Clinical leadership and prevention in practice: is a needs led preventive approach to the delivery of care to improve quality, outcomes and value in primary dental care practice a realistic concept?

Background: There is a need to improve access to, and the quality of, service delivery in NHS primary dental care. Building public health thinking and leadership capacity in clinicians from primary care teams was seen as an underpinning component to achieving this goal. Clinical teams contributed to service redesign concepts and were contractually supported to embrace a preventive approach.

The association between social deprivation and the prevalence and severity of dental caries and fluorosis in populations with and without water fluoridation.

Background: To determine the association between social deprivation and the prevalence of caries (including caries lesions restricted to enamel) and enamel fluorosis in areas that are served by either fluoridated or non-fluoridated drinking water using clinical scoring, remote blinded, photographic scoring for caries and fluorosis. The study also aimed to explore the use of remote, blinded methodologies to minimize the effect of examiner bias.

Methods: Subjects were male and female lifetime residents aged 11-13 years.

Evaluating the use of fluorescent imaging for the quantification of dental fluorosis.

Background: The quantification of fluorosis using fluorescence imaging (QLF) hardware and stain analysis software has been demonstrated in selected populations with good correlation between fluorescent image metrics and TF Index scores from photographs. The aim of this study was to evaluate the ability of QLF to quantify fluorosis in a population of subjects (aged 11-13) participating in an epidemiological caries and fluorosis survey in fluoridated and non-fluoridated communities in Northern England.

Methods: Fluorescent images of the maxillary incisors were captured together with standardized photographs were scored blind for fluorosis using the TF Index.

Dental fluorosis in populations from Chiang Mai, Thailand with different fluoride exposures - paper 2: the ability of fluorescence imaging to detect differences in fluorosis prevalence and severity for different fluoride intakes from water.

Background: To assess the ability of fluorescence imaging to detect a dose response relationship between fluorosis severity and different levels of fluoride in water supplies compared to remote photographic scoring in selected populations participating in an observational, epidemiological survey in Chiang Mai, Thailand.

Methods: Subjects were male and female lifetime residents aged 8-13 years. For each child the fluoride content of cooking water samples (CWS) was assessed to create categorical intervals of water fluoride concentration.

Dental fluorosis in populations from Chiang Mai, Thailand with different fluoride exposures - paper 1: assessing fluorosis risk, predictors of fluorosis and the potential role of food preparation.

Background: To determine the severity of dental fluorosis in selected populations in Chiang Mai, Thailand with different exposures to fluoride and to explore possible risk indicators for dental fluorosis.

Methods: Subjects were male and female lifetime residents aged 8-13 years. For each child the fluoride content of drinking and cooking water samples were assessed.

Adolescents' perceptions of the aesthetic impact of dental fluorosis vs. other dental conditions in areas with and without water fluoridation.

Background: The use of fluorides for caries prevention is well established but is linked with an increased risk of dental fluorosis, some of which may be considered to be aesthetically objectionable. Patient opinion should be considered when determining impact on aesthetics. The aim of this study was to assess participant rating of dental aesthetics (from photographic images) of 11 to 13 year olds participating in an epidemiological caries and fluorosis survey in a fluoridated and a non-fluoridated community in Northern England.

The water fluoridation debate.

Unlabelled: Water fluoridation schemes have been employed for over 50 years. Water fluoridation has been a source of continuous debate between those who advocate its use as a public health measure and those who oppose it. There have been no new fluoridation schemes in the U.

Water fluoridation as a public health measure.

Unlabelled: Water fluoridation schemes have been used as dental public health measures for over 50 years. This second paper in a series of three aims to provide a background to the history of water fluoridation schemes and the evidence base that led to their implementation. The article will also discuss the processes and chemicals involved in fluoridation during water treatment.

Why fluoride?

Unlabelled: Fluoride has been used in dentistry for over 100 years for the purpose of preventing dental caries. During this time there has been great debate over the mode of action, the optimum method of delivery, and the potential risks associated with its use. This, the first of three papers, will provide a summary of the history of the use of fluoride, the mode of action, benefits and different methods of delivery.