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A 44-year old woman presented with a painful mouth. This pain was the result of prolonged inadequate dental hygiene. Extensive calculus formation was present on the molars next to the parotid oroficia.

In the thesis 'Barriers to effective periodontal care, published in 1984, an investigation was described on professional periodontal care lagging behind the development of periodontology. The objectives of the investigation were to assess whether dentists were treating periodontal disease as a behavioural problem using effective communication techniques, and whether serious periodontal disease had such low frequency that dentists had not the opportunity to become experienced in recognizing the disease. It was concluded that serious periodontal disease had a low frequency and was not influenced by communication on periodontal care. After 25 years, these conclusions are still valid: the percentage of risk patients is still 5-10% and the correlation between seriousness of periodontal disease and periodontal care provided is still limited. Not all dentists do have affinity to periodontal care, but they do have affinity to practical aspects, such as removing dental calculus deposits. A classification of obvious recognizable diseases and treatments would make periodontal care more manageable for dentists.

In research into a professional cross-section of dental hygienists, we studied the extent to which task redistribution has an influence on job satisfaction. The research among randomly chosen dental hygienists consisted of questions about organizational and personal characteristics, the set of assigned tasks, task characteristics and job satisfaction. The respondents were divided into 3 clusters which differed in the breadth of their sets of tasks. Although prevention and periodontology services remain the core tasks in dental hygienists' jobs, the degree of task redistribution differed strongly from cluster to cluster. Respondents with a considerable degree of task redistribution experienced the most task variation, but scored significantly lower on the task characteristics autonomy, feedback, task identity and task importance. This explains why redistribution does not directly correspond with a greater degree of job satisfaction. Moreover, it is precisely the dental hygienists with a broad set of tasks who are significantly less satisfied with their salary than those with a traditional set of tasks.

In research into a professional cross-section of dental hygienists, we studied the extent to which task redistribution has an influence on job satisfaction. The research among randomly chosen dental hygienists consisted of questions about organizational and personal characteristics, the set of assigned tasks, task characteristics and job satisfaction. The respondents were divided into 3 clusters which differed in the breadth of their sets of tasks. Although prevention and periodontology services remain the core tasks in dental hygienists' jobs, the degree of task redistribution differed strongly from cluster to cluster. Respondents with a considerable degree of task redistribution experienced the most task variation, but scored significantly lower on the task characteristics autonomy, feedback, task identity and task importance. This explains why redistribution does not directly correspond with a greater degree of job satisfaction. Moreover, it is precisely the dental hygienists with a broad set of tasks who are significantly less satisfied with their salary than those with a traditional set of tasks.

A 47-year-old man developed subcutaneous emphysema of the right side of his face during a dental cleaning procedure by the dentist.

Ageing is accompanied by the natural loss and wear of hard and soft dental tissues. While ageing can influence pathological processes affecting the dentition, it is not the cause of these processes. The development, growth, attrition, abrasion, and loss of teeth is determined in part by ageing. Periodontal disease is the result of the accumulation of dental plaque and can occur in young animals. Unfortunately, gingivitis or periodontitis is often not diagnosed or diagnosed too late by pet owners and veterinarians.

Daily oral hygiene is a matter-of-course. However, many people disregard the difficulties of effective cleansing of the dentition and need to be made aware of the problems; in everyday practice, more attention must be given to detailed individual instruction and recall. A systematic order of cleansing, the use of the proper instruments in the proper way and particularly the avoidance of traumatic forces are important to prevent damaging side effects, such as gingival recession, abrasion and erosion. Patients with periodontal problems are in need of conscientious instruction after their initial treatment, as careful plaque control has proven to be effective in the prevention of further deterioration. Moreover, patients with an increased risk of plaque retention, due to restorative, prosthetic and orthodontic devices or implants, need special care and frequently repeated instructions.

In order to get insight in the prevalence of dental diseases in dogs and cats and dental treatments, a postal survey amongst veterinarians in the Netherlands was carried out. 70% of the veterinarians answered to practice routine oral examinations of dogs and cats. Of dental diseases observed in dogs and cats periodontal diseases were most often mentioned. Dental treatments as calculus removal and extractions were performed by nearly all veterinarians. 50% of the veterinarians asked for assistance of a dentist in case a dental treatment could not be performed by themselves.

Nine dental hygienists working in a periodontal practice were interviewed. Their work is discussed. The initial therapy entails patient instruction, indices, supra- and subgingival debridement and polishing of the teeth. The duration of the initial therapy is between three and seven hours. About 25% of the time is spend on patient education. Most dental hygienists working in a periodontal practice experience high job satisfaction.

The expected decrease in the prevalence of edentulousness in elderly people does not guarantee a good oral health. Since the elderly will retain more natural teeth in the future, whether or not suppleted with prosthetic provisions, their oral self-care becomes more demanding. However, in elderly people oral self-care becomes also more difficult. Attention has to be given to the tertiary prevention, also (or in particular) in elderly people.

Clinical, histologic and scanning electron microscopic study of the use of the Prophy-Jet. The Prophy-Jet (Cavitron-International) is used for the removal of gross stain and heavy plaque. In this study the plaque and stain removal capacities have been investigated in patients with a healthy and inflamed gingiva. The influence of the spray of cleaning powder (sodiumbicarbonate) on the gingiva has been studied in gingival biopsies of Beagle dog. With the use of a scanning electron microscope the dentine and cementum have been investigated after spraying during 30 seconds to 2 minutes. The clinical results show that the plaque and the stain are removed easily and significantly except for the deep interproximal regions where the handpiece tip cannot be used in a correct angulation to the tooth surface. All patients showed gingival desquamation which could last up to 3 days. After treatment several patients suffered from aphthous ulcers. The gingiva of the Prophy-Jet treated areas in the Beagle dog showed severe epithelial desquamation, even of the papillary connective tissue, which in certain areas, can lead to necrosis. A spray lasting for 30 seconds removed approximately 10 micrograms of dentine or cementum. From these results it can be concluded that the negative aspects of the use of the Prophy-Jet are very important. It should therefore be used with caution.