers to oral health care. The results suggest that certain groups such as women, the unemployed, low income earners and people living with HIV in non-metropolitan regions have difficulty accessing oral health care. Discrimination and stigmatisation also pose barriers to accessing oral health care. Specific strategies need to be incorporated in the broader oral health care strategy to improve the status quo. Recommendations It is important for the national and provincial Departments of Health to acknowledge the barriers to oral health care experienced by people living with HIV/AIDS and to fine tune policy, educate staff and monitor processes with regards to the management of HIV/AIDS to ensure that staff are competent to carry out their duties while respecting the rights and dignity of those living with HIV and avoid discrimination and stigmatisation. Those that have an unmet need for care may benefit from social and financial support.

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Oral Health Status and Treatment Needs of Pregnant Women Attending Antenatal Clinics in KwaZulu-Natal, South Africa

International Journal of Dentistry, 2019

During pregnancy, the oral cavity is characterised by an acidic environment and an inflammatory r... more During pregnancy, the oral cavity is characterised by an acidic environment and an inflammatory response brought about by vomiting and changes in hormonal levels, respectively, thereby increasing the mother’s risk of developing caries. Although evidence exists to support an association between pregnancy-associated periodontal disease and adverse pregnancy outcomes, there is a paucity of studies which focus on the caries prevalence and other oral manifestations of pregnant women. The aim of this study was to assess the oral health status and treatment needs of pregnant women attending antenatal clinics in KwaZulu-Natal, South Africa. Randomly selected mothers (n=443) attending a maternal obstetrics unit participated in the study. A questionnaire elicited demographic information about the participants, while the measurement of decayed, missing, and filled indices (DMFT) determined their caries status. Oral lesions were noted if present. Descriptive statistics for independent variables...

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A simple point of care test can indicate the need for periodontal therapy to reduce the risk for adverse pregnancy outcomes in mothers attending antenatal clinics

Biomarkers : biochemical indicators of exposure, response, and susceptibility to chemicals, Jan 6, 2017

Although the association between periodontal disease (PD) and adverse pregnancy outcomes has gain... more Although the association between periodontal disease (PD) and adverse pregnancy outcomes has gained recognition amongst antenatal healthcare workers, not much has changed in practice to address it. This prospective study tested the hypothesis that BANA (N-benzoyl-DL-arginine-2-naphthylamide), a diagnostic test for PD, may inform obstetricians and other antenatal healthcare practitioners, of the risk of adverse pregnancy outcomes in mothers attending antenatal clinics. At first visit, the presence of suspected periodontopathogens was assessed by BANA testing of dental plaque from 443 mothers attending antenatal clinics in KwaZulu-Natal, South Africa and an association later sought with pregnancy outcomes. The accuracy of BANA to predict adverse pregnancy outcomes was evaluated by the calculation of likelihood ratios. The study complied with the Declaration of Helsinki. Significant differences were found between pregnancy outcomes of BANA-negative and BANA-positive mothers (p < 0.0...

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Further evidence for periodontal disease as a risk indicator for adverse pregnancy outcomes

International Dental Journal, 2016

Background: Although there is increasing evidence to suggest an association between periodontal d... more Background: Although there is increasing evidence to suggest an association between periodontal disease and adverse pregnancy outcomes, the issue remains controversial. Study objective: This study tested the hypothesis that periodontal disease is a risk indicator for preterm delivery of low-birthweight infants. Materials and methods: The study sample comprised 443 pregnant women with a mean (AE standard deviation) age of 24.13 (AE5.30) years. At first visit, maternal oral health status was assessed by the measurement of probing pocket depth and clinical attachment loss, and periodontal status was graded as absent, mild, moderate or severe. An association was sought between pregnancy outcomes and maternal periodontal status. Results: While controlling for other factors, significant associations were found between pregnancy outcomes and maternal periodontal index scores. Conclusion: This study provides further evidence that periodontal disease is a risk indicator for adverse pregnancy outcomes.

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Kaposi's Sarcoma and Lymphoedema in a HIV Sero-positive Patient: A Case Report and Literature Review

European Journal of Dental and Oral Health, Oct 26, 2021

Kaposi sarcoma (KS) is one of the most common neoplasms diagnosed in HIV-seropositive subjects. K... more Kaposi sarcoma (KS) is one of the most common neoplasms diagnosed in HIV-seropositive subjects. KS is an angioproliferative disorder of endothelial origin and is a locally aggressive multicentric mucocutaneous malignant neoplasm. Aggressive HIV-KS is associated with increased HHV8 viral load, disseminated lesions, and intraoral exophytic lesions, and may also present with facial lymphoedema which may be life-threatening or mild. A 26-year-old, male, presented with severe oral pain and facial swelling. He had multiple oral lesions and an incisional biopsy confirmed Kaposi sarcoma. A multiple site incisional biopsy and immunohistochemistry for HHV8 was done and based on the clinical, histopathological, and immunohistochemical results a diagnosis of HIV associated oral and cutaneous KS with severe lymphoedema was confirmed. This aim of this case presentation is to describe a case of immunodeficiency virus-related lymphadenitis, oral and cutaneous KS associated with the complication severe lymphoedema in a HIV infected patient who was not on HAART therapy for three years after being diagnosed with HIV.

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Trigeminal neuralgia: case report and literature review

Stomatological Disease and Science, 2019

Trigeminal neuralgia (TN), also known as tic doloureaux, is a nerve disorder of the face and is c... more Trigeminal neuralgia (TN), also known as tic doloureaux, is a nerve disorder of the face and is considered to be one of the most painful human conditions. A 51-year-old male presented with severe intermittent pain on the left side of his face. Magnetic resonance image scan with contrast revealed a close association of the superior cerebella artery and the trigeminal nerve on the left side of the face. Oral medication is the first line of treatment for TN, because of its non-invasiveness, low cost and high effective rate. Surgical intervention for TN aims to relieve the pressure of the offending artery or vein that is compressing the trigeminal nerve or in other instances; surgery may stop the uncontrolled pain signals. An important criterion for clinical diagnosis is pain that cannot be attributed to another disorder and also the lack of evident neurologic disorder. TN is one of the most debilitating diseases an individual may suffer and an early astute diagnosis of TN will provide patients with relief from suffering, unnecessary dental and medical intervention. Appropriate and early diagnosis of TN is important to formulate an optimal management plan based on the patient's age and general condition. The aim of this case report is to describe a case of Classical TN, and subsequent successful surgical management with microvascular decompression.

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Oral health care experiences of people living with HIV in Kwazulu-Natal and Western Cape, South Africa

International Journal of Human Rights in Healthcare, 2015

Purpose – The purpose of this paper is to ascertain the oral health experiences of people living ... more Purpose – The purpose of this paper is to ascertain the oral health experiences of people living with HIV/AIDS in the provinces of Kwazulu-Natal (KZN) and Western Cape (WC) in South Africa. Many studies have reported that people living with HIV have unmet needs for dental care and this study considered the various factors that affect the accessibility and utilisation of dental services as these factors are even more pertinent for the people living with HIV who have increased need for dental care. Design/methodology/approach – The participants were selected among HIV-positive people attending selected Community Health Centre and regional hospital HIV clinics in KZN and WC provinces. The sample consisted of people living with HIV that were 18 years or older and who had given written, informed consent. The sample (n=435) comprised mainly of black females in the age group 20-29 years. In total, 347 participants (79.8 per cent) had an oral health problem of which 83 per cent (n=288) rece...

Stigma and disclosure as barriers to regular dental care for people living with HIV/AIDS in Kwazulu-Natal and Western Cape, South Africa

Ethnicity and Inequalities in Health and Social Care, Mar 12, 2014

Purpose – The purpose of this paper is to determine the oral health care experiences of people li... more Purpose – The purpose of this paper is to determine the oral health care experiences of people living with HIV in Kwazulu-Natal (KZN) and the Western Cape (WC) and also to identify the role of stigma and discrimination in the oral health care experiences for people living with HIV in KZN and the WC. Design/methodology/approach – This study was a survey among HIV-positive people attending selected Community Health Centres and regional hospitals, HIV clinics in KZN and WC provinces in South Africa. The sample consisted of people living with HIV that were 18 years or older and who had given written, informed consent. A cross-sectional study structure has been employed using a standardized format using a semi-structured interview and an administered questionnaire to collect data. The study classified participants as living in metropolitan or non-metropolitan areas. Findings – Apprehension of loss of confidentiality, stigma and discrimination were the barriers that deterred participants from seeking care. Respondents stated that they feared what the dentist and staff would think of them being HIV positive and feared being discriminated against by the dentist and staff. In some instances there appears to be a difference between policy and practice regarding the oral health care needs of and services rendered to people living with HIV in public health facilities as there are still patients who do not obtain care and for whom the attitudes of the health care provider constitutes the major barrier to accessing that care. Research limitations/implications – The results are specific to KZN and WC and have to be extrapolated with caution to the rest of South Africa. Additionally, this study did not have a control group of HIV-negative people which would have enabled one to determine whether certain barriers were unique to people living with HIV. Practical implications – To make recommendations with respect to addressing the issue of stigma and discrimination in the oral health care experiences for people living with HIV in KZN and the WC as there is a definite need for the government to address the resource needs of rural areas and less developed areas of South Africa. Health care is a much-needed resource in these high prevalence areas and governments must ensure that all their HIV/AIDS projects and policies should have a rural component built into them. Social implications – This study emphasizes the importance of embracing people that are being discriminated and marginalized by society such as people living with HIV to ensure that they feel a franchised member of society who can take the initiative to be in control of their own health and, with the necessary aid from public resources and societal support, join forces to reduce the public health burden and its impact on the socio-economic milieu. Originality/value – To the best of the author&#39;s knowledge, there is no other study that has compared differences in the use of oral health care services by people with HIV in South Africa and these results serve as an indication of some the important issues in this regard.

A Case Report on Symptomatic Primary Herpetic Gingivostomatitis

Journal of Dental Health, Oral Disorders & Therapy, 2017

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Barriers to oral health care among people living with HIV in Kwazulu Natal and the Western Cape

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Oral Health Status and Treatment Needs of Pregnant Women Attending Antenatal Clinics in KwaZulu-Natal, South Africa

International Journal of Dentistry, 2019

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A simple point of care test can indicate the need for periodontal therapy to reduce the risk for adverse pregnancy outcomes in mothers attending antenatal clinics

Biomarkers : biochemical indicators of exposure, response, and susceptibility to chemicals, Jan 6, 2017

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Further evidence for periodontal disease as a risk indicator for adverse pregnancy outcomes