Studies show that receiving new dentures is a stressful life event and it may require considerable coping skills from individuals to get adapt to them (Klock and Haugejorden, 2002). Oral health related quality of life (OHQoL) measures are being increasingly used to evaluate oral health care and evaluate treatment outcomes (Baker et.al 2008). Cross- sectional observation on people receiving dentures suggested an element of relationship between an individual’s coping strategies and OHQoL (Heydecke et al. 2004). Further exploring this relationship and identifying the determinants of successful denture outcomes may help may help individuals receiving new dentures adapt to them better.

The main aim of my study was to explore and observe if coping strategies of individuals receiving new dentures (for the first time and as a replacement) determined its successful outcome to improve their OHQoL. Based on a systematic literature review, I also identified various clinical and psychosocial factors which may influence denture outcomes and populated them within Wilson and Cleary (1995) model which theoretically linked clinical status, individual factors and environmental and observed them alongside the coping strategies (see figure).

I carried out a prospective longitudinal cohort study on adults receiving new conventional (partial and full) dentures in a University based dental hospital in India to test the relationships that were hypothesised. This is the first study to explore the relationship between individuals’ coping strategies and OHQoL. It is particularly interesting for as to using a robust theoretical model (Wilson and Cleary, 1995) to gain more clarity on factors that influenced successful denture outcomes.

Sarab Elyousfi

Exploring participation as a new perspective for child oral health promotion

PhD Student: Sarab Elyousfi

Supervisors: Dr Jan Owens and Professor Barry Gibson

Participation has been high on the agenda of health promotion because it is a key element of the Ottawa Charter; which almost three decades ago stressed its’ necessity and outlined it as a key guiding principle in enabling people in matters concerning their health. Around the same time, the United Nations legally acknowledged the rights of the child, including the right to participate in all matters that may affect them. Subsequently, participation as a new perspective of child-health promotion became important. Although the movement and commitment to child participation has been around for quite a while, translating that into practice has been slow.

A systematic review (Marshman et al., 2015) revealed that 83% of children’s oral health research involved them as objects rather than as active participants and children’s voices are still not being heard. Although there has been a strong call for participatory child-centred approaches there is a lack of research and insight regarding children’s participation in oral health and oral health promotion.

The aim of my PhD study is to explore the dynamics & meaning of children’s participation in an oral health promotion (OHP) programme.

This was an ethnographic case study; it is qualitative, allowing for more flexibility and adaptation to a changing setting. This is particularly important for health promotion research which involves the study of complex human behaviour in natural settings that cannot be controlled for scientific investigation. In any particular setting, participants are bound by intrinsic rules and norms that they may be so familiar with that they act automatically and thus it is something that is difficult to articulate but may be observed (Guest et al., 2013). In observing things as they occur, a more accurate picture can be acquired and subtleties may be revealed which other methodologies may not be able to unveil.

Rebecca Knapp

The impact of dental caries and its treatment under general anaesthetic on oral health-related quality of life in children

The infographic

PhD Student: Rebecca Knapp

Supervisors: Zoe Marshman, Fiona Gilchrist and Helen Rodd

Dental caries (tooth decay) is a significant public health problem, with nearly 50% children in the UK affected by the time they are 8-years-old. Treatment for caries under general anaesthetic (DGA) is a relatively common procedure, 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 50,000 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). As well as the cost at a society level, the negative effects of dental caries on children and their families are well documented, and include physical, physiological and social impacts. Measures of oral health-related quality of life (OHRQoL) can be used to evaluate the impact of dental caries and dental treatment on everyday life from a patient’s perspective.

We conducted a systematic review of the impact of DGA treatment on children’s oral-health OHRQoL, and found overall improvements following treatment, although some subscales showed worsened OHRQoL scores. All but one of the included studies relied on parental reports of OHRQoL, which may not fully represent the views of children themselves (Knapp et al, 2016). The review highlighted the need for further research using child-reported measures to assess the impact of dental caries and its treatment, as well as research exploring the effect of different treatment approaches under DGA.

My project will, therefore, involve a longitudinal assessment of OHRQoL using a child-centred measure for children having treatment of dental caries under DGA.

Andrew Rawlinson

Periodontal Treatment and Oral Health-Related Quality of Life

PhD Student: Andrew Rawlinson, BChD(Hons), MDS, FDSRCSEd. Professor of Restorative Dentistry. Staff candidate

Supervisors: Dr Mario Vettore, Professor Sarah Baker and Professor Peter Robinson

Outline of research: Destructive periodontal diseases are common in adults in the UK, with 37% of individuals having mild periodontal pocketing, 8% having moderate and 1% having severe periodontal pocketing (White et al., 2012). The cost of treating periodontal conditions presents a significant financial burden to patients affected and the UK NHS, where it is has been estimated that approximately £250 million per year is spent on treatment. The total cost to the economy has been calculated at £2.8billion, including time off work, lost UK revenue etc (Chapple, 2004).

Until relatively recently, the outcomes of health interventions in the management of periodontal diseases have largely been measured with clinical parameters. These measures have demonstrated that treatment can improve the clinical condition (Cobb, 2002), but ignore the effect of periodontal disease and its treatment on psychological and social well being of individuals.

This research will investigate individual factors including sense of coherence, self-efficacy, self-esteem and locus of control that may influence oral hygiene behaviours, adherence to treatment regimens, coping with stress and health beliefs. In doing so, they may influence the clinical and OHQoL outcomes of care. The Wilson and Cleary model (Wilson and Cleary, 1995) will be used to enable comprehensive research on this topic.

Recent publications:

Gonçalves P. C. G., Griffiths G., Rawlinson A. A Study of the Periodontal State of a Late Medieval United Kingdom Population. Achieves of Oral Biology, 2015, 60(12):1797-1801.
Qasim SB, Delaine-Smith RM, Fey T, Rawlinson A, Rehman I. Freeze gelated porous membranes for periodontal tissue regeneration. Acta Biomaterialia, 2015, 23:317-328 . Doi:10.1016/j.actbio.2015.05.001
Berahim Z., Moharamzadeh K, Jowett AK, Rawlinson A. Evaluation of Osteogenic and Cementogenic Potential of Periodontal Ligament Fibroblast Spheroids Using a Three-Dimensional In Vitro Model of Periodontium. International Journal of Dentistry, 2015, http://dx.doi.org/10.1155/2015/605813.
Berahim Z, Moharamzadehd K, Rawlinson A, Jowett AK. Characterization of periodontal spheroids in vitro. Chiang Mai Journal of Science 2013;40(6):1020-1029.
Bakri I, Douglas CWI, Rawlinson A. The effects of stress on periodontal treatment: a longitudinal investigation using clinical and biological markers. Journal of Clinical Periodontology 2013;40:995-961.
Jowett A, Marlow I, Rawlinson A. A Double Blind Randomised Controlled Clinical Trial Comparing a Novel Anti-stain and Calculus Reducing Dentifrice with a Standard Fluoride Dentifrice. Journal of Dentistry 10.1016/j.jdent.2012.12.005. [Epub ahead of print] Journal of Dentistry 41(2013) 313-320.
Zheng X, Cook JP, Watkinson M, Yang S, Douglas I, Rawlinson A, Krause S. Generic protease detection technology for monitoring periodontal disease. Faraday Discussions 2010;149:1-11.
Berahim Z, Moharamzadeh, Rawlinson A, Jowett AK. Biological interaction of 3D periodontal fibroblast spheroids with collagen-based and synthetic membranes Journal of Periodontology 2011:82;790-7.
Jowett AK, Orr MTS, Rawlinson A, Robinson PG. Psychosocial impact of periodontal disease and its treatment with 24-h root surface debridement. Journal of Clinical Periodontology 2009;36: 413–418.

Ninu R Paul

What Happens to patients who undergo orthognathic surgery?

PhD Student: Ninu R Paul

Supervisors: Professor Sarah R Baker, Dr Keith G Smith and Professor Barry J Gibson

Orthognathic surgery or jaw surgery is an elective surgery to correct severe malocclusion that cannot be treated through orthodontics alone. At the end of approximately 2 years of orthognathic treatment the patient would have a different dental relationship and most often a different facial appearance. The two main reasons why people opt for orthognathic surgery is due to appearance and functional concerns (difficulty in chewing, biting etc.). Alanko and colleagues (2010) also found that individuals who opt for orthognathic surgery experience psychological concerns such as anxiety and depression. But after having gone through the surgery what happens to these individuals? Rather surprisingly there has been little research on the impact of and adaptation of patients after orthognathic surgery. With orthognathic surgery this adaptation required learning to recognize their altered face and also gauging the reaction of others to the change (Cadogan and Bennun, 2011).

The aim of my study is to detail what happens to patients who undergo orthognathic surgery. For this I have to map the experiences of patients who would undergo and have undergone orthognathic surgery through face to face semi structured interviews using grounded theory.

This project is funded by -University of Sheffield interdisciplinary PhD network entitled ‘Construction of Human perfection’ with Departments of Law, Engineering, English and Dentistry.

Tom Broomhead

'Neighbourhood effects - spatial inequalities in oral health'

PhD Student: Tom Broomhead

Supervisors: Professor Sarah Baker (Dentistry) and Dr Dimitris Ballas (Geography)

Currently, there is a lack of theoretical research investigating the effects of neighbourhood environments on oral health outcomes. Previous work has often failed to take into account the inter-related functions and feedback mechanisms between individual characteristics and those of their environment, leading to outcomes that are simply quantified with little explanation as to why such patterns occur.

Therefore, the aim of my PhD is to investigate how neighbourhoods influence patterns of spatial inequalities in tooth decay, and why such patterns exist. To do this I will conceptualise the most important features of neighbourhoods using a framework devised by Macintyre et al., (2002), and use this to create numerous pathways by which neighbourhoods influence oral health. Two simulation methods will be used to help test this theory. Spatial microsimulation modelling is a geographical technique capable of creating a representative synthetic population from existing data sources. This synthetic population will be used to test the theoretical pathways using agent-based models, which bridge the gap between individual and environmental characteristics, and allow for dynamic interactions to be modelled. Through my research, I hope to shed more light on why where we live matters (if at all) for our oral health. This research is funded by a Medical Humanities Sheffield studentship.

I have a background in social and spatial geography, having graduated with a Bachelors degree in Human Geography in 2009, and a Masters degree in Social and Spatial Inequalities in 2011, both from the Department of Geography, University of Sheffield. I have also previously worked as a research assistant at the School of Clinical Dentistry, University of Sheffield.

Sarah Bell

Sarah graduated with a dental degree from Dundee University in 2006. She started working in the Dental Hospital in 2007 and joined the University in 2009 as a Clinical lecturer in Orthodontics. She is undertaking her clinical training in orthodontics alongside her PhD part-time (supervisors Dr Philip Benson and Prof Allison James).

Najila Al-Dossari

Najla graduated with a degree in Dental Hygiene from King Saud University, Riyadh, Saudi Arabia and MSc in Dental Public Health from University of Sheffield in 2004 and 2011 respectively. She joined the dental school again in the same year 2011 as a postgraduate researcher towards a PhD exploring the agency of Saudi mothers in relation to children’s oral health in Saudi Arabia. Najla is currently working on this project (supervised by Dr Barry Gibson and Dr Jan Owens).

Previous students

Orawan Nammontri

My research interest relates to the psychological factors which influence people’s oral health related quality of life.

My PhD research entitled the effect of an intervention to enhance sense of coherence on oral health related quality of life in children: a cluster randomised controlled trial. The intervention aimed to promote oral health via improving the psychological factor ‘sense of coherence’ which has been tested as one of the most factor influencing individual´s experiences of their oral health and quality of life. The predictors of oral health related quality of life in children were also explored by using the structural equation modelling (SEM). My project is funded by Royal Thai Government from 2008 to 2012.

I was born in Khon Kaen, the commercial and political centre of Northeastern (ISAN) Thailand. The city hosts the largest education and learning centre in the Northeast of Thailand, Khon Kaen University, where I received the bachelor (Doctor of Dental Surgery) and the master in Public Health

In 2008, I was awarded a full PhD scholarship from the Royal Thai Government and started the doctoral degree in Dental Public Health at the University of Sheffield.

I am a current PhD student who has joined the course in the Unit of Dental Public Health since October 2008.

In 1997, I joined the Ministry of Public Health, Thailand as a full time dentist and a head of Dental Department at Mahachanachai community hospital, Yasothon.

In 2000 till present, I worked as a dentist and instructor in the Department of Dental Public Health, Sirindhorn College of Public Health, Khon Kaen.

Nammontri O, Robinson PG, Baker SR. Enhancing oral health via sense of coherence: a cluster randomised trial. Journal of Dental Research (in press)

Sheffield is my second hometown. I have many lovely and good friends in Sheffield who I am able not only to share great ideas and spend memorable time with but also support emotionally to one another when things seem not to go on my way. Studying in Sheffield has made me more confident and allowed me to gain worth experiences. Particular in the Department of Oral Health and Development the professors, lecturers, staff and all postgraduate students are welcoming and very willing to answer queries and offer assistance.

Samiya Subka

Samiya is an international student sponsored by the Libyan Government. She graduated from Alfateh University, Libya. She is a paediatric dentist who obtained her Masters in Paediatric Dentistry at Bristol University in 2008. She is undertaking a clinical PhD (Supervised by Prof Chris Deery and Prof Helen Rodd).

Marta Krasuska

I joined the University of Sheffield in 2010 as a PhD student at the Academic Unit of Dental Public Health. My PhD explores the response shift phenomenon in people with sensitive teeth. I particularly focus on how individuals form judgements about their oral health quality of life (OHQoL) over time, and what psychological mechanisms are involved in this process. I also investigate how response shift can be measured in longitudinal studies involving quality of live assessments through self-report measures.

I graduated with an MSc in psychology from the University of Warsaw in 2008. During the degree I spent one year studying at the Faculty of Economics and Business, University of Neuchatel, in Switzerland. In 2009-2010 I was a Marie Curie fellow at the University Medical Centre Hamburg-Eppendorf as a part of Murinet project.

Krasuska M, Riva S, Fava L, Mackensen S, Bullinger M. (2012) Linking Quality-of-Life Measures Using the International Classification of Functioning, Disability and Health and the International Classification of Functioning, Disability and Health- Children and Youth Version in Chronic Health Conditions The Example of Young People with Haemophilia. American Journal of Physical Medicine & Rehabilitation.

Wulf F, Krasuska M, Bullinger M. (2012) Determinants of decision-making and patient participation in paediatric clinical trials: A literature review. Open Journal of Pediatrics, 1-17.

Eamar Al-Gtewi

Eamar graduated with a Masters of Dental Public Health (MDPH) from the University of Sheffield in 2009 before joining us to study for a PhD in 2011. The title of his research is "Using online support groups to explore the experiences of individuals with head and neck cancer and their carers" (supervised by Drs Sarah Baker and Jan Owens).

Fiona Gilchrist

Fiona graduated with her dental degree from Glasgow University in 1998 and received her MClinDent in paediatric dentistry from Edinburgh University in 2005. She has completed her specialist and consultant training in paediatric dentistry and is currently a lecturer in our Unit. She is undertaking her PhD part-time while continuing with her clinical, teaching and administrative roles in the School (Supervised by Prof Chris Deery, Dr Zoe Marshman and Prof Helen Rodd).

Abdulsalam Eddaiki

Abdussalam graduated with a BDS degree in 2001 from Garyounis University/Libya, and MSc/Orthodontics from Jordan University of Science and Technology/Jordan in 2009. He joined the dental school in 2011 as a clinical PhD student investigating the factors affecting compliance with orthodontic treatment. Abdussalam is currently conducting a systematic review to identify the factors that has been studied in the current literature as a potential predictors of patient compliance (Supervised by Prof Philip Benson and Dr Zoe Marshman).

Ekta Gupta

Ekta graduated with a Bachelors degree in Dental Surgery (BDS) from India. She joined the dental school in 2008 for pursuing her Masters in Dental Public Health. Upon completion of the Masters degree, she worked as a researcher on a systematic review of the Determinants of OHQoL in adults' from 2010 to 2011. In 2011 she started her PhD in dental school investigating the determinants of OHQol in adults (Supervised by Dr Sarah Baker and Prof. Peter.G.Robinson).

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Do coping strategies determine denture success to improve oral health-related quality of life in denture wearers?