The Use of the International Caries Detection and Assessment System (ICDAS) in a National Health Service General Dental Practice as Part of an Oral Health Assessment

2010 ◽  
Vol os17 (4) ◽  
pp. 153-160 ◽  
Author(s):  
Charles Ormond ◽  
Gail Douglas ◽  
Nigel Pitts
Keyword(s):  
Oral Health ◽  
National Health Service ◽  
Health Service ◽  
Health Assessment ◽  
Assessment System ◽  
Caries Detection ◽  
Dental Practice ◽  
General Dental Practice ◽  
The Mean ◽  
Mean Time

Introduction The 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). Aim The 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. Method After 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. Results The 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. Conclusions These 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.

Abstract 153: Automated Angiographic Assessment Of Coronary Artery Vasomotion In Kawasaki Disease Patients

Circulation ◽  
2015 ◽  
Vol 131 (suppl_2) ◽  
Author(s):  
Mitchel Benovoy ◽  
Farida Cheriet ◽  
Roch L Maurice ◽  
Nagib Dahdah
Keyword(s):  
Health Assessment ◽  
Assessment System ◽  
Vascular Health ◽  
Pressure Gradients ◽  
Intracoronary Imaging ◽  
Temporal Tracking ◽  
Vascular Physiology ◽  
The Mean ◽  
Spatio Temporal ◽  
Stiffness Characteristics

Background: Mechanical properties of coronary arteries (CA) hold clues to vascular health and viability. Traditionally assessed with intracoronary imaging, we present an angiography-based system to assess CA vasomotion using automatic vessel segmentation and spatio-temporal tracking. Elastic moduli computed from dynamic CA calibers are compared between non-KD patients (CTL), KD patients with no CA aneurysms (KDAN-), and those with aneurysms (KDAN+). Methods: Proximal CA angiograms are automatically segmented and tracked over a cardiac cycle. CA centerline is extracted and the mean caliber is computed from diameters along its length. The resulting caliber variation reflects the CA vasomotion (Figure 1a). We then calculated the Vasomotion Standard Deviation (VSD) and CA recoil with the mean constriction velocity (MCV). Finally, Elastic Pressure moduli were computed using trans-myocardium pressure gradients. Results: We analyzed 51 left CA segments from 23 patients (5 CTL, 5 KDAN-, 13 KDAN+). Data are mean ± SD normalized pixels (npx). VSD was significantly reduced ( p <0.01) in KDAN+ (0.25±0.05) and KDAN- (0.27±0.04) vs CTL (0.38±0.07 npx). Coronary recoil was significantly reduced (p<0.05) in KDAN+ vs CTL, with MCV 3.50±0.67 vs 4.59±1.94 npx/sec. Pressure-dependent stiffness characteristics were equally atypical (Figure 1b). Conclusion: The proposed angiography-based stiffness assessment system shows abnormal CA vascular physiology in our cohort of KD patients. These results concur with previous invasive studies. The potential usability of this system for vascular health assessment could be applied to previously recorded CA angiograms for risk stratification.

An Investigation into the Bitewing Radiographic Prescribing Patterns of West Kent General Dental Practitioners

2011 ◽  
Vol os18 (3) ◽  
pp. 107-114
Author(s):  
Peter W Mauthe ◽  
Kenneth A Eaton
Keyword(s):  
Behavioural Change ◽  
Primary Care Trust ◽  
Prescribing Patterns ◽  
Caries Detection ◽  
Practice Research ◽  
Dental Practice ◽  
The West ◽  
Bitewing Radiography ◽  
General Dental Practice ◽  
Dental Practitioners

Aims The primary aims of the study were to investigate the use of bitewing radiography within primary dental care and adherence to guidelines on bitewing radiography by general dental practitioners (GDPs) in the West Kent Primary Care Trust (PCT) area. Within the overall aims, the study had objectives to investigate the use of radiographic guidelines, audit and caries risk assessment, the influence of private and National Health Service (NHS) practice, and the influence of the demographic profile of the GDPs on these variables. Methods Data were gathered via a piloted self-completion questionnaire, circulated to all GDPs listed on the NHS Choices website as practising in the West Kent PCT area. Three mailings and follow-up telephone calls were used. The resulting data were entered into a statistical software database and, where relevant, statistically tested, using the chi-square test. Results Of 223 GDPs, 167 responded (75%). GDPs with a high NHS commitment were significantly less likely to follow Faculty of General Dental Practice (UK) guidance on prescribing bitewing radiographs for adults ( P<0.01) and children ( P<0.05) than were mainly private GDPs. Mainly NHS GDPs were more likely ‘always/mostly’ to follow National Institute for Health and Clinical Excellence guidance (83 compared to 59) ( P<0.05) and also to risk-assess patients (83 compared to 62). Only 115 (71%) had carried out a radio graphic audit or peer review in the preceding three years. Those with postgraduate qualifications were more likely ( P<0.05) to carry out radiographic audit. Conclusions The study confirmed previous research reporting the under-use of radiography for caries detection and also the failure of some GDPs to comply with ionising radiation regulations. West Kent GDPs with a high NHS commitment were less likely to follow radiographic guidance than their private counterparts. This suggests that further efforts to disseminate information on radiographic guidelines and to educate GDPs are necessary to improve adherence with all aspects of radiography within general dental practice. Research into factors that influence GDPs’ decision-making with regards to radiographic prescription may further inform the profession as to the best methods to lead to behavioural change. The dental profession and its regulators need to make a concerted effort to educate and inform GDPs so that this behaviour is modified.

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