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Conscientious self-application of oral hygiene procedures by the patient is related to the need to obtain and to keep plaque-free teeth. This need is aroused by pleasant aspects. One appointment is reserved to demonstrated proper plaque control techniques. Instruction on the correct brushing method is explained with the aid of demonstration models and afterwards in the mouth with the use of a hand mirror. It is necessary to confirm the effectiveness of the instructed method in plaque removal with each patient. We describe a modified BASS toothbrushing technique. Patients without periodontitis, for example in case of chronic gingivitis, are instructed for flossing. Patients with periodontitis receive instruction for use of interdental cleaning (floss and/or interproximal brushes). Patient motivation is repeated during treatment period, control routine visit and maintenance phase. At each visit, technique efficiency is controlled visually or by bleeding test and plaque control is corrected.

The importance of maintenance care for controlling periodontitis and preventing disease recurrence is well-documented. Supportive periodontal therapy is essentially based on periodontal risk assessment, oral hygiene reinforcement and professional cleaning. As most of the referred periodontal patients return to the general practitioner at some point, supportive periodontal therapy should be continued in general practice. This manuscript offers the clinician, in particular the general practitioner, a number of guidelines to organize maintenance care.

As in previous years, the dental status of schoolchildren from Geneva has been examined on a yearly basis between 1980 and 1990. A global assessment is presented here, showing a gradual increase in the percentage of caries-free children, especially in kindergarten classes. Moreover, a single evaluation of first permanent molars is presented.

Summary: France has changed from a country where hepatitis A is endemic to one where residents are at risk of hepatitis A infection: in 20 years, the seroprevalence in 20-year-olds has fallen from 50% to less than 10%. Prophylaxis for close contacts of an index case has therefore become a major problem because their risk of hepatitis A is high. Polyvalent immunoglobulins are recommended in several countries, but no immunoglobulins are approved for this indication in France. Immunoglobulins are also expensive and only slightly efficacious. A vaccine against hepatitis A administered to young children or adolescents can break the epidemic chain and protect adults very effectively by limiting virus circulation. Many countries propose early vaccination to at-risk contacts, with vaccination generally advised within a week of the initial infectious contact. Although more specific and more plentiful data are still necessary before this recommendation can be generalized, it must be taken into account. This medical decision should thus be made on an individualized basis after discussion between the physician and family about the risk. [Copyright &y& Elsevier]

Abstract: Objectives: Imogam rage® (IgR) prescriptions were assessed in the rabies prophylaxis centre of Poitiers (France). Material and methods: All medical records closed between January 1 and June 1, 2005 were retrospectively analyzed. An infectious disease specialist examined the pertinence of IgR prescription according to WHO references adapted to the epidemiological situation by the Pasteur Institute French rabies center. The indicator used was the proportion of patients treated by IgR among all patients treated by vaccination or vaccination with IgR. Results: During the study period, 69 medical records have bewereen analyzed: 48 (70%) patients were treated including 22 (46%) with IgR. Imogam rage® indication was not appropriate for 21 (95%) patients (one contact with a rodent, 8 low gravity contact, 12 contacts with a French animal) that is to say 86 IgR® vials. The direct cost was 8,032 euros. Conclusion: This assessment permitted to underline an overprescription of IgR®, to adapt guidelines to the local situation, and to improve care quality by adaptating medical record files, improving the prescription decisional tree and the local guidelines, and improving the training of interns. [Copyright &y& Elsevier]

The popularity of polishing air devices (AP) is rising with the increased distribution of commercial units in both United States and European dental offices and clinics. The instrument's efficiency and effectiveness in stain removal has been demonstrated with minimal impact on soft tissue trauma and abrasion. This article reviews the literature on AP. Future research is indicated to explore surgical clinical applications of airpowder polishing as well as more detailed information regarding the biological basis for its use.

This retrospective study was carried out on 20 patients with periodontal lesions treated by the same operator by scaling root planing. The investigation was designed to study the variability of the level of attachments through different charts of probing before and after treatment over a period of 5 years maintenance. Through efficient scaling and root planing different results were obtained according to sites of different localisations and depth. It shows the uncertain and occasional characteristics of periodontal lesions, and gives useful informations for treatment choices and regular maintenance program.

Pulling all registers in the treatment of periodontal disease with taking advantage of optimized treatment phases is very ef­fective in most of the cases and can lead to reasonable remission (probe depth of ≤ 5 mm) if not complete recovery (probe depth of ≤ 3 mm without bleeding on probing). To maintain treatment success after active periodontal therapy a so­ called “periodontal maintenance” recall interval is required. Not uncommonly, this recall program leads to bypassing further treatment options and turns into an ongoing long­term patient care. This article tries to shed light on the questions asked about patient treatment and handling with the elimination of the disease as chief objective. Hence, pathways of triage and treatment endpoints are being challenged and the expression “recall” is being readjusted.