Children's ORal HEAlTh REsearch (CREATE)

The group aims to improve the oral health and treatment experiences of children and young people through a combination of clinical and social scientific research strategies that:

• Give children an active voice in relation to their oral health.
• Explore and evaluate the impact of oral health on the daily lives of children and their families.
• Develop child-centred measures, decision aids and resources.

The contribution of this group to promoting child-centred oral health research has been acknowledged internationally and we have active national and international collaborations with researchers in the UK and worldwide.

Research projects

Malocclusion-specific measure of oral health-related quality of life – Malocclusion Impact Questionnaire - MIQ

The Malocclusion Impact Questionnaire (MIQ) has been developed by research teams at the Eastman Dental Institute, London and the School of Clinical Dentistry, Sheffield. The Malocclusion Impact Questionnaire contains 17 items and was developed for self-completion by children aged 10-16 years.

Enquiry Form

Children’s experiences of dental anxiety measure - CEDAM

The Children’s experiences of dental anxiety measure (CEDAM) is a new measure of dental anxiety developed with children and colleagues from Kings College London, University of Reading, and University of Glasgow for use for routine clinical assessment and research purposes. It was developed to be completed by children aged 10-16 years. An electronic version of CEDAM is currently in development.

YOUR teeth YOU are in control

Development of a self-help Cognitive Behavioural Therapy resource for young people with dental anxiety.

Key Contact: Professor Zoe Marshman Z.Marshman@sheffield.ac.uk

This is a two-year project to develop a self-help Cognitive Behavioural Therapy resource for young people with dental anxiety. This project hosted by Sheffield Teaching Hospitals NHS Foundation Trust involves collaboration with Kings College London, University of Reading, University of Glasgow and Five Areas Ltd. This project will result in the first CBT resource for young people with dental anxiety and accompanying resources for parents and dental teams.

Resources available include:

• YOUR TEETH YOU ARE IN CONTROL – guide for young people 9-16 years
• PARENT’S GUIDE – HOW TO HELP YOUR CHILD FEEL HAPPIER ABOUT VISITING THE DENTIST – 16 page guide for parents
• PARENT’S GUIDE – 1 page summary
• INFORMATION FOR THE DENTAL TEAM ON USING THE CBT GUIDE – 1 page summary
• DENTAL TEAM COPY - YOUR TEETH YOU ARE IN CONTROL – 36 page guide for dental team members

Enquiry Form

Further information

Patient evaluation of British Orthodontic Society website on orthognathic surgery

The British Orthodontic Society (BOS) have produced a new website to contain general information on the benefits and risk of orthognathic surgery. Information is provided in the following sections;

• A patient journey documentary, highlighting the key stages of treatment.
• A ‘surgery explained’ section with animations explaining the common surgical procedures with voice-overs.
• Before and after image gallery to show the changes to the teeth and face surgery can bring.
• A patient perspective section allowing the viewer to hear from a range of patients how the treatment was for them.
• An aftercare section containing information on recovery and diet post-operatively, and video checklist for patients and clinicians.

The website was developed by a working party of orthodontists and a maxillofacial surgeon. The views of patients were incorporated into the design of this website:

yourjawsurgery.com

The aim of this research project is to explore patients’ evaluations of yourjawsurgery.com through qualitative interviews. The findings of the research will provide recommendations to improve the website from patients perspectives.

Management of dental caries in children

FiCTION - Filling Children's Teeth: Indicated Or Not?’

Funded by NIHR Health Technology Assessment

Key Contact: Professor Chris Deery

Study Active: 2010-2017

This multi-centred clinical trial is a collaboration between dental schools in Dundee, Sheffield, Leeds, Newcastle, Cardiff and London. The aim of the trial is to provide an evidence base for the most effective approach to the management of dental caries in the primary teeth of children.  

Links

• http://dentistry.dundee.ac.uk/nihr-hta-fiction-trial
• http://research.ncl.ac.uk/fictiontrial/

For further information email: c.deery@sheffield.ac.uk

Patient decision aids

Patient decision aids are currently being developed as PhD projects for:

• Decision Aid for Braces ‘DAB’ for young people and parents considering fixed orthodontic treatment (Abdulsalam Eddaiki 2011-2015)

This PhD project developed a patient decision aid (PDA) for young people with malocclusion considering whether to have orthodontic treatment or not, in order to facilitate shared decision-making and improve patient-clinician interaction. The project included a pilot evaluation of the PDA in reducing decisional conflict, increasing knowledge and meeting expectations.

• Young people and parents faced with the decisions to undergo dental treatment with sedation or general anaesthesia (Joe Hulin 2012-2015)

The above patient decision aid (PDA) was developed for young people faced with the decision to undergo dental treatment with either inhalation sedation, intravenous sedation or general anaesthetic. The content of the PDA was informed by a series of qualitative interviews with patients who had already undergone dental treatment with sedation or general anaesthetic and their parents/guardians. Preliminary results suggest that the PDA significantly increases patients' and parents/guardians' knowledge when compared to standard care.

Funded by Society for the Advancement of Anaesthesia in Dentistry

Children's engagement with health messages

All About Me: making sense of health messages in a hands-on exhibition space

Children’s health is high on the research and policy agenda of many nations. However, we know very little about how children engage with health messages and how they make them meaningful to their own lives. This collaborative research project between the Centre for the Study of Childhood and Youth (CSCY) and Eureka Children’s Museum uses a specific, real- world setting, Eureka’s new exhibition space ‘All About Me’, to explore how children go about constructing understandings of health and their own and others’ bodies. Within the ‘All About Me’ exhibition is a giant mouth and dental role play area which is very popular with children and has been a significant feature of the research project.

Funded by: University of Sheffield Collaborative R&D funding

www.eureka.org.uk/about-us/galleries/all-about-me/

PhD projects

Oral health-related quality of life of children undergoing a general anaesthetic for the management of dental caries

Dental treatment of children under general anaesthetic (DGA) is a relatively common procedure worldwide particularly in young children, children with dental anxiety, those with extensive treatment requirements or for children with additional care needs. Hospital episode statistics have shown that around 60,000 children in England are admitted to hospital per year for the extraction of one or more carious teeth, at a cost of around £30 million pounds (Public Health England 2014). A systematic review of the impact of DGA treatment on children’s OHRQoL found improvement in oral health and in psychological, social and overall wellbeing, although all of the included studies relied on parental reports of OHRQoL of their children. Further research into changes in OHRQoL from the child’s perspective was recommended using a child-centred measure with appropriate evaluative properties (Jankauskiene and Narbutaite 2010).

This project involved a longitudinal assessment of OHRQoL using a child-centred measure for children having treatment of dental caries under DGA.

The project was funded by the PAPOR studentship.

Key Contact: Professor Zoe Marshman

Child-reported and clinical outcomes following aesthetic management of developmental defects of enamel

PhD Student: Noren Nor Hasmun

Supervisors: Professor Helen Rodd, Dr Mario Vettore and Dr Claire Elcock

Tooth formation is a complex process and a number of environmental or genetic factors may upset tooth development resulting in changes to the amount or quality of enamel that is formed. One of the most common conditions we see is called Molar Incisor Hypomineralisation (MIH), affecting around 10% of children, and resulting in abnormal yellow, brown or white ‘patches’ (opacities) of enamel. Some children with visible opacities on their front teeth understandably experience profoundly negative impacts on their quality of life. They may be reluctant to smile as they are embarrassed about their teeth, as illustrated in this quote from one of our young patients: ‘I don’t like the colour, I’m conscious about it, when I am talking I don’t like showing them…. I’m actually quite bothered’.

Treatment of these conditions can be challenging and there is no consensus as to which approach works best for the aesthetic improvement of enamel opacities on anterior teeth. This clinical project therefore aims to evaluate the effectiveness of different treatment modalities (such as tooth bleaching, microabrasion, and composite resin restorations) in the management of enamel opacities associated with MIH from both the child’s and the clinician’s perspective.

Funder: Malaysian Higher Education Department & Universiti Teknologi

Exploring participation as a new perspective for child oral health promotion

Gaining an understanding of children's perspectives of oral health and understanding how they experience participation in oral health promotion may improve the quality of oral health promoting activities. Although there has been a strong call for participatory child-centred approaches, research is lacking with respect to children's participation. The aim of this study is to explore the dynamics and meaning of children's participation in an oral health promotion programme. It is an ethnographic case study which involves participant observations and semi-structured interviews.

Sarab El Yousfi. Funded by Libyan Ministry of Higher Education.

Publications

View publications list

Marshall A, Loescher A & Marshman Z (2016) A scoping review of the implications of adult obesity in the delivery and acceptance of dental care.. Br Dent J, 221(5), 251-255. View this article in White Rose Research Online

Marshman Z, Morgan A, Porritt J, Gupta E, Baker S, Creswell C, Newton T, Stevens K, Williams C, Prasad S, Kirby J & Rodd H (2016) Protocol for a feasibility study of a self-help cognitive behavioural therapy resource for the reduction of dental anxiety in young people. Pilot and Feasibility Studies, 2(1). View this article in White Rose Research Online

Porritt J, Jones K & Marshman Z (2016) Service evaluation of a nurse-led dental anxiety management service for adult patients. British Dental Journal, 220(10), 515-520. View this article in White Rose Research Online

Patel N, Hodges SJ, Hall M, Benson PE, Marshman Z & Cunningham SJ (2016) Development of the malocclusion impact questionnaire (MIQ) to measure the oral healthrelated quality of life of young people with malocclusion: Part 1 - qualitative inquiry. Journal of Orthodontics, 43(1), 7-13. View this article in White Rose Research Online

de Souza MC, Harrison M & Marshman Z (2016) Oral health-related quality of life following dental treatment under general anaesthesia for early childhood caries - a UK-based study. International Journal of Paediatric Dentistry, n/a-n/a. View this article in White Rose Research Online

Benson PE, Cunningham SJ, Shah N, Gilchrist F, Baker SR, Hodges SJ & Marshman Z (2016) Development of the malocclusion impact questionnaire (MIQ) to measure the oral healthrelated quality of life of young people with malocclusion: Part 2 - cross-sectional validation. Journal of Orthodontics, 43(1), 14-23. View this article in White Rose Research Online

Csikar J, Kang J, Wyborn C, Dyer TA, Marshman Z & Godson J (2016) The Self-Reported Oral Health Status and Dental Attendance of Smokers and Non-Smokers in England. PLOS ONE, 11(2), e0148700-e0148700. View this article in White Rose Research Online

Worsley DJ, Marshman Z, Robinson PG & Jones K (2016) Evaluation of the telephone and clinical NHS urgent dental service in Sheffield.. Community Dent Health, 33(1), 9-14.

Gray-Burrows KA, Day PF, Marshman Z, Aliakbari E, Prady SL & McEachan RRC (2016) Using intervention mapping to develop a home-based parental-supervised toothbrushing intervention for young children. Implementation Science, 11(1). View this article in White Rose Research Online

Morgan AG, Rodd HD, Porritt JM, Baker SR, Creswell C, Newton T, Williams C & Marshman Z (2016) Children's experiences of dental anxiety. International Journal of Paediatric Dentistry. View this article in White Rose Research Online

Wallace A, Rogers HJ, Zaitoun H, Rodd HD, Gilchrist F & Marshman Z (2016) Traumatic dental injury research: on children or with children?. Dental Traumatology. View this article in White Rose Research Online

Gilchrist F & Marshman Z (2015) Does orthodontic treatment improve oral health-related quality of life?. Evidence-Based Dentistry, 16(3), 86-86.

Marshman , Gupta , Baker , Robinson , Owens , Rodd , Benson & Gibson (2015) The voice of the child in oral health research. The voice of the child in oral health research, 25(5), 375-382. View this article in White Rose Research Online

Marshman Z (2015) Guest Editorial: ‘The voice of the child in oral health research’. International Journal of Paediatric Dentistry, 25(5), 309-309. View this article in White Rose Research Online

Gilchrist F, Marshman Z, Deery C & Rodd HD (2015) The impact of dental caries on children and young people: what they have to say?. International Journal of Paediatric Dentistry, 25(5), 327-338. View this article in White Rose Research Online

Marshman Z, Gupta E, Baker SR, Robinson PG, Owens J, Rodd HD, Benson PE & Gibson B (2015) Seen and heard: towards child participation in dental research. International Journal of Paediatric Dentistry, 25(5), 375-382. View this article in White Rose Research Online

Benson PE, Da’as T, Johal A, Mandall NA, Williams AC, Baker SR & Marshman Z (2015) Relationships between dental appearance, self-esteem, socio-economic status, and oral health-related quality of life in UK schoolchildren: A 3-year cohort study. The European Journal of Orthodontics, 37(5), 481-490. View this article in White Rose Research Online

Fontanini H, Marshman Z & Vettore M (2015) Social support and social network as intermediary social determinants of dental caries in adolescents. Community Dentistry and Oral Epidemiology, 43(2), 172-182.

Stewart M, Keightley A, Maguire A, Chadwick B, Vale L, Homer T, Douglas G, Deery C, Marshman Z, Ryan V & Innes N (2015) Investigating the Management of Carious Primary Teeth in General Dental Practice: An Overview of the Development and Conduct of the Fiction Trial. Primary Dental Journal, 4(4), 67-73.

Page LAF, Thomson WM, Marshman Z & Stevens KJ (2014) The potential of the Child Health Utility 9D Index as an outcome measure for child dental health. BMC oral health, 14, 90.

Harris J, Marshman Z & Short JA (2014) Development and qualitative evaluation of a communication tool for children with autism spectrum disorders and other communication difficulties. Journal of Disability and Oral Health, 15(2), 33-39.

Worsley DJ, Jones K & Marshman Z (2014) Patients are asking about e-cigarettes. What do we tell them?. BDJ, 217(2), 91-95. View this article in White Rose Research Online

Broomhead T, Baker SR, Jones K, Richardson A & Marshman Z (2014) What are the most accurate predictors of caries in children aged 5 years in the UK?. Community Dental Health, 31(2), 111-116.

Page LA, Thomson WM, Marshman Z & Stevens KJ (2014) The potential of the Child Health Utility 9D Index as an outcome measure for child dental health.. BMC Oral Health, 14, 90. View this article in White Rose Research Online

Rodd H, Hall M, Deery C, Gilchrist F, Gibson BJ & Marshman Z (2014) 'I felt weird and wobbly.' Child-reported impacts associated with a dental general anaesthetic.. Br Dent J, 216(8), E17. View this article in White Rose Research Online

Gilchrist F, Rodd H, Deery C & Marshman Z (2014) Assessment of the quality of measures of child oral health-related quality of life.. BMC Oral Health, 14, 40. View this article in White Rose Research Online

Flett AM, Hall M, McCarthy C, Marshman Z & Benson PE (2014) Does the British Orthodontic Society orthognathic DVD aid a prospective patient's decision making? A qualitative study.. J Orthod, 41(2), 88-97. View this article in White Rose Research Online

Marshman Z, Baker SR & Robinson PG (2014) Does dental indifference influence the oral health-related quality of life of prisoners?. Community Dent Oral Epidemiol, 42(5), 470-480. View this article in White Rose Research Online

O' Donnell SC, Marshman Z & Zaitoun H (2013) 'Surviving the sting': The use of solicited diaries in children and young people with oral mucosal disease. International Journal of Paediatric Dentistry, 23(5), 352-358. View this article in White Rose Research Online

Rodd HD, Hall M, Deery C, Gilchrist F, Gibson B & Marshman Z (2013) Video diaries to capture children's participation in the dental GA pathway.. Eur Arch Paediatr Dent, 14(5), 325-330.

Gilchrist F, Rodd HD, Deery C & Marshman Z (2013) Involving children in research, audit and service evaluation.. Br Dent J, 214(11), 577-582. View this article in White Rose Research Online

Porritt J, Buchanan H, Hall M, Gilchrist F & Marshman Z (2013) Assessing children's dental anxiety: A systematic review of current measures. Community Dentistry and Oral Epidemiology, 41(2), 130-142. View this article in White Rose Research Online

Csikar J, Wyborn C, Dyer T, Godson J & Marshman Z (2013) The self-reported oral health status and dental attendance of smokers and non-smokers. Community Dental Health, 30(1), 26-29.

Porritt J, Buchanan H, Hall M, Gilchrist F & Marshman Z (2013) Assessing children's dental anxiety: a systematic review of current measures.. Community Dent Oral Epidemiol, 41(2), 130-142.

Public Engagement

Life Festival

"I Can't Eat and Sleep and Stuff": Children's Experiences of Having Dental Decay

Fiona Gilchrist, School of Clinical Dentistry

Fiona discusses the cutting edge of paediatric dentistry, and describes how new treatments are introduced into dental practice.

Learning about the Mind and Body

On Saturday 31st October 2015 Zoe Marshman and a team of ten undergraduates and postgraduates, led by final year student Amelia Coulby joined colleagues from Psychology at Western Park Museum for a day of activities designed to teach children and parents about different aspects of the mind and body. This free event covered topics such as the development of attention and control, the brain, language and the mouth and how to care for it.

Discovery Night (2015)

The CREATE group , as part of the University of Sheffield, Science and Engineering week held at Firth court, engaged with children, young people (aged 3-17 years) and their parents through talks, exciting demonstrations and hands-on activities. Our photo booth turned out to be very popular with children asked to dress up and use props to show us what they think professionals working in the dental school (e.g. dentist, researcher, professor) look like.
The new NIHR-funded self-help Cognitive Behavioural Therapy resource developed with young people with dental anxiety received very positive feedback from both children and their parents.

Life Festival (2014)

As part of the Faculty Life Festival 60 children (aged 5-7 years) from Hunters Bar Infant School were invited to Firth Court for a half day event to disseminate research conducted within the group. The evaluation of the event was very positive from the perspective of the school, children and provided valuable insights into future projects.

Staff

Professor Sarah Baker

Professor Helen Rodd

Professor Philip Benson

Professor Chris Deery

Professor Barry Gibson

Professor Zoe Marshman

Dr Jan Owens

Dr Fiona Gilchrist