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Mouth ulcers are common and produce a variety of symptoms, ranging from intermittent discomfort to debilitating pain with effects on speech, chewing and swallowing. Clinically, mouth ulcers can be challenging, as a wide range of diagnoses can give rise to lesions of similar appearance. Although the majority of lesions are benign and require little clinical input, others may signify undiagnosed systemic disease or malignancy, warranting prompt investigation and treatment. Separation of differential diagnoses is driven largely by a thorough history and identification of malignant features on examination. We provide an overview of mouth ulcers and a guide to management.

Objectives Our primary aim was to validate the Liverpool Peritonsillar abscess Score (LPS) externally in a new patient cohort. Our secondary aim was to modify the LPS in the light of the COVID‐19 pandemic to produce a no‐examination variant for use in this instance. Design Prospective multicentre external validation study. Setting Six different secondary care institutions across the United Kingdom. Participants Patients over 16 years old who were referred to ENT with any uncomplicated sore throat such a tonsillitis or peritonsillar abscess (PTA). Main outcome measures Sensitivity, specificity, positive predictive value and negative predictive value for both the original LPS model and the modified model for COVID‐19. Results The LPS model had sensitivity and specificity calculated at 98% and 79%, respectively. The LPS has a high negative predictive value (NPV) of 99%. The positive predictive value (PPV) was slightly lower at 63%. Receiver operating characteristic (ROC) curve, including the area under the curve (AUROC), was 0.888 which indicates very good accuracy. Conclusions External validation of the LPS against an independent geographically diverse population yields high NPV. This may support non‐specialist colleagues who may have concerns about mis‐diagnosing a PTA. The COVID‐19 modification of the LPS has a similar NPV, which may be of use where routine oral examination is to be avoided during the COVID‐19 pandemic.

Aim Recently, more and more dentists have found themselves engaging in the delivery of non-surgical facial aesthetics (NSFA) as part of their regular practice routine. NSFA is a growing field in aesthetic medicine that is practised by a range of clinicians including doctors, dentists and registered prescriber nurses and is an industry estimated to be worth over £3 billion in the UK alone. In the past few years, several public scandals in aesthetic medicine have prompted reactions by several bodies including the Government and Royal Colleges. With Health Education England (HEE) having recently released standards in education, it is clear that a shift in attitude towards training is imminent. With a large volume of dentists making up this NSFA workforce it is reasonable to consider the stance of undergraduate training and the relevance of the existing knowledge within dentistry in the context of the HEE standards.Method All dental schools in the UK were contacted to establish the range of subjects taught within the curriculum, with particular reference to those relevant to NSFA. The two largest aesthetic pharmacies were contacted regarding numbers of registered dentists they serve.Results Twelve out of 16 dental schools responded. Two-thirds of responding dental schools do not cover NSFA in their curricula. However, many dental schools cover related subjects including: facial anatomy/material science/neuromuscular junction physiology (100%), anatomy of the aging face (66%), pharmacology of botulinum toxin (25%) and ethical-legal implications of aesthetic dentistry/NSFA (50%/42% respectively).Conclusion Dentists are well placed to deliver NSFA given their background in relevant subjects and surgical training. With the emergence and growth of such a large multi-disciplinary field it is crucial that dentistry is not left behind. Just as most dental schools have embraced the evolution of cosmetic dentistry and implantology, it would be prudent to consider that training standards around NSFA are reflected in both undergraduate curricula and appropriate post-graduate clinical training for dentistry.

Introduction Communication is considered one of the cornerstones of clinical dentistry and is underpinned in the General Dental Council's Standards for the dental team. Communicating effectively with patients allows for more accurate identifcation of a patient's presenting complaint, better patient satisfaction, concordance, in?uences emotional and physical wellbeing, reduces dental anxiety and contributes to the satisfaction of both the patient and clinician. Identifying the clinical students' levels of confdence in a range of communication scenarios will help to highlight topics in which communication is strong and areas where there is a need for both didactic and communication scenario-based teaching. Methodology A paper-based, non-incentivised anonymised questionnaire was delivered to the clinical dental students of years 3, 4 and 5 of a fve-year undergraduate dental programme in a single UK institution. Dental students' self-reported confdence, or lack thereof, in dealing with various dental-themed communication scenarios were determined. A total of 167 students completed the questionnaire, comprising of 60 year 3 students, 51 year 4 students and 55 year 5 students. There were 57 males and 109 females in total. The data were analysed as a single cohort. Results Confdence in dental-themed scenarios across all years was reported at more than 78%. With respect to smoking, alcohol and cancer-themed scenarios, confdence was rated at 75%, 59% and 59% respectively. However, confdence was reported at only 27% for dental neglect and 14% for HPV-related scenarios. Conclusion Dental programmes must offer students a range of communication skill scenarios in a safe and simulated environment involving not just traditional dental scenarios, but more complex scenarios, that are deemed more diffcult to broach involving the interaction of HPV, oral cancer, systemic disease and dental neglect. Compared to all other domains that were examined, students reported confdence in dealing with HPV-related scenarios most diffcult. The General Dental Council and programme directors that formulate education curricula should consider including outcomes related to HPV, oropharyngeal cancer and its vaccine.