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BACKGROUND: Some older people stop visiting the dentist when they get older. This study aims to identify the characteristics and oral health status of older people who do visit community dental practices.METHODS: In this exploratory cross-sectional study, the oral health of Dutch community-dwelling older people was assessed. A random sample of general dental practitioners and older people who visit the dental practice was drawn. The dentists were asked to prospectively select one older patient and describe this patient using a specially developed registration form; the patient was requested to complete a questionnaire. Data were described for 3 distinct groups of older people. Statistical measures for distribution and dispersion were used to describe the oral health of community-dwelling older patients in relation to the age.RESULTS: A total of 373 (40.4%) dentist registration forms and 372 (40.3%) patient questionnaires were returned. Data were available for 364 (39.4%) dentist-patient couples. Amongst the patients, 52.8% were female and most had a high socioeconomic status. About 65.7% had one or more problems related to general health, and 75.2% used medication. Regarding the overall oral health status, the average number of teeth was 20, 3.5% were edentulous. Oral health problems were more common in the older patient group (aged 75+), in whom frailty was also most common.CONCLUSIONS: Older people who visit community dental practices are still relatively healthy, non-frail, and highly educated. Even in this group, there is a turning point in both general and oral health from the age of 75.

Background The purpose of this study was to evaluate the multifaceted impact of the COVID-19 pandemic on dental practices and their readiness to resume dental practice during arduous circumstances. Methods The authors distributed an observational survey study approved by The University of Texas Health Science Center at San Antonio Institutional Review Board to dental care practitioners and their office staff members using Qualtrics XM software. The survey was completed anonymously. The authors analyzed the data using R statistical computing software, χ2 test, and Wilcoxon rank sum test. Results Nearly all participants (98%) felt prepared to resume dental practice and were confident of the safety precautions (96%). Only 21% of dentists felt the COVID-19 pandemic changed their dental treatment protocols, with at least two-thirds agreeing that precautions would influence their efficiency adversely. Although most participants were satisfied with the resources their dental practice provided for support during the pandemic (95%), most were concerned about the impact on their general health and safety (77%) and to their dental practice (90%), found working during the pandemic difficult (≈ 60%), and agreed there are challenges and long-term impacts on the dental profession (> 75%). Conclusions Dental care professionals, although affected by the COVID-19 pandemic and at high risk of developing COVID-19, were prepared to resume dental practice during most challenging circumstances. Practical Implications The pandemic has affected dental care practitioners substantially; thus, there is need to formulate psychological interventions and safety precautions to mitigate its impact. Further research should evaluate the long-term effects on dentistry and oral health and interceptive measures for better communication and programming around future challenges.

INTRODUCTION: Understanding how different countries have responded to mitigate the risk of severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) transmission in dental offices is important. This article describes the different approaches taken towards optimal fallow periods in Canadian jurisdictions. METHODS: We searched publicly available information from dentist and dental hygiene regulator websites across the 10 provinces and 3 territories in Canada. We also searched for guidance documents on dental associations' websites or through personal communication with government officials. We extracted and tabulated information on fallow period recommendations or guidance, when available. RESULTS: Nine jurisdictions (6 provinces and all 3 territories) acknowledge or provide guidance on fallow periods following aerosol-generating procedures. Among those who have provided guidance regarding a fallow period, recommendations follow the Centers for Disease Control and Prevention guidance if the air changes per hour (ACH) in the dental operatory is known. CONCLUSION: The evidence for deciding on optimal fallow period is limited and still being explored, resulting in substantial variation across Canadian jurisdictions. A focus on developing scientific evidence relevant to dentistry and assimilating existing science is crucial to establishing consistency and uniformity in information to deliver safe oral health care services.

This study is the first to identify and investigate German dentists tried for war crimes by British courts after 1945. Drawing on wide-ranging archival court documents and sources from various international archives, we found and studied 11 dentists from the Third Reich who were put on trial, the majority of whom were accused of manslaughter, homicide or being accessories to murder. Of the accused, two were sentenced to death while the rest (n = 9) were forced to serve prison sentences. After their release, all nine of these dentists were able to resume and advance their professional careers in Germany, most as owners of a private dental practice (n = 8) and one as a clinic director. Many settled in small towns, where they became esteemed members of their local communities.

Electrolyzed waters, containing mainly hypochlorous acid, are used in dental practice because of their high microbicidal effect. For wider use, three neutral electrolyzed water-based gels, namely, HOCl-containing aqueous gels were prepared with a thickening/gelling agent in this study. We evaluated their microbicidal effects against four strains and storage stabilities indicated by available chlorine concentration. Immediately after preparation, all gels (70 ppm) could completely remove microbes by a 3-min treatment. The gel prepared with xanthan gum remarkably reduced its available chlorine concentration even under shaded and refrigerated storage conditions, failing to maintain its microbicidal effect following 1-day storage, whereas other gels, prepared with carboxyvinyl polymer or agar, maintained effective concentration (>20 ppm), with high microbicidal effects following 9-day and 21-day storage, respectively. Neutral electrolyzed water-based gels might be useful to remove oral microbes. Based on our results, agar is the most suitable thickening/gelling agent from the viewpoint of storage stability.

The objective of this article is to review the role of the dentist in the early diagnosis of pediatric obstructive sleep apnea (OSA) and to provide an in-depth review of the best evidence-based practices available to treat and/or to refer these patients for intervention. Material and methods A narrative review was performed using indexed data bases (PubMed, Medline, EMBASE, OVID, Scopus and Cochrane) up to year 2020, and approximately 1000 articles were reviewed. The articles included were those with the best information provided. Results Detailed review of the literature suggests that the role of the dentist has been redefined owing to their expertise in the orofacial region. Every patient consulting a dental practice is not merely a dental patient; he/she also requires a comprehensive medical review. The role of the dentist is pivotal in pediatric patients once diagnosed with OSA; as the patients grow, growth modification can be achieved, and future management will be easier. Initiating dental treatments during growth can benefit patients two-fold, saving them from malocclusion, and intervening in orofacial structural growth can help to avoid cumbersome treatments, such as CPAP and various surgeries. Proper diagnosis and management of systemic illnesses can prevent compromised quality of life, delays in treatment, morbidity and, in some cases, mortality.

OBJECTIVES: To describe treatment and monitoring outcomes of posterior teeth with cracks at baseline followed in the National Dental Practice-Based Research Network for up to three years. MATERIALS AND METHODS: Two hundred and nine dentists enrolled a convenience sample of 2,858 patients, each with a posterior tooth with at least one visible crack and followed them for three years. Characteristics at the patient, tooth and crack level were recorded at baseline and at annual recall visits. Data on all teeth referred for extraction were reviewed. Data on all other teeth, treated or monitored, seen at one or more recall visits were reviewed for evidence of failure (subsequent extraction, endodontics or recommendation for a re-treatment). RESULTS: The survival rate for teeth with cracks at baseline exceeded 98% (only 37 extractions), and the failure rate for teeth that were treated restoratively was only 14%. Also, only about 14% of teeth recommended at baseline for monitoring were later recommended to be treated, and about 6.5% of teeth recommended for monitoring at baseline were later treated without a specific recommendation. Thus, about 80% of teeth recommended at baseline for monitoring continued with a monitoring recommendation throughout the entire three years of the study. Treatment failures were associated with intra-coronal restorations (vs. full or partial coverage) and male patients. CONCLUSIONS: In this large 3-year practice-based study conducted across the United States, the survival rate of posterior teeth with a visible crack exceeded 85%. CLINICAL RELEVANCE: Dentists can effectively evaluate patient, tooth, and crack level characteristics to determine which teeth with cracks warrant treatment and which only warrant monitoring.

The UK Dental Medicines Advisory Service (UKDMAS) provides advice to dentists and other dental healthcare professionals concerning the use of medicines and medical devices in dentistry. The commonly asked questions posed to the UKDMAS concerning the prescribing, administering or dispensing of medicines in dental practice are discussed with answers supplemented by relevant information from clinicians. These include: different classes of medicines, unlicensed medicines, prescriptions, Patient Group Directions, Patient Specific Directions and dispensing of medicines - if appropriate.

Background: Every effort needs to be made to better understand the current state of practice and trends relating to root caries management which will be of benefit to dentists universally in the practice of dentistry. Aim: This article presents a multicountry questionnaire survey of the current state of practice in the management of root caries among dentists in nine different countries to get a wider range of opinions and perspectives. Methodology: A questionnaire related to root surface caries was distributed among practicing dentists in nine different countries, namely the United Kingdom, Libya, Jordan, Saudi Arabia, Egypt, Brazil, India, Malaysia, and Iraq. Questionnaire responses were analyzed, and the results were compared among groups. Results: The results showed statistically significant differences among dentists in most questionnaire aspects. Bleeding is the greatest obstacle facing dentists when restoring root surface lesions. Reported survival rates reflect uncertainty about the material and/or approach of choice in the management of root surface caries. Conclusion: This questionnaire survey revealed the current status of management of root surface caries in clinical practice in various countries. Substantial attention is required to bridge the knowledge gap and address the current void of uncertainty as relates to root caries management by providing a common ground for communication between dentists from all around the globe. In all, this work found a degree of consensus at the international level on what appears to work well among the dental practices surveyed and identified several issues with existing approaches that need to be addressed in future studies.

Objectives Most dentists maintain awkward and restricted postures for prolonged periods that stress the body while providing direct patient care. Information about working posture must be analysed in a more systematic manner to provide a deeper understanding of the relationship between working posture and work-related musculoskeletal disorders (MSD). Therefore, the present study aimed to clarify the effects of different lines of vision during tooth preparation, such as the direct and the mirror view technique, on-body tilt (angle), muscle activity, and sitting balance, which may correlate with the reduction or prevention of MSD. Methods A mannequin head with a maxillary right first molar embedded in a model was attached to the dental chair headrest. Two different techniques for tooth preparation were selected: direct view and mirror view. Muscle activity, body tilt (angle), and sitting balance were analysed as independent parameters. Results Different tooth preparation techniques had a distinct influence on body tilt (angle), muscle activity, and sitting balance. The direct view technique resulted in significantly larger values for all parameters, except for the activity of the spinal column erector muscles than the mirror view technique. Conclusion Based on these results, the direct view technique for tooth preparation, which is used by most dentists in practice, imposes a burden on the lower back, shoulders, and neck of the dentist.

The primary aims of the present study were (1) to quantify and characterize anaphylactic type I reactions related to local anesthetics (LAs) drawing on the French Pharmacovigilance Database System over a 35-year period and (2) to focuse on reactions associated with dental procedures. The secondary aim was to infer an incidence rate in dental practice. All cases of anaphylactic reactions were selected using the algorithmic Standardized MeDRA Query “anaphylactic reaction.” For each reaction, comprehensive data were collected, in particular the severity of symptoms, risk factors for anaphylaxis, and allergy testing. Imputability was assessed and a crude incidence rate in dental practice was estimated. The first-line search identified 416 anaphylactic reactions, mostly of grade II (138) or III (240) severity. When restricted to dental practice, this number fell to 26 (grade I: 4; grade II: 10; grade III: 11; and grade IV: 1). Lidocaine was most often involved (81.49%) and mostly associated with anaphylactic reactions of grade II and III. Overall, 11 cases of fatal anaphylaxis were recorded, but no in dental practice. In dental practice, lidocaine was also the most frequently involved LA (57.69%). All these findings highlight the very low incidence of type I-IgE-mediated reactions to LA, particularly in dental practice. The incidence rate of LA anaphylctic episodes in dental practice was estimated as 0.0261 anaphylactic episodes per million LA cartridges. True anaphylactic reactions to LAs do occur and may justify a thorough investigation in dental practice.

Objective To assess Indonesian dentists' knowledge of risk factors and diagnostic procedures related to oral cancer (OC) and to determine the factors that influenced their level of knowledge. Methods A modified version of a questionnaire that had been used to assess dentists’ knowledge regarding OC in Canada was used. A total of 816 dentists were invited to participate in the study. Results The total response rate was 49.2%; however, the number of dentists from 5 regions in Jakarta were equally represented. Use of tobacco or alcohol and history of previous OC were the top 3 risk factors that were answered correctly by dentists, but there was a high proportion of dentists who considered some without any evidence as risk factors. Almost half of the dentists did not know the early signs of OC and that erythroplakia and leukoplakia were associated with increased risks of developing OC. Only about 27% of dentists had a high level of knowledge of risk factors and fewer dentists demonstrated a good knowledge of diagnostic procedures. Dentists’ age group, year of graduation, and experience of continuing education significantly influenced the level of knowledge of diagnostic procedures (P Conclusion Dentists in Jakarta had a considerable level of knowledge of major risk factors of OC, although some gaps in their knowledge, especially in diagnostic procedures, were present. Increasing these competencies may aid in the prevention and early detection of OC.

Purpose The clivus is a region in the anterior section of the occipital bone that is commonly imaged on large-volume cone-beam computed tomography (CBCT). There have been several reports of incidental clivus variations and certain pathological entities that have been attributed to the variations. This study aimed to evaluate the effects of these variations within the scope of dentistry. Materials and Methods Medical databases (PubMed, Scopus, and Web of Science) were searched using a controlled vocabulary (clival anomalies, cone-beam CT, canalis basilaris medianus, fossa navicularis magna, clival variation). The search was limited to English language, humans, and studies published in the last 25 years. The articles were exported into RefWorks® and duplicates were removed. The remaining articles were screened and reviewed for supporting information on variations of the clivus on CBCT imaging. Results Canalis basilaris medianus and fossa navicularis magna were the most common anomalies noted. Many of these variations were asymptomatic, with most patients unaware of the anomaly. In certain cases, associated pathologies ranged from developmental (Tornwaldt cyst), to acquired (recurrent meningitis). While no distinct pathognomonic aspects were noted, there were unique patterns of radiographic diagnosis and treatment modalities. Most patients had a normal course of follow-up. Conclusion Interpretation of CBCT volumes is a skill every dentist must possess. When reviewing large-volume CBCT scans, the clinician should be able to distinguish pathology from normal anatomic variations within the skull base. The majority of clivus variations are asymptomatic and will remain undetected unless incidentally noted on radiographic examinations.

Objective This systematic review updates the evidence for association between oral health characteristics and frailty status, identifying gaps in translational dental research and application of frailty assessment into clinical practice. Background Clinicians have little guidance on stage-appropriate dental treatment for medically complex older adults. Oral health characteristics have been associated with frailty status, determined through validated assessment tools representing a concise measure of health. Translation of frailty assessment into dental practice has not been the focus of previous reviews. Methods Utilising the PRISMA framework for systematic reviews, a comprehensive database search identified articles describing the association of interest. Those included were cross-sectional or longitudinal, in English, included participants aged 50 years or older, used validated frailty assessments and measured clinically relevant oral health outcomes. From 835 screened articles, 26 full-text articles were eligible for quality appraisal and synthesis. Results Frailty prevalence ranged from 8.5% to 66.0%. Most studies utilised the Fried frailty criteria. Qualitative synthesis of 17 cross-sectional and nine longitudinal studies demonstrated significant covariate-adjusted association between frailty status and number of teeth, chewing ability, prosthetic characteristics, dental caries, periodontitis, dental utilisation and oral health-related quality of life factors. Variability in findings reflected study sample diversity based on country of study origin, age at recruitment, sample size, frailty assessment type, use of clinical versus self-reported outcome measures and differences in statistical analysis. Conclusion Despite robust evidence of association with oral health characteristics, frailty assessment has yet to be sufficiently applied to translational dental research and clinical practice.

The misuse of drugs of dependence is a major public health issue in Australia, and prescribing of these medications by dentists has increased in recent years. While there has been much focus on the appropriate indications and clinical use of these medicines in dental practice, the legal requirements of prescribing are equally important. Dental practitioners need to be aware of their legal obligations, as inappropriate prescription practices may lead to regulatory or criminal prosecution. Although dentists hold registration through the National Scheme and there is nationally standardised scheduling of drugs in Australia, the legislation governing drug laws differs for each state and territory, especially when prescribing drugs of dependence. This article summarises the legislation governing the prescription of drugs of dependence in Australia that is relevant to dental practice, providing insights into how dentists might contribute to the appropriate, safe and legal use and management of these medications.

Cleft lip and palate (CLP) is the most common of craniofacial anomalies in humans. CLP results from disruption of embryonic processes during orofacial development; while syndromic clefts may have clearer aetiology, non-syndromic clefts are heterogeneous in aetiology. It is important for GDPs to understand the classification of CLP and the structure of centralized cleft centres in order to communicate with cleft teams. This article aims to clarify the role of GDPs within cleft management and discusses challenges in maintaining oral health in this group of patients, including increased risk of dental caries and periodontal disease, dental anomalies and psychosocial considerations. CPD/Clinical Relevance: The GDP should be responsible for maintaining good oral health for the patient with cleft lip and palate, focusing on prevention from a young age and restorative work if needed.

Background/purpose Several pharmacotherapeutic methods have been used for the treatment of COVID-19 with varying degrees of success. No definitive treatment or vaccine has been officially approved to-date. This review aimed to highlight COVID-19 pharmacotherapeutic agents that are relevant to dental practice in terms of their clinical indications in COVID-19 and dental practice, as well as their adverse effects as they impact the dental patient. Material and methods Systematic search was performed using the following keywords combinations: Pharmacotherapy AND COVID-19 OR Pharmacotherapy AND SARS-CoV-2 OR Treatment AND COVID-19. Studies were categorized according to the type of pharmacotherapy used. Pharmacotherapeutic agents were extracted and only those relevant to dental practice were included for review. Results For analysis, a total of 79 clinical trials research articles were included that included COVID-19 pharmacotherapeutic agents relevant to dental practice. Those were analgesics (paracetamol; non-steroidal anti-inflammatory agents); antibiotics (azithromycin, doxycycline, metronidazole); antivirals (penciclovir); and immunomodulatory agents (hydroxychloroquine, corticosteroids). While some COVID-19 drugs are less relevant to dental practice, as antivirals and hydroxychloroquine, their association with long-term adverse effects requires adequate knowledge among dental practitioners. Conclusion Many of COVID-19 pharmacotherapeutic agents are used to treat oral diseases particularly orofacial pain and inflammatory conditions. Furthermore, some of these drugs may induce adverse effects that complicate dental treatment. Thorough knowledge of COVID-19 therapy and its dental implications is essential for dental practitioners, and is expected to contribute to a better understanding and effective utilization of these therapeutic agents.

This article aims to help the practitioner identify structures found in routine three-dimensional imaging studies of the head and neck region and understand their significance and possible need for intervention. The prevalence of advanced imaging in dental practice, especially cone beam computed tomography, highlights the need to recognize and identify various high-density structures that are, in fact, soft tissue calcifications or alterations of normal bony anatomy. The wide range of these findings includes both benign and malignant pathologic entities as well as age-related calcifications and remodeling of normal anatomic structures and dystrophic calcifications.

The COVID‐19 pandemic has posed an extraordinary challenge to the world. Dental healthcare personnel are considered to be at high risk as they work in close proximity to the oral cavity of patients. New procedures of approach and management should be incorporated in different aspects of routine dental practice. In addition, pediatric dentists are posed with unique and extraordinary challenges of parental anxiety and behavioral guidance of pediatric patients and parents/guardians. The aim of this study was to highlight the changing perceptions of pediatric dental practice as the ‘new normal’ in the post‐COVID era.

Healthcare-associated infections are well-studied in the literature, but remain a significant challenge for healthcare workers (HCWs) in dental practice. This type of infection is strongly correlated with the hand route of transmission of infectious agents. Thus, hand hygiene can be considered a crucial element in the prevention and control of infections.The coronavirus disease 2019 (COVID-19) outbreak is an experience of a new human coronavirus infection that has been difficult for HCWs, such as dentists and dental assistants, to control. Handwashing (HW) is a keystone method for the prevention and control of spreading severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).In healthcare settings, contrary to the general consideration of HW as a simple practice, HW is regarded as a specific procedure that should be clearly instructed to HCWs. Handwashing is based on using a correct method and the necessary equipment, and its role should be continually emphasized to reinforce compliance. Proper HW might contribute to avoiding possible cross-infection during healthcare activities, particularly in the pandemic situation.The aim of this article was to report on different HW techniques in medical and dental practice, and appropriate HW equipment to perform this simple but important procedure to prevent cross-infection, particularly during the current COVID-19 outbreak.

Introduction: Gender-based preferences are common in dental practice and maybe even more prevalent in academic dentistry. A large number of females have been entering the practice of general dentistry for the past two decades. The present study was done to assess dental students' perception of gender preferences in dentistry using a questionnaire in Saudi Arabia. Materials and Methods: A survey was conducted using a pretested questionnaire among dental interns pursuing their internship at different dental schools in Saudi Arabia. The questionnaires were distributed to 482 interns who were willing to participate in the survey. All the responses were collected, tabulated, and analyzed accordingly using appropriate statistical methods. Results: Four hundred and eighty-two dental interns (180 males and 302 females) responded to the survey. Most female interns (68%) prefer female patients for their treatments to the opposite gender. Seventy-five percent of the male interns felt more capable than females to handle stress and workload associated with branches such as prosthodontics, surgery, and implantology. 52.1% felt that female students fared well in academics. Conclusion: The present study shows that more females are taking up this profession in the current situation. It also shows that females are as competitive as males in dentistry and that most of the dental interns want to take up postgraduation after completion of the course. Both males and females are given equal working space and respect in this field of dentistry.

Objective: To investigate the impact of the Covid-19 pandemic on the patient flow and economy as experienced by dental practices in Denmark. Material and methods: A survey regarding experience of patient flow, economical turnover, financial strain and willingness to pay for large treatments during the first year of the Covid-19 pandemic (March 2020 to March 2021), along with information on the characteristics of the practice (specialist practice, ownership, practice operation and size) was distributed to all dental practices in Denmark in March 2021. Results: Of the 1728 practices, 581 (33.6%) answered the survey. A decline in patient flow and a decline in economical turnover were reported by 79% and 84.4% of the practices, respectively. Financial strain was reported by 15.8% and an increased willingness to pay for large treatments was reported by 32.1%. A large decline in turnover and financial strain were associated with non-specialized practices, practices with a single owner and small practices. Logistic regressions showed that practices not receiving referrals had an odds ratio of 2.34 (CI: 1.32-4.14) for having a large decline in economic turnover compared with practices receiving referrals and that small practices had an odds ratio of 1.92 (CI: 1.16-3.19) for reporting financial strain compared with large practices. Conclusions: Reportedly, the Covid-19 pandemic resulted in a decline in both patient flow and economical turnover in Danish dental practices. Large and more specialized practices seem to have managed the economic crisis better.

Objectives: To evaluate the pediatric dental practices and precautions taken during the period of COVID-19 outbreak and how could the decrease in oral health services lead to increase disk of oral problems such as the spread of dental caries, oc-clusal discrepancies and in appropriate antibiotic prescription in children. Materials and Methods: A web-based survey was conducted to pediatric dental specialists in Egypt. An online questionnaire was used to collect data and a message explaining the purpose of the study was sent to all participants. Results: 33.3% of respondents suspended their dental practice during this period, 41.1% performed only emergency treatment and 25.6% provided their regular preventive and therapeutic services. The estimated percentage of patients at high risk of caries from March to June was 2.4%, 2.8% and 3.52% respectively. Regarding occlusal discrepancies it increased from 1. 88% in March to 2.6% in July. Antibiotic prescription increased from 2.85% in March to 4.85% in July. There was a significant difference between the type of speciality and the percentage of participants not practicing dentistry. Conclusion: Decreased dental practice and preventive services of paediatric dentists during the COVID-19 lock-down period estimated increase in caries risk, antibiotic prescription, and occlusal discrepancies in children. Good degrees of awareness of the COVID-19 precautions and infection-control measures among the pediatric dental practitioners in Egypt. © 2021 Gehan Gaber Allam.

Introduction Osteosarcoma is the most common primary malignant bone tumour, usually arising in the long bones, with occurrence in the head and neck accounting for 8% of all osteosarcomas. Clinical features include swelling, pain, facial dysesthesia and abnormal mobility of teeth. Treatment consists of a combination of surgery, radiotherapy and chemotherapy.Case series Here, we present four cases of osteosarcoma of the jaws - two maxillary and two mandibular. All cases were initially assessed in the dental primary care setting before being referred for specialist opinion.Discussion The purpose of this paper is to present an overview of an uncommon but serious disease which can mimic common life-threatening dento-facial conditions. We discuss the diagnostic features, with an overview of clinical, histopathological and radiographic features.Conclusion These cases are important reminders of the potential clinical and radiographic appearance of a rare cause of facial swelling, and highlight the role of the general dental practitioner in early diagnosis and referral.

Introduction- Improvements in oral health and oral healthcare have resulted in people usually retaining at least some natural teeth for life. Increased numbers of older patients require complex dental treatment as their dentition is already heavily restored. Treatment needs are often complicated further by acute and chronic medical conditions that become more common with increasing age.\ud \ud Objectives- To explore the access to daily oral care and access to dentistry for those living in a residential care home.\ud \ud Methods- For this research, a residential care home and a dental practice within the local area to the care home was approached. A total of 45 participants were interviewed.\ud \ud Statistical Analysis- Semi-structured interviews with three separate cohorts were performed, the patients or their friends and families, care home staff, and the dental teams. The data were analyzed using thematic analysis.\ud \ud Results- The three cohorts of patients had similar concerns in accessing the dentists including transport, communication, training, and the need for raised awareness of the importance of oral health. The access to daily oral care was impacted upon by apathy and lack of education or training.\ud \ud Conclusion- Better training is required for care home staff and older people living in care on the importance of oral health. The provision of dental services for this community could be delivered differently with a focus on preventing and maintaining independence as long as possible.

There are around 8,500 new cases of oral squamous cell carcinoma (SCC) diagnosed in the UK each year and the incidence appears to be increasing. Although surgical and non-surgical treatment options have improved significantly in the last few decades, five-year survival has not, with an average five-year survival of 56% in the UK. Providing patients have access, there are frequent opportunities for oral cancer screening by their general dental practitioner. We present two cases of SCC managed in our department, both of whom were referred following a protracted period of review in general dental practice, where the initial 'benign diagnoses' were not re-evaluated during this time. This delay can considerably impact on patient outcomes, including survival. We outline each patient's clinical course, and key learning points to help dental practitioners detect lesions that require prompt referral to the oral and maxillofacial service for urgent investigation., Key points Describes two cases of delayed referral of oral squamous cell carcinoma and their clinical progression. Outlines key learning points to help dental practitioners detect lesions requiring urgent referral. Provides the reader with an overview of oral cancer including risk factors, signs and symptoms. Emphasises why early referral is essential for improved prognosis.

Objective: Novel newly discovered coronavirus, also known as severe acute respiratory syndrome coronavirus-2, is a recently emerging virus that has been rapidly spreading globally since December 2019. Due to the vicinity inoro-dental treatment and aerosol production, people inside the dental office are at high risk of being infected with severe acute respiratory syndrome coronavirus-2. This guideline aims to protect the dental health-care workers during their plans to re-open and increasingly continue their routine services until further notice from their governing body. Methods: A panel of experts in dentistry and infection prevention and control reviewed the local and global research and guidelines related to infection prevention and control during coronavirus disease-2019, along with the re-opening guidance provided by different entities. Results: Such a document might either be adopted or adapted to any regional and international organization that wishes to use a revised professional guideline in infection prevention and control dental services. Conclusion: A careful re-opening plan should be developed and implemented, including strict infection control measures before resuming the dental practice.

Background Extraction of mandibular third molars (M3M) close to the inferior alveolar nerve (IAN) has a higher risk of neurological disturbance. This review aims to evaluate the evidence supporting the use of the coronectomy technique compared to complete extraction for such M3Ms. Case studies by a specialist oral and maxillofacial surgeon are included to illustrate clinical practice. Methods Three databases (Cochrane Library, Embase, PubMed) were searched (November 2020). Additional articles were sought by hand searching the reference list of included articles. All studies published in English comparing outcomes of coronectomy with complete extraction with at least 50 subjects and 6 months follow-up were included. Results Of the six included studies, five reported a lower rate of IAN disturbance after coronectomy compared with complete extraction. There were no reported cases of lingual nerve disturbance. Other outcomes of coronectomy such as pain, infection, alveolar osteitis were either similar or lower compared to complete extraction. There were high rates of root migration but low rates of exposure and reoperation. Follow-up protocols varied considerably. Conclusions There is medium quality evidence to support the option of coronectomy for high risk M3M cases. Further studies to develop follow-up protocols to assist general dental practice is warranted.

The routine scale and polish is the most commonly performed treatment procedure in general dental practice. With a large proportion of state dental health expenditure in the UK and Ireland being used to provide ‘routine scale and polish’ treatments, it is necessary to establish the true value of this treatment for patients. In this narrative review, we discuss the available evidence regarding provision of the routine scale and polish. Based on the available studies, there is little evidence to support the use of the routine scale and polish alone for the prevention of periodontal disease. CPD/Clinical Relevance: This paper evaluates the evidence surrounding the routine provision of scaling and polishing for the prevention of gingivitis and periodontitis.

Objectives To present the treatment approach for the restoration of localised anterior erosive wear using a combination of dental materials.Clinical considerations A patient presented in a private dental practice concerned about the aesthetics of his anterior teeth. The patient's history and clinical examination revealed erosive wear on the labial and palatal aspects of his maxillary central incisors and right lateral incisor. The formulated treatment plan was to restore the teeth in a conservative way. A diagnostic wax-up was performed and confirmed with the patient with chairside mock-up. The treatment provided included direct composite restorations, replacement of a porcelain-fused-to-metal crown on his left lateral incisor with a porcelain-fused-to-zirconia crown, and lithium disilicate ceramic veneers on the worn labial surfaces of the central incisors and the right lateral incisor. The preparations for the ceramic veneers were carried out with the aid of the diagnostic mock-up, thus minimising the need for tooth removal of the worn teeth.Conclusions Pre-operative planning for tooth surface loss cases can help to ensure that little or no remaining tooth structure is removed during the restorative procedures. A strict bonding protocol is crucial to ensure longevity of the restorations.

Introduction:The coronavirus disease 2019 (COVID-19) pandemic has created a new scenario for dental practice, and teledentistry (TD) is a field of relevance for dentists.Objective:To evaluate the impact of the COVID-19 pandemic on the knowledge, practices, and expectations of dentists toward TD and its association with sociodemographic variables.Methods:A cross-sectional survey was administered to dentists in Colombia as part of global research on the impact of COVID-19 on dentistry. The core questionnaire included 5 additional questions on TD that were added by the Colombian research team in 5 domains about TD: Q1, knowledge; Q2, practices; Q3, expectations; Q4, usefulness; and Q5, reimbursement. Sociodemographic variables were also measured. The questionnaire was validated in a pilot test and administered via digital media. Descriptive and bivariate analysis for sociodemographic and TD variables were done. For the evaluation of the chances of a determined answer, an ordinal multinomial logistic regression (Q1 and Q2) and binomial logistic regression (Q3 and Q5) analyses were made.Results:In total, 5,370 dentists answered the survey (women: 3,878; mean age: 45 y). The response rate of the survey was 16.84%. Knowledge and practice of TD before the COVID-19 pandemic were both low (25.75% and 12.42%, respectively); however, since the beginning of the current pandemic, knowledge increased by 62.72% and practice by 42.53%. Some 93.1% of respondents considered that TD could be useful in their clinical practice, and 59.55% would consider practicing it after the pandemic. A high number of dentists (88.58%) did not charge for these services. Logistic regressions showed significant differences according to sociodemographic variables.Conclusions:The COVID-19 pandemic has had a great impact on TD, increasing knowledge and practice significantly. Dentists expect to continue practicing TD in the future. However, some geographical, technological, and attitudinal barriers need to be broken down to increase daily use of TD.Knowledge Transfer Statement:This article provides an overview about the impact of COVID-19 pandemic in the knowledge and attitudes about teledentistry (TD) in general dentists and both clinical and nonclinical specialists. Although some barriers to the use of TD continue, this pandemic brought with it a new scenario for dental practice, which must be implemented through training for professionals to increase its use.

Abstract Objectives The present study aimed to investigate the dentists’ knowledge of the risks from the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and how it will impact their practice. Materials and Methods An ad hoc self-administered anonymous questionnaire was submitted to Italian dentists. Statistical Analysis Differences in rates were calculated using the chi-square test. The level of significance was set at p < 0.05. Results A total of 849 dentists fully completed the survey. Eighty-eight per cent of Italian dentists are worried about the health of their families, with no difference in high-risk (red zone) and low-risk (orange zone) regions. About 86% of professionals report some income loss and 94% fear a drop in patients after the quarantine phase, with the dentists working the red zone claiming a greater economic loss and fearing a reduced practice after the end of the lockdown. Discussion A large majority of the Italian dentists appears to be aware of the need for changes in their dental practices by planning specific sterilization processes between appointments, testing patients for SARS-CoV-2 serology, asking patients not to be accompanied, and reducing the number of visits per day. Conclusion The survey expresses the serious concern of the dentists for the pandemic’s effects on their profession.

Background Limited evidence is available regarding dentists' knowledge and interpretation of infective endocarditis (IE) prophylaxis guidelines. The aim of this study was to determine understanding and management of rheumatic and non-rheumatic valvular heart disease (VHD) in the dental setting in Western Australia (WA). Methods A cross-sectional survey of dentists within Perth utilised an online Qualtrics questionnaire developed after consultation with stakeholders. A sampling frame was compiled from the Australian Health Practitioner Regulation Agency with contact details obtained from the White Pages (online), using five quintiles of Socio-Economic Indexes for Areas according to dentist's place of practice. Results Of 41 (13.7% of 300 approached) dentists completing the survey (95.1% general dentists, mean years of practice=15.6), 90.2% reported following the Australian Therapeutic Guidelines (ATG) regarding IE antibiotic prophylaxis in VHD. Most (92.7%) were unaware of the rheumatic heart disease (RHD) control program. Nearly all participants indicated prophylaxis for clearly invasive procedures such as tooth extraction (100.0%) and periodontal surgery (95.1%). Many dentists made the decision to prescribe antibiotics themselves (36.6%). Conclusions The majority of dentists followed the ATG's IE prophylaxis recommendations for cardiac lesions and dental procedures. There was limited knowledge of the national RHD guidelines and the WA RHD control program.

The current study was aimed to verify whether pediatric dentists could determine chewing performance level in children by using Karaduman Chewing Performance Scale (KCPS). Typical developing children and children with cerebral palsy (CP) who were referred to pediatric dentistry above the age of 2 years were included in the study. The chewing performance level was scored according to KCPS. One experienced physical therapist and three pediatric dentists independently assessed the chewing videos of the children and scored each child’s chewing function. The correlation between the KCPS scores of the physical therapist and the pediatric dentists was used for reliability. The agreement between the scorings of the physical therapist and pediatric dentists was assessed using Fleiss kappa statistics. Fifty-four typical developing children and 43 children with CP were included. A strong positive correlation between the KCPS scoring of the physical therapist and pediatric dentists was found (r=0.911–0.939, p

A tuberosity fracture can prevent or delay the timely delivery of the most appropriate treatment option for a maxillary molar. This is a relatively common complication, but should not prevent treatment in general practice provided the clinician has adequately risk assessed, planned and obtained informed consent. Should a fracture occur, its initial management in general practice is encouraged. This article aims to improve patient outcomes by providing a troubleshooting guide. A fracture classification is suggested to aid assessment, recognition and management. Should referral to secondary care be required, a classification system will provide a basis for discussion and clarity on further management. CPD/Clinical Relevance: This article provides a tuberosity fracture classification to guide clinicians in the management of patients who have sustained such a fracture.

Background The authors of this practice-based study estimated the risk of experiencing tooth fractures and crack progression over 3 years and correlated baseline patient-, tooth-, and crack-level characteristics with these outcomes. Methods Two-hundred-and-nine National Dental Practice-Based Research Network dentists enrolled a convenience sample of 2,601 participants with a cracked vital posterior tooth that had been examined for at least 1 recall visit over 3 years. Data were collected at the patient, tooth, and crack levels at baseline, annual follow-up visits, and any interim visits. Associations between these characteristics and the subsequent same-tooth fractures and crack progression were quantified. Results Of the 2,601 teeth with a crack or cracks at baseline, 78 (3.0%; 95% confidence interval, 2.4% to 3.7%) subsequently developed a fracture. Of the 1,889 patients untreated before year 1, 232 (12.3%; 95% confidence interval, 10.9% to 13.8%) had some type of crack progression. Baseline tooth-level characteristics associated with tooth fracture were the tooth was maxillary and had a wear facet through enamel and a crack was detectable with an explorer, on the facial surface, and in a horizontal direction. Crack progression was associated with males and teeth with multiple cracks at baseline; teeth with a baseline facial crack were less likely to show crack progression. There was no commonality between characteristics associated with tooth fracture and those associated with crack progression. Conclusions Development of tooth fractures and crack progression over 3 years were rare occurrences. Specific characteristics were associated with the development of tooth fracture and crack progression, although none were common to both. Practical Implications This information can aid dentists in assessing factors that place posterior cracked teeth at risk of experiencing adverse outcomes.

INTRODUCTION: The COVID-19 pandemic has had wide-ranging effects on dental practice across the world. In particular, if has also affected the training of dental residents, who are specialists in training. Thus, the aim of this study was to assess the knowledge, perception and attitude of dental residents in Nigeria to the pandemic and its perceived impact on the dental residency training programme across the country. MATERIALS AND METHODS: This was a cross-sectional study of dental residents in teaching hospitals across Nigeria. Self-administered questionnaires were distributed to consenting participants through an online data collection platform (Google forms), between April and June 2020. Data were collected on sociodemographics, knowledge and awareness of coronavirus as well as impact of the pandemic. Data analysis was carried out with the Statistical Package for Social Sciences (SPSS) version 20. Level of significance was set at p-value

Introduction. Early diagnosis of calcified atheromas may decrease morbidity and mortality caused by brain and cardiovascular diseases, in which atherosclerosis is the main etiological factor of these pathologies. Dental examinations with the aim of detecting this pathology have been in progress since 1981, such as panoramic radiography, considered the most widely studied method for this diagnosis. However, some limitations of this exam have been reported with reference to inability to visualize the cervical region and difficulty of establishing a precise diagnosis because of many structures and calcifications that have similar radiographic characteristics. Case Report. The present study to describe a dental radiographic technique for establishing the differential diagnosis of calcified atheromas regarding other calcifications and reporting 3 clinical cases that demonstrate its effectiveness in different clinical situations. Discussion. Manzi Projection can promote a differential diagnosis of calcified atheromas in dental practice and consequently subsidize the clinician for referring the patient to the physician.

Background: Oral antiplatelet and anticoagulant drugs are widely used in a large number of patients visiting the dentist, and there has been much controversy over the years towards their clinical management. The aim to carry out a literature review in order to develop an update on dental management in anticoagulated and / or anti aggregated patients, focusing on oral surgery. Material and methods: A bibliographic search was carried out in PubMed on studies published between January 1, 2018, until December 10, 2020, using the keywords ('antiplatelet' OR 'antiplatelets') AND ('dentistry'), and ('anticoagulant' OR 'anticoagulants') AND ('dentistry'). Results: The number of studies included in this review was 13, and the number of patients among all of them was 3.497 patients under treatment with some type of antithrombotic drug, who underwent different oral surgery treatments. Conclusions: There is a low risk of peri- and postoperative bleeding events during basic oral surgery treatments in antiplatelet or anticoagulated patients, which can be easily managed through the use of local haemostatic measures. Keywords: Oral surgery, antiplatelet drugs, anticoagulant drugs, dental treatment.

Aim To investigate the dentists’ opinions towards social media (SM) use in daily practice and the expected limitations from its use in Saudi Arabia. Methods An electronic survey was carried out throughout May–June 2020 among a sample of dentists in Saudi Arabia. The survey covered three parts: the first part covered professional and demographic information, the second part covered the use of mobile phones and SM in dental practice, while the third part assessed dentists’ opinion on SM use. Descriptive statistics included frequency distributions and percentages and independent t test/ANOVA test for the relationship between the mean of dentists’ opinion towards SM and demographic variables. A p value of 0.05 or less was considered statistically significant. Results The majority of respondents (80%) believe that SM plays an active role in patients’ decisions regarding the selection of a healthcare provider. The mean dentists’ opinion scores on the use of SM were significantly lower among participants working more than 50 h per week compared with other participants (p = 0.014). Conclusion The majority of sampled dentists believe that SM plays an active role in patients’ decisions regarding the healthcare provider’s selection. Directed campaigns can help dentists optimize the use of SM for both professional and personal purposes.

Many viruses have been posing threat to the world from time to time and recently in this category, a novel coronavirus called COVID-19 (SARS-CoV2) was detected in December 2019 and is causing havoc all over the world COVID-19 spreading through person-to-person transmission routes including direct transmission, like cough, sneeze, droplet inhalation and contact transmission, like contact with oral, nasal and eye mucous membranes The operators in oral health care profession expose to great risk of COVID-19 infection due to face-to-face communication and their exposure to fluids from the conjunctiva, oral cavity, nose and also other body fluids, and handling with the sharp instruments Oral health care professionals (dentists and dental hygien-ists) play a prime role in preventing the spread of COVID-19 Several dental hospitals and clinics have been completely closed or have been providing minimal treatment for emergency cases However, prophylactic and emergency treatments are being provided in some countries and a few supporting regular dental treatment Oral health practitioners are prone to risk as they are hardly prepared for such unexpected global outbreak Lack of universal protocol or guidelines to control the infection and dental care provision during such a pandemic condition could be of better help The present study fills in the missing gap with necessary recommendations comprising of preventive steps for disease/infection transmission during dental practice to block the operator-to-patient and vice-versa transmission routes in dental clinics and hospitals © 2021, Radiance Research Academy All rights reserved

Background Several nonendodontic diseases can occur in the periapical region, resembling endodontic inflammatory conditions. Therefore, the aim of the present study was to determine the frequency of nonendodontic periapical lesions diagnosed in a Brazilian population. Material and Methods The files of two Oral Pathology laboratories were reviewed and all cases including at least one clinical diagnosis of endodontic periapical lesions were selected for the study. After initial selection, demographic and clinical data, clinical diagnosis and final diagnosis were reviewed and tabulated. Final diagnosis included endodontic periapical lesions, and benign and malignant nonendodontic periapical lesions. Data were descriptively and comparatively analyzed among the three groups, with a significance level of 5% (p0.05). Conclusions The frequency of nonendodontic periapical lesions was high and, although the general distribution was similar to the results from other populations, some features were probably associated with the profile of the studied populations and to the methods applied in the present study. Knowledge on differential diagnosis of endodontic and nonendodontic periapical lesions is essential to avoid unnecessary treatments and diagnostic delay in routine dental practice. Key words:Differential diagnosis, nonendodontic, periapical lesion, pulp necrosis.

The UK has an increasingly ageing population and, inevitably, the prevalence of anticoagulation among dental patients will grow. This same group of patients are retaining their natural teeth longer and will potentially require dental treatment and oral surgical procedures and so, general dental practitioners will need to be aware of the implications of anticoagulant drugs. Equally, to comply with requirements set by the General Dental Council's ‘Standards for the Dental Team’ it is imperative to ensure that, as clinicians, we put patients' interests first, and provide quality care based on current evidence. CPD/Clinical Relevance: It is important that dentists have knowledge and expertise to consult and treat medically compromised patients for patient safety and to adhere to best practice guidelines.

Coronavirus disease is now spreading in different countries of the world. The alarmism created through the media also creates confusion in people about virus spreading. The health care environments among which the dental practice could be places of spread of the virus, especially places where patients with systemic pathology could be exposed to this. The purpose of this article is to clarify coronavirus disease 2019 and its management in the dental practice. Only by following the normal guidelines on disinfection and sterilization of environments and operators, with some additional rules on the management of patients in the waiting room, it is possible to limit this risk. Limiting the risk of spreading the virus is one of the keys to its eradication.

Anaphylaxis is a severe and potentially life-threatening allergic reaction that can occur in the dental practice. There are a number of dental-related causes including mouthwashes, local anaesthetics, latex and antibiotics. The dental team must be able to respond effectively and manage the life-threatening situation appropriately following Resuscitation Council UK guidelines. The timely administration of adrenaline is life-saving; any delays can lead to a poor outcome. With the current national supply issues with adrenaline auto-injector devices, there is an expectation that GDPs should be competent at drawing up adrenaline from an ampoule and administrating it intramuscularly. The aim of this article is to provide an update on the management of anaphylaxis in the dental practice with particular reference to the procedure for intramuscular injection of adrenaline., Key points Anaphylaxis is a life-threatening emergency and the incidence is on the increase.Adrenaline needs to be administered promptly to optimise survival.GDPs need to be competent at administering adrenaline intramuscularly using a syringe and needle.

Covid-19 pandemic is a novel disease with gradual emergence of its signs and symptoms. Oral healthcare providers had a setback in their dental practices due to the high rate of infectivity and the risk of contracting the disease through the patients carrying the virus. Once the dental practice resumed to its normalcy the dental surgeons came across a variety of oral manifestations in patients with a history of Covid and post recovery. An attempt is made to recognise the Covid-19 oral manifestations with plausible explanation of the mechanism of development of such oral signs.

The objective of implementing newer techniques in dentistry is to overcome the shortcomings of traditional ones. Dentistry, being a dynamic field, is always on the lookout for innovative techniques, and embracing newer technology has indeed improved patient care in many ways. Lasersare being used as an adjunct or alternative tool to conventional dental procedures. Many dental disciplines such as oral surgery, oral medicine, periodontics, paediatric dentistry, implantology, and operative dentistry have benefitted from the use of laser technology. Lasers have become an invaluable tool in many procedures, including caries removal, caries decontamination, caries prevention, cavity preparation, soft tissue surgeries, root canal decontamination, analgesic and anti-inflammatory effects, to name a few. Laser treatment in dentistry can be quicker and more efficient. Other benefits would include markedly less pain, lack of bleeding, minimal need of anaesthesia and reduced postoperative discomfort. Also, patients may be able to resume their daily activities shortly after the treatment is rendered, owing to faster healing. However, the caveat would be that adequate training is a mandatory prerequisite before handling patients with these powerful instruments. This article briefly reviews the basic science of lasers and gives a brief account on the updates of their diverse applications in the general dental practice.

White spot lesions caused by enamel demineralization are frequently encountered in dental practice. Their management has always been an important issue in modern dentistry. However, the real dilemma was treating aesthetic demands with noninvasive or minimally invasive techniques preserving the natural tissues. The introduction of resin infiltration technique seems to provide an intermediary treatment modality between prevention and restorative therapy. This case report is aimed at reporting the management of MIH opacities in anterior teeth with resin infiltration technique.