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Aims and Objectives: An audit was carried out to assess the delivery of dietary advice in general dental practice for patients diagnosed with chronic/aggressive periodontitis, with the objective of finding ways to deliver dietary advice and improve patient education on a potentially important modifiable risk factor.Methodology: Following a retrospective pilot sample, an initial sample of 50 patients (of dentists, a dental therapist and dental hygienist) was selected. The delivery of dietary advice and the method by which it was given was recorded as part of the data set. A semi-structured interview was also completed to discuss various aspects of delivering dietary advice. A staff meeting was carried out following the first cycle to raise awareness and inform on the link between diet and periodontal disease. Following this a second cycle was carried out to complete the audit cycle and the results were analysed.Results: It was evident that following the first cycle dietary advice was not being given with respect to periodontal prevention. While the standard set was not met following re-audit there was significant improvement in the delivery of dietary advice as well as different ways to deliver the information. The feedback from the semi-structured interview suggested various obstacles in delivering dietary advice including lack of knowledge at first and also overloading patients with too much information initially.Conclusion: Using the entire dental team can be an effective way of educating our patients on risk factors for periodontal disease. It is important to note that this audit focused on clinicians delivering the advice and future direction should consider patient compliance and uptake of information. [ABSTRACT FROM AUTHOR]

Background and Aims: Dentists experience considerable occupational stress. Stressful clinical situations can provoke high levels of negative emotions, and situations which are associated with positive emotions tend to be overlooked by practitioners. Reflection regarding difficult situations is encouraged to facilitate learning. Cognitive behavioural therapy (CBT) formulations may be applied to situations appraised both positively and negatively. Analysis and interpretation of the dentist's coping behaviour and the consequent outcomes facilitate learning and reflection upon individual interactions with patients.Method: Twenty primary care dental practitioners in the greater Lincoln area participated in a semi-structured interview which explored their stressful and positive clinical experiences. Some of the episodes were analysed to create CBT formulations.Results and Discussion: CBT formulations are presented and the learning points highlighted by this structured presentation are discussed. In particular, it is suggested that this structured reconstruction of events, which highlights dentists' emotions, responses and the transactional effects of coping responses, might well facilitate objective reflective learning either individually or as part of peer to peer support. It should facilitate dentists' emotional processing of events and may thus contribute to stress reduction.Conclusion: CBT formulations of positive and negative dental scenarios may be constructed. It is proposed that this is a useful technique to foster reflection and learning in clinical situations and should lead to improved communication skills and shared decision-making, resulting in fewer complaints and thereby reduced stress. It should also improve dentists' emotional processing. [ABSTRACT FROM AUTHOR]

There are often moments in life when you can pinpoint exactly where you were, what you were doing and how you felt. From the ecstasy of your wedding to the moment you found out about a family bereavement, those feelings stay with you for the rest of your life. As dental professionals, it is understandable that, given the pressures exerted by UDAs and the way the contracts are, many patients will be treated and forgotten about by the time the next person is in the chair. [ABSTRACT FROM AUTHOR]

Background and Aims: The stressful nature of dental practice is well established. Much less information is available on the coping strategies used by dentists and the emotions which underlie the stressful experience. Previous research has been almost exclusively questionnaire-based, limiting the range of emotions explored. This study used qualitative methods to explore the full extent of emotions and coping strategies associated with stressful events in primary dental practice.Method: Semi-structured interviews were conducted with 20 dentists in Lincoln and the surrounding area. Verbatim transcriptions were analysed using thematic analysis.Results: Participants reported a wide variety of stressful situations, consistent with the existing literature, which were associated with a diverse range of negative emotional responses including anxiety, anger and sadness. Dentists tended to have more difficulty identifying positive events and emotions. The designation of a situation as stressful or otherwise was dependent on the dentist's personal interpretation of the event. Data relating to the effects of stressors and the coping strategies used by dentists will be presented in subsequent papers.Conclusion: The situations which dentists find difficult are accompanied by a diverse set of emotions, rather than omnipresent 'stress.' This has implications for stress management programmes for those in dental practice. [ABSTRACT FROM AUTHOR]

The aim of this paper is to give readers an overview of contemporary standard setting methods used within dental education, and to provide a better understanding of the subject. We hope that it will be of benefit not just to those in academic dentistry, but all practitioners involved with both undergraduate and postgraduate assessment. [ABSTRACT FROM AUTHOR]

Part-time general dental practitioners (GDPs) and dental care professionals (DCPs) working in practice are being increasingly utilised to deliver undergraduate clinical dental education to both dental and hygiene/therapy students. As such, there is a need for appropriate recruitment processes and ongoing staff development in the different and complex role of the clinical teacher. Recently a group of experienced dental practitioners, making a journey from GDP to part-time clinical teacher, identified common themes, experiences, challenges and realisations. These were: 'what is clinical dental education?'; 'me as a clinical teacher'; and 'specific teaching issues'. The themes highlighted the complexity of dental education and the different environment of the teaching clinic from general practice. Some of the themes identified could be a starting point for the induction process to facilitate an easier transition from experienced GDP to clinical teacher. With the current demands from both students and patients alike, the 'three way dynamic of patient, student and teacher' needs to be supported if dental schools are to attract and develop the highest quality clinical teachers. It is of critical importance to give an exceptional experience to students in their clinical education as well as to patients in terms of excellent and appropriate treatment. The challenge for deans and directors of education is to find the resources to properly fund teacher recruitment, induction and the development of part-time GDPs in order to produce the expert teachers of tomorrow. [ABSTRACT FROM AUTHOR]

The Health and Social Care Act 2012 heralded wide reaching reforms intended to place clinicians at the heart of the health service. For NHS general dental practice, the conduits for this clinical leadership are the NHS England local professional networks. In Greater Manchester, the local professional network has developed and piloted a clinician led quality improvement project: 'Healthy Gums DO Matter, a Practitioner's Toolkit'. Used as a case study, the project highlighted the following facilitators to clinical leadership in dentistry: supportive environment; mentoring and transformational leadership; alignment of project goals with national policy; funding allowance; cross-boundary collaboration; determination; altruism; and support from wider academic and specialist colleagues. Barriers to clinical leadership identified were: the hierarchical nature of healthcare, territorialism and competing clinical commitments. [ABSTRACT FROM AUTHOR]

The dental profession is well placed to contribute important information in child protection cases but no previous research has been reported that assesses the volume or impact of this information. Comprehensive oral assessment clinics were introduced and established as an integral part of comprehensive medical assessments for children with welfare concerns in Greater Glasgow and Clyde. An assessment protocol and standardised paperwork for comprehensive oral assessments were developed to enhance information sharing and patient access to appropriate care. Two cases are presented and discussed to demonstrate the value of dental input. [ABSTRACT FROM AUTHOR]

Objective To develop a national level cost model of both the direct and indirect costs of hospitalisations for impacted teeth in Australia. This model will then be used to compare a watchful monitoring strategy for impacted third molars versus prophylactic removal under GA, and calculate possible cost savings in the scenario where Australia would adopt guidelines comparable to the UK.Methods Western Australian real hospitalisation data for impacted/embedded teeth removal for 2008/2009 were extrapolated into a national, Australian-wide cost-distribution model for removal strategy. The components of a watchful monitoring strategy were calculated over a one-year, and 20-year period. Cost estimates for both strategies were then compared.Results The estimated number of hospitalisations for impacted teeth in Australia in 2008/2009 for the age group 15-34 years was 97,949. The estimated average annual direct cost was $350 million, the indirect cost was $181 million and total cost was $531 million. Individual cost of the watchful monitoring strategy over 20 years was $1,077, with an annual estimated cost of $53. The proposed guidelines would lead to an annual figure of 83,850 individuals avoiding hospitalisation and shifting to watchful monitoring strategy, and an annual reduction of costs ranging between $420-513 million.Conclusion With no evidence to support the prophylactic removal of asymptomatic wisdom teeth, a proposed watchful monitoring strategy is a more cost-effective alternative in the Australian context. [ABSTRACT FROM AUTHOR]

Introduction In 1980 the British Society of Periodontology published a series of educational goals which have guided periodontal curricula at UK dental schools. Further, a survey of UK dental schools evaluated aspects of teaching and learning in periodontology. The aims of this project were to identify teaching practices and assessments in periodontology and best practice which may be developed in the future.Materials and methods A questionnaire was sent to dental schools who had participated in the previous survey. The questionnaire sought information on aspects of teaching and learning in periodontology: teaching manpower, curriculum structure, assessment, research opportunities for students and whether implantology is delivered in the undergraduate curriculum.Results There is consistency between the education providers with respect to teaching and learning in periodontology. Most are developing integrated learning between dental undergraduates and members of the dental team although there are opportunities for further development. Students are expected to have knowledge of complex treatments but are not expected to be competent at undertaking periodontal surgery nor placing and restoring implants.Conclusion The findings confirm that there is considerable consistency between the education providers with respect to aspects of teaching and learning in periodontology. [ABSTRACT FROM AUTHOR]

Objective The aim of this study was to understand the opinion of general dental practitioners about the current level of implant education at both undergraduate and postgraduate levels.Materials and methods A questionnaire was sent to the general dental practitioners working in a group of practices in the West Midlands, UK. The completed responses were analysed.Results Ninety-one out of 101 dentists responded to the questionnaires (95.6%). Sixty-seven (77%) dentists stated that they learnt only theoretical aspects of dental implants during their undergraduate training. The majority of them stated that the training they received was not adequate. In addition, few barriers in dental implant provision by general dentists were also identified in the survey. The main barriers were risk of failures (56.3%), to avoid complications (65.5%) and the cost of learning (51.7%). The results were correlated to the implant competences set by the regulatory organisations such as General Dental Council and Association of Dental Education Europe.Conclusion The present study confirmed that the current implant education at both undergraduate and postgraduate levels in the UK does not instil confidence to the GDPs to provide and maintain dental implants. [ABSTRACT FROM AUTHOR]

Objective To investigate dentists' views on the likely impact of direct access (DA), the clinical competence of hygienists and therapists to work autonomously and possible predictors of such views.Design Random survey of registered dentists.Setting UK, 2014.Subjects and methods A random sample of UK-based dentists registered with the General Dental Council (GDC). A unique-access online questionnaire was developed, with a paper alternative. Email and postal reminders were sent.Main outcome measures Measures of positive/negative views regarding the impact of DA and clinical competence of hygienists and therapists to work without a dentist's prescription.Results One hundred and fifty-nine responded (response rate: 27%), 78 (49.1%) of whom were female. No significant sources of response bias were identified. While 122 (77%) had not undergone joint training with dental hygienists or therapists at the undergraduate level, 98 (62.4%) currently worked with a hygienist and 33 (21.0%) with a therapist. Eighty-three (53.2%) disagreed with the GDC decision regarding DA for hygienists, and 94 (59.1%) felt the same regarding therapists. Concern was greatest in respect to diagnosis, treatment planning and restorations. Comments were predominantly negative and reflected concerns over patient safety, what was seen as hygienists' and therapists' inadequate training or expertise, the undermining of the dentist's role, service delivery, the reform being poorly planned, implemented or being a cost-cutting exercise. Experience of teamwork was not predictive of positive/negative views.Conclusions Response was low, thus posing a potential threat to the study's representativeness. Many dentists had concerns and reservations about DA which were unrelated to teamwork experience. The dissemination of information on curricula and scope of practice may help allay such concerns, as may a greater emphasis on joint training at both the undergraduate level and within continuing professional development programmes. [ABSTRACT FROM AUTHOR]

Objective To undertake a pilot study and examine whether the communication assessment tool (CAT) is useful in assessing patient perceptions of dentists' interpersonal skills.Design Cross-sectional questionnaire study.Setting Three speciality dental clinics in a University teaching hospital in the United Kingdom.Participants, materials and measures One hundred patients, seen by 20 dentists, were recruited to the study. Patients completed the CAT after their consultation.Main outcome measures Patient ratings of excellent interpersonal skills within a dental consultation according to dentists' experience, gender and speciality.Results Complete data was received from 95 patients. On average, dentists' communication skills were rated as excellent 73% of the time. Patients were least satisfied with opportunities to ask questions within their consultation and with their level of involvement in decision-making. There were suggested differences in patients' perceived satisfaction with communication according to dentists' experience and gender.Conclusion Overall, patients are satisfied with the quality of communication with their dentist. Our findings are comparable to those from larger studies suggesting that the CAT is an effective tool to use in a dental context. The CAT would be useful in documenting the development of dentists' and students' interpersonal skills. [ABSTRACT FROM AUTHOR]

Aim This study aimed to compare the effect of extended margin and conventional bleaching trays on tooth bleaching and tooth sensitivity.Method and methods Twenty subjects (18-56 years) were investigated in a split arch design clinical study that was conducted in a general dental practice. Each subject received a custom made bleaching tray and 10% carbamide peroxide gel. The bleaching trays had the borders extended 5 mm beyond the gingival margins on the right side and finished just at the gingival margin on the left side. Shade change and tooth sensitivity were the primary outcomes studied and analysed in this study. The shade of the six upper and lower anterior teeth was assessed using a value-ordered shade guide before, one week and two weeks after treatment. Sensitivity was self-assessed using a visual analogue scale (VAS) at the end of the first and second weeks of the study.Results At the end of week two, the mean shade change was 5.01 (± 3.37) and 5.10 (± 3.36) for teeth covered by extended and non-extended tray design, respectively. The mean VAS sensitivity scores for teeth covered by extended and non-extended tray design were 0.96 (± 1.39) and 0.66 (± 0.96), respectively. There was no significant statistical difference between the two designs at any assessment point with regard to shade change and sensitivity (p >0.05).Conclusions It can be concluded that an extended tray design confers no superior effect in terms of the whitening outcome achieved or in reducing levels of sensitivity. Thus, both tray designs can be used depending on a dentist's personal preference. [ABSTRACT FROM AUTHOR]

Objectives To evaluate the use and knowledge of the index of orthodontic treatment need (IOTN) by general dental practitioners (GDPs) working within Scotland.Setting Scottish general dental services (SGDS).Methods Questionnaires were posted to randomly selected dentists (n = 356) working within the SGDS for self-completion and return.Main outcome measures Use of IOTN.Knowledge of IOTN Participants were asked to match 12 malocclusions to the correct IOTN category. Kappa statistics evaluated agreement to a gold standard.Results The overall response rate was 64%. Sixty-one percent of respondents did not use IOTN. The most common reason for using the index was to assess treatment eligibility (40.2%). The main reason for non-use was that it was only considered suitable for secondary dental care (27%). Over half (56%) of respondents had received IOTN training at undergraduate level. Knowledge of the index was found to be low - the mean level of agreement was k = 0.42 (fair). 10.5% of respondents scored k ≥0.61(substantial). The factors most likely to contribute to both use and knowledge of IOTN were having a postgraduate qualification and carrying out orthodontic treatment in practice.Conclusion Overall use and knowledge of IOTN among GDPs in Scotland appears to still be low. More resources need to be directed towards improving both undergraduate and postgraduate orthodontic training with the focus on IOTN in particular. [ABSTRACT FROM AUTHOR]

Objective To determine the views of current dental clinical academic trainees regarding their current posts.Design Online questionnaire emailed to 51 dental academic trainees. Survey results were collected over a six-week period. Eighteen closed statement questions were included using a five-point scale from 'strongly agree' to 'strongly disagree'. All questions had a section for open text comments.Results The response rate for the survey was 73%. A total of 38% were male and 62% female. Just under half of the sample (43%) had a higher teaching qualification. The majority of trainees were from oral surgery (22%), closely followed by restorative and dental public health (both 14%). The main reason trainees stated for choosing an academic post was to be involved in research (68%). The majority of dental clinical academic trainees would recommend a career in academia.Conclusion The majority of dentistry's academic trainees (73%) would recommend an academic career to their peers, a positive change in the culture of modern clinical academia. [ABSTRACT FROM AUTHOR]

Substance misuse is a major health concern in the United Kingdom, as the consequences for individuals are significant and may include multisystem organ damage. It is important for the dentist to know which patients are misusing substances as some pharmacological agents routinely used in dental practice may be contraindicated. The dentist should be aware of the range of clinical presentations that may arise from substance misuse and when suspected, a thorough drug history must be obtained. Patients may require special consideration and further investigations when planning elective procedures, particularly under intravenous conscious sedation. Therefore, management within a specialist centre and liaison with other health professionals may be indicated to ensure treatment is provided safely. [ABSTRACT FROM AUTHOR]

Orthodontic treatment is as popular as ever. Orthodontists frequently have long lists of people wanting treatment and the cost to the NHS in England was £258m in 2010-2011 (approximately 10% of the NHS annual spend on dentistry). It is important that clinicians and healthcare commissioners constantly question the contribution of interventions towards improving the health of the population. In this article, the authors outline some of the evidence for and against the claims that people with a malocclusion are at a disadvantage compared with those without a malocclusion and that orthodontic treatment has significant health benefits. The authors would like to point out that this is not a comprehensive and systematic review of the entire scientific literature. Rather the evidence is presented in order to stimulate discussion and debate. [ABSTRACT FROM AUTHOR]

As the health and expectations of the UK population improve, demand for orthodontic treatment is increasing. This article will examine who actually needs orthodontic treatment and who is currently receiving it, while also providing an opinion on the the risks versus benefits in providing demand-led treatment. [ABSTRACT FROM AUTHOR]

There is currently considerable interest from general dental practitioners (GDPs) in the use of simple orthodontics to treat adult malocclusions. There is controversy in this, particularly in relation to 'quick fixes', simple orthodontics and 'straight teeth in six months' as opposed to more conventional treatment where the whole malocclusion is treated. This article will present a case for the use of simple aesthetic adult orthodontics in a measured and planned way. It will discuss the processes, planning and the importance of consent. It will also highlight how digital technology is used to preview, consent and execute an aesthetic result. Many of the recent systems emerging, have been as a result of the demand and supply of cosmetic dentistry. This, to a degree, has not helped since the implication of a 'quick-fix' is associated with this field. There has also been discussion on what the limits of GDP orthodontics should be. There is variability in how GDPs approach orthodontics, their experience, skill and ability to treat to an acceptable standard. Short courses may be one way of delivering orthodontic training but some of these courses are not regulated and the amount of internal mentoring is variable. This article highlights some of the systems in use, and potential upsides and downsides of this approach. [ABSTRACT FROM AUTHOR]

Alcohol is widely consumed by the majority of the UK population and alcohol-related harm is estimated to cost society £21 billion per year in healthcare, lost productivity costs, crime and antisocial behaviour. The dental setting offers an ideal opportunity to screen for harmful alcohol consumption; however, current emphasis is on the management of acute complications and risk associated in treating patients with excessive alcohol intake rather than screening and patient education. This article outlines ways in which dentists could improve their recognition of 'at risk' patients and then offer practical advice to help reduce the harmful effects of alcohol. [ABSTRACT FROM AUTHOR]

In part 2 of this series, we look at the clinician's role in replacing multiple missing teeth and the associated soft tissues and bone, following severe forms of trauma. These patients usually wish to have fixed prostheses to help restore their appearance and function. In order to fulfil the patient's request, the multidisciplinary team can be faced with significant challenges, often requiring extensive reconstructive surgery and complex implant oral rehabilitation. The aim of this paper is to highlight to the general dental practitioner some of the challenges faced in rehabilitating severe trauma patients with implant retained prosthesis. By understanding the challenges it is hoped that the general dental practitioner will be able to make an assessment of the clinical situation and seek appropriate specialist advice to ensure optimal results for their patients. In the longer term, the management of these patients requires a shared care approach between the general dental practitioner and relevant specialists. [ABSTRACT FROM AUTHOR]

This series of papers examines how the Anglo-American dental profession was established in the eighteenth century, examining its need for a name and identity, public recognition and official status. This second paper will explore the introduction of the title dentist to the public, and the development of the concept of the dental patient [ABSTRACT FROM AUTHOR]

Gingival black triangles (GBTs) are generally considered to be aesthetically unacceptable, have a multifactorial aetiology and a range of treatment options. This review covers the surgical and non-surgical management of GBTs. Surgical methods address recontouring, preserving or reconstructing the soft tissue including the interdental papilla as well as the alveolar bone. Non-surgical approaches include restorative techniques (including the use of prostheses and gingival-coloured materials), orthodontic movement, tissue engineering and tissue volumisers. This review covers the aetiology and management of GBTs, highlighting the importance of considering the options currently available when treating a lost dental papilla. A lack of longitudinal studies investigating the long-term outcomes of the options in management of GBTs presence is identified. [ABSTRACT FROM AUTHOR]

When Britain went to war in 1914, the British Expeditionary Force was deployed without a single dentist. Initially considered combatants, the only dental professionals who could serve at the Front were medically qualified dental surgeons in the Royal Army Medical Corps. In treating the traumatic facial and jaw injuries caused by trench warfare, the dental surgeons of this era earned their place on specialist surgical teams and established the principles of oral and maxillofacial surgery. This article will examine the contribution of specialist dental surgeons to the management of facial and jaw wounds in the First World War along the chain of evacuation from the battlefield to the home front, using illustrative examples from the Hunterian Museum at the Royal College of Surgeons of England. [ABSTRACT FROM AUTHOR]

This series of papers will examine how the Anglo-American dental profession was established in the eighteenth century, examining its need for a name and identity, public recognition and official status. This paper outlines the evolution of the names of the profession, from tooth-drawer to dentist, and notes the importance of the name to the profession. [ABSTRACT FROM AUTHOR]

Social media sites have become an established means of communication due to the exponential growth in number of users across the world and the encouragement of interaction between users through site features. The purpose of this study was to determine the extent to which Loma Linda University School of Dentistry students use social media accounts, the types of accounts they prefer, their interest in incorporating social media into courses and their perceptions of the usefulness of social media in private practice. In addition, we wanted to determine the degree of student interest in the integration of these social tools into their instruction. One thousand one hundred and sixty-two students from Loma Linda University School of Dentistry were invited by e-mail to complete a confidential 18 item multiple choice survey through Surveymonkey.com. The overall response rate was 30% (n = 351) from the pooled response periods; the first in 2011 and the second in 2013. Similar to other studies, Facebook was used by 91% of the School of Dentistry students, and less than half used Google+, Twitter and LinkedIn. Of the respondents, 68% of students reported communicating on social media daily and 80% saw value for practising dentists to operate accounts. Time and privacy concerns were the largest barriers to usage at 16% and 12% respectively. One third of respondents were in favour of the incorporation of social media in their courses. [ABSTRACT FROM AUTHOR]

There has been a reported increase in the incidence of self-harm within the United Kingdom. This is of great concern, as a number of studies have shown self-harm to be a major risk factor to completed suicide. However, the identification of self-harm provides an opportunity for support and treatment. Mental health is an area that often receives little attention in the undergraduate dental curriculum. Yet dental practitioners, as healthcare professionals, need to be vigilant for any risk factors or signs of mental illness among their patients and make appropriate onward referrals. The purpose of this article is to examine the current evidence and aspects of self-harm, particularly in young adults and adolescents that are relevant within a dental settling. [ABSTRACT FROM AUTHOR]

This paper describes the historical origins and purpose of 'evidence-based practice' and describes the barriers to the growth of evidence-based practice within dentistry. It describes a new research agenda-setting process for dentistry, which includes identifying and prioritising the topics of most relevance to the work of primary dental care practitioners. By undertaking the work described in this paper we were striving to make research more relevant to the day to day decisions made by dentists in practice by introducing a new process, the intention being to promote and promulgate the practice of evidence-based dentistry. [ABSTRACT FROM AUTHOR]

Infection control and knowledge of common infectious agents is a cornerstone of safe dental practice. This paper summarises the measures that need to be taken to control cross infection and discusses some of the infectious agents of concern to dental practitioners. [ABSTRACT FROM AUTHOR]

Skin cancer is common and an increasing problem in the UK. It frequently occurs on the head and neck skin. A significant proportion of the adult population in the UK visits the dentist each year, thus making dental practitioners ideally placed to identify suspicious lesions, which could be skin cancer, as part of their routine extra-oral examination. These patients can then be referred on to hospital or their GP for further management. The dentist can also give advice on risk factors and self-monitoring to patients. This paper aims to describe the risk factors, pathology, presentation and treatments for the three most common forms of skin cancer - basal and squamous cell carcinomas, and malignant melanoma, to give the dental practitioner the knowledge and confidence to examine for and identify these skin cancers. [ABSTRACT FROM AUTHOR]

International and UK professional organisations, Cochrane systematic reviews, and international and UK guidance documents all support the application of preventive fissure sealants (PFSs) as an effective treatment for reducing caries. However, PFSs are well known to be underutilised in primary care. This paper collates data from PFS-relevant studies in Scotland, which has a large population of children at caries risk, to identify the beliefs and factors dentists perceive as influencing their decision not to provide this treatment. This information provides a platform to suggest how to increase the application of PFSs in this region (a standardised audit incorporating evidence-based behaviour change techniques, supplemental guidance on how to implement gold-standard recommendations in practice, training). This may also be relevant outside of Scotland, as well as to the implementation of other evidence-based behaviours in practice. [ABSTRACT FROM AUTHOR]

It is likely that many foundation dentists (FDs) will have completed only minimal amounts of restorative dentistry for a number of months immediately prior to commencing work as FDs. Thus this audit aimed to assess the performance of the FDs when they carried out a number of simulated clinical exercises: amalgam cavities and restoration; Class IV resin composite restorations; and full crown preparations for metal-ceramic restorations. A total of 67 FDs completed the assessments and some results did indicate a high level of concern and need for further evaluation of restorative practice. [ABSTRACT FROM AUTHOR]

The speciality of endodontics encompasses numerous elements, but the use of a variety of instruments to shape root canal systems probably challenges the clinical time of practitioners more than any other. The aim of this article is to review some of the historic and contemporary approaches to this challenging practical objective. [ABSTRACT FROM AUTHOR]

This article outlines the European Federation of Periodontology's (EFP) manifesto Periodontal Health for a Better Life which was informed by the first joint EFP/American Academy of Periodontology workshop on periodontitis and systemic health. The EFP manifesto calls upon the dental profession to engage in screening and providing preventive advice to patients who are at risk of common chronic diseases and conditions such as cardiovascular disease, diabetes and cancer. In particular, the article emphasises the dental team's role in promoting behaviour change in their patients aimed at reducing smoking and obesity levels, by promoting healthy nutrition and exercise. The chairman of the National Association of Primary Care Medicine, Dr Charles Alessi, has strongly endorsed this model and highlighted the important opportunities offered by a capitation-based new contract for the dental team to engage fully in preventive medicine in support of medical colleagues and in the best interests of public health and patients across England. [ABSTRACT FROM AUTHOR]

The United Kingdom Clinical Aptitude Test (UKCAT) has now been an active part of UK dental admissions for seven years with the test being used by 11 dental schools within their admissions processes. This paper gives an overview on UKCAT and highlights some of the on-going work in relation to its development. This paper also highlights what UKCAT is and some developments with respect to the UKCAT. It also facilitates the process of keeping dental practitioners informed. [ABSTRACT FROM AUTHOR]

The long-term clinical management of caries and periodontal diseases requires a double approach, one that is concerned with both treatment and prevention. Dentists should recognise the risk factors and their likely triggers to be able to implement the right strategy as early as the diagnostic phase. This comprehensive assessment can easily be done in general practice. All it takes is to combine the patient's general information with the systemic and behavioural factors, and the clinical observations with the local factors. The resulting patient profile can thus effectively support treatment by providing the necessary explanations, advice or prescriptions in relation with the clinical procedures. The modifiable risk factors need to be monitored and the behaviours changed to stabilise or limit disease progression. The practitioner's active approach is meant to meet the patient's demand for preventive counselling. [ABSTRACT FROM AUTHOR]

This paper explores Levi Spear Parmly's vision for the education of dentists in the early nineteenth century and how his work impacted on Anglo-American dental schools. [ABSTRACT FROM AUTHOR]

The aim of this article is to explore the diverse and complex nature of pharmacological drug-drug interactions in the general dental practice setting. Using published NHS statistics, this article will highlight medications for common medical conditions that could interact with frequently prescribed drugs by the general dental practitioner. [ABSTRACT FROM AUTHOR]

Background Hungary has become a popular destination for foreign patients in the last two decades, particularly in dental care. Since 2008, increasing prices in Western Europe coupled with Hungary's accessibility and availability of dental treatment, has meant the country has become a leader in 'dental tourism'. As the quality of care in Hungary is high and prices are more affordable than in Western Europe, and due to the freedom of movement of people, services and goods within the EU, patient flow into Hungary has increased progressively.Objectives The aim of this article is to provide comprehensive empirical evidence from the perspective of a recipient country in dental tourism.Methods A questionnaire survey was conducted among Hungarian dentists (n = 273). Qualitative in-depth interviews were conducted with representatives of dental professional bodies (n = 10). Both research methods aimed to elicit dentists' views on the presence of dental tourism - particularly the push and pull factors (for example, source countries, competitors, information sources, patient motivation).Results The findings show that there are several reasons why Hungary could maintain a leading position in dental tourism. First, the cost/benefit ratio is outstanding. The affordable price and value for money were already recognised in the early 1990s and were appreciated even before Hungary joined the EU. Secondly, the high quality of Hungary's dental profession: a) dental professionals in Hungary are well-qualified dental practitioners who have received high level dental training; b) dental professional standards are up-to-date and often supervised; c) in Hungary dental technology, the quality of materials and equipment used in dental practices is of European level quality. The rate of complications in dental care is around 5%, similar to other European countries. Finally, previous treatment experiences are positive and patient satisfaction levels are high. More and more patients seek care in Hungary, and more and more patients state that they would be willing to return for further treatment in the future. [ABSTRACT FROM AUTHOR]

Earlier this year English Heritage, the BDA Museum and The Lindsay Society for the History of Dentistry unveiled a plaque to Lilian Lindsay (1871-1960). This paper outlines the history and administration of the blue plaque scheme and celebrates the contributions made by dentists who have been commemorated with plaques. [ABSTRACT FROM AUTHOR]

This paper is intended to provide an overview of current thinking in the more relevant medical conditions to oral surgery for primary care practitioners, giving the detail necessary to assist the primary dental clinical team in caring for patients with oral complaints that may be seen in general dental practice. Space precludes inclusion of discussion and illustration of uncommon or more complex medical conditions. Clinical tips for planning, execution and post-surgical care are discussed, and a brief overview of pre-operative, peri- and post-operative care is provided to minimise risk. [ABSTRACT FROM AUTHOR]

This article provides an opinion on the NHS NICE guidance on wisdom tooth removal introduced in 2000. Guidelines should support clinical decision-making by providing recommendations based on sound evidence but the wisdom tooth guidelines were published without any research evidence. General dentists and oral surgeons in England and Wales are under pressure to comply with this guidance but what have been the implications for patient care? There is growing evidence that patients have not been best served, with significant numbers developing caries in an adjacent tooth before consideration of wisdom tooth assessment. [ABSTRACT FROM AUTHOR]

Objectives To estimate the frequency of trigeminal nerve injuries associated with local anaesthetic administration, as experienced by UK dentists.Method A convenience sample of clinicians attending 12 study days over the UK was invited to complete an anonymised questionnaire exploring the nature of professional practice, dentists' practice demographics, experience of nerve injuries and related factors. Dental procedures related to reported trigeminal nerve injuries (TNIs) were divided into low risk, likely local anaesthetic (LA) related nerve injury, and high risk procedures, more likely to be direct nerve damage by the procedure (procedural related nerve injury). Data were analysed using Microsoft Excel and SPSS V17.Results Overall 79% of attendees completed a questionnaire (n = 415); clinicians held an average of 19 years' clinical experience. The numbers of clinicians surveyed included general dental practitioners (n = 290; 64%) and oral surgery (OS) specialists (n = 125; 36%). The estimated incidence of TNIs for the UK GDP workforce was 3,770 TNIs per year or 0.13 TNI per dentist per year. For specialists the incidence was increased to 0.39 TNI per specialist per year. Of all injuries only half were reported, mainly to indemnity organisations. LA-related injuries were most common for GDPs and third molar surgery for OS specialists. It is estimated that TNIs will occur in 1 in 3,289 high risk procedures such as third molar surgery and 1 in 14,330 for low risk procedures, such as restorative dentistry, most likely LA-related. From 25% to 29% of these dental procedures related TNIs were permanent.Conclusions Nerve-related injuries in dentistry are not uncommon. Dental practitioners should be aware of the significant disability associated with iatrogenic nerve injuries and risk factors relating to LA-related trigeminal nerve injury. Clinicians should familiarise themselves with infiltration LA-techniques that may reduce these nerve injuries and with the Care Quality Commission regulations for reporting injuries to patients as a result of treatment. [ABSTRACT FROM AUTHOR]

A number of electronic apex locators are available for use during endodontic treatment. The use of third and fourth generation electronic apex locators (EAL) are recommended to help clinicians determine the apical limit of the root canal system (RCS). The presence of different irrigating media in the RCS does not impact significantly on the performance of third/fourth generation apex locators. The devices are most accurate at determining the apical limit when the attached endodontic file contacts the periodontal ligament space and the visual analogue displays 'Apex' or '0.' Given the accuracies of modern generation EALs, the clinician should be able to consistently identify the apical limit of the tooth under treatment. Their use in conjunction with appropriate radiographs and the clinician's knowledge of average RCS lengths and anatomy will maximise the successful outcome of any orthograde endodontic treatment. [ABSTRACT FROM AUTHOR]

Immunological reactions to chlorhexidine, including allergy (Type I hypersensitivity) and allergic contact dermatitis/stomatitis (Type IV hypersensitivity), have been recognised for many years. This potential safety issue, however, is not well known within dentistry. The purpose of this paper is to alert dentists and dental care professionals to the potential of chlorhexidine in causing hypersensitivity reactions and to consider this possibility if unexplained hypersensitivity reactions occur. [ABSTRACT FROM AUTHOR]

Risk-based, patient-centred decision-making, supported by best available evidence is an essential component for the correct prevention, control and management of dental caries. This article reviews the importance of caries risk assessment in adults as a prerequisite for appropriate caries preventive and treatment intervention decisions. A clinical case will be used to demonstrate how risk assessment can be easily incorporated in everyday clinical practice, using information readily available in the dental-medical history and clinical examination. [ABSTRACT FROM AUTHOR]

A review of the personal papers relating to Frank Harrison and held by the School of Clinical Dentistry in Sheffield reveal what a dedicated clinician he was and the significance of his achievements from over 100 years ago, both locally and nationally for his chosen profession and also for the people of Sheffield. In addition to being one of the first dentists in the world to experiment with X-rays in dentistry, and the first to write up his findings in a dental journal, he designed and patented dental instruments, wrote books, lectured on fine art (particularly Venetian and Florentine art), and gave lectures to the public in the hope that they would heed his message on the importance of maintaining good oral health. A search of national archives and library resources has added further information about his family and professional accomplishments. [ABSTRACT FROM AUTHOR]

The article discusses the benefits of Oral Health Assessments (OHAs) in patients suffering from tooth surface loss (TSL). It is stated that OHAs involve the patient more with the dentists, and enables them to express their dental needs and hence facilitates communication between the dental team and patient. OHAs are also helpful in measuring the cost effectiveness of treatment and the efficiency of dentists.

Sjögren's syndrome (SS), an autoimmune, multi-factorial disorder, affects around 5% of females and 0.5% of males in the general population. The dental practitioner has a key role in recognising the clinical features of this condition, organising referral for specialist care and managing the oral health of these patients. In this article, we summarise the clinical manifestations, diagnosis and management of SS relevant to dental practitioners. [ABSTRACT FROM AUTHOR]