The aim of this article is to explore the use of Incognito™ Lite as an alternative to competitors advertising a ‘Smile in Six Months’ or rather short-term orthodontics for improving dental appearance through tooth moveme...The aim of this article is to explore the use of Incognito™ Lite as an alternative to competitors advertising a ‘Smile in Six Months’ or rather short-term orthodontics for improving dental appearance through tooth movement. The focus is on the varied clinical use of this appliance system and its comparative advantages, disadvantages and placement techniques. Some alternatives are discussed and appraised. Two cases successfully treated with Incognito™ Lite are then presented. Clinical relevance: A reliable and predictable tool for aesthetic alignment of teeth, creating a broader range of treatment options for both the clinician and the patient.
Cone Beam Computed Tomography (CBCT) has recently seen an expansion in use, however there are few robust, evidence-based guidelines to inform practitioners. This article reports the case of a large dentigerous cyst in th...Cone Beam Computed Tomography (CBCT) has recently seen an expansion in use, however there are few robust, evidence-based guidelines to inform practitioners. This article reports the case of a large dentigerous cyst in the maxilla affecting the eruption of multiple teeth, considers the use of CBCT in the management of such lesions, and discusses guidelines on the use of CBCT in dentistry. Clinical relevance: As CBCT use increases it is important that practitioners understand the guidelines surrounding its use. Due to the prevalence of dentigerous cysts, it is likely that they will be encountered clinically, and it is important that clinicians referring patients with such lesions are familiar with the principles of managing them.
Type-1 dentine dysplasia is a rare hereditary condition, associated with an abnormality in dentine formation. Deceptively, teeth have the clinical appearance of normality, however, radiographically, a different picture i...Type-1 dentine dysplasia is a rare hereditary condition, associated with an abnormality in dentine formation. Deceptively, teeth have the clinical appearance of normality, however, radiographically, a different picture is seen; with multiple periapical radiolucencies associated with non-carious, unrestored teeth. This article reports the diagnostic and management challenges associated with dentine dysplasia in adults. Clinical relevance: Early diagnosis and preventive advice within primary care are imperative in the long-term outcomes.
This review article aims to analyse whether patient feedback and questionnaires improve quality of care. It is recognized that patients cannot assess the medical competence of the clinician, yet patient experience provid...This review article aims to analyse whether patient feedback and questionnaires improve quality of care. It is recognized that patients cannot assess the medical competence of the clinician, yet patient experience provides an insight into the process of care through the patients’ eyes. Patient experience measures are more reliable for use to assess quality than patient satisfaction surveys. It is inappropriate to use patient satisfaction surveys as a basis for remuneration of dentists within the NHS. Patient Reported Outcome Measures (PROMs) have been a successful measure of patient experience in medicine and their introduction to dentistry needs to be considered. Clinical relevance: This article will enable clinicians to understand the importance of patient experience measures as a more reliable way of improving the quality of clinical care than patient satisfaction surveys.
This series of three papers reviews the causes, diagnosis and differential diagnosis, and outlines the management of sore and/or swollen lips. Clinical relevance: Sore and/or swollen lips are not uncommon, often have a l...This series of three papers reviews the causes, diagnosis and differential diagnosis, and outlines the management of sore and/or swollen lips. Clinical relevance: Sore and/or swollen lips are not uncommon, often have a local cause but may reflect a systemic disease. The previous 2 papers in the series discussed their causes. This paper reviews their diagnosis and treatment.
Short-term orthodontics (STO) serves to align anterior teeth. It has become popular in cosmetic dentistry as an alternative to destructive veneers and lengthy conventional orthodontics. The aim of this article is to rais...Short-term orthodontics (STO) serves to align anterior teeth. It has become popular in cosmetic dentistry as an alternative to destructive veneers and lengthy conventional orthodontics. The aim of this article is to raise awareness of the clinical limitations of STO and highlight some of the difficulties encountered with orthodontic retention. It also gives an overview of accredited training available to dentists who wish to develop their orthodontic skills. Clinical relevance: Greater awareness of the clinical limitations of short-term orthodontics will aid GDPs in appropriately selecting their cases and obtaining informed consent from patients. In addition, the article serves as encouragement for those GDPs wishing to develop their orthodontic skills and pursue further accredited training.
Improving patients’ aesthetics is an important request in daily practice. Tooth whitening is a treatment option available for improving aesthetics. This paper will pose questions asked by our patients on bleaching techni...Improving patients’ aesthetics is an important request in daily practice. Tooth whitening is a treatment option available for improving aesthetics. This paper will pose questions asked by our patients on bleaching techniques and outcomes and offer appropriate up-to-date answers. Clinical relevance: This paper addresses the most important questions raised by patients and colleagues concerning vital tooth whitening (VTW).
This is a case of a patient presenting to his general dental practitioner (GDP) with altered sensation in his lower lip with no obvious cause. Due to a prompt referral, the patient was investigated and diagnosed with an...This is a case of a patient presenting to his general dental practitioner (GDP) with altered sensation in his lower lip with no obvious cause. Due to a prompt referral, the patient was investigated and diagnosed with an extramedullary presentation of multiple myeloma. A numb lip can present in general dental practice, although this is not common. There are several causes, for example, dental infection or fractured mandible. Clinical relevance: It is very important for the dental practitioner to recognize when there could be a potential sinister underlying cause and prompt referral, under the two week rule referral system, is indicated
Dental fear in the paediatric population can be a significant barrier to providing optimal dental care. Pharmacological management techniques utilized to manage anxiety, such as conscious sedation and general anaesthesia...Dental fear in the paediatric population can be a significant barrier to providing optimal dental care. Pharmacological management techniques utilized to manage anxiety, such as conscious sedation and general anaesthesia, are expensive and require specialized equipment with additional staff training. With recent advances in technology, video glasses are an economic and novel distraction technique that may aid in improving behaviour management and facilitate dental treatment. Clinical relevance: Nervous children may find difficulty in accessing care owing to their inability to co-operate and accept dental treatment. This paper describes an innovative technique that may aid the clinician in overcoming this barrier.
The aim of this review is to update dental professionals on the issues and challenges associated with the clinical management of dentine hypersensitivity (DH) and to provide simple guidelines based on presenting clinical...The aim of this review is to update dental professionals on the issues and challenges associated with the clinical management of dentine hypersensitivity (DH) and to provide simple guidelines based on presenting clinical features that may help them successfully manage the condition in their day-to-day clinical practice. Details on the management of DH have been previously published in Dental Update which indicated that there was a need for such guidelines. The authors of these guidelines also suggested that, despite the various published clinical studies, there does not currently appear to be one ideal desensitizing agent that can be recommended for treating DH. A joint working relationship between the dental professional and the patient in changing the patient’s behaviour is therefore essential if the condition is to be successfully treated. Clinical relevance: Dentine hypersensitivity is a persistent and a troublesome clinical condition which at times is under diagnosed by dental professionals who may struggle to resolve the problem to their patients’ satisfaction successfully. The recent UK Forum guidelines on the management of DH, based on the presenting features of the condition, provide practical recommendations, helping dental professionals to manage this persistent problem correctly.
Phantom bite syndrome was first described by Marbach over 40 years ago as a mono-symptomatic hypochondriacal psychosis. He used the term to describe a prolonged syndrome in which patients report that their ‘bite is wrong...Phantom bite syndrome was first described by Marbach over 40 years ago as a mono-symptomatic hypochondriacal psychosis. He used the term to describe a prolonged syndrome in which patients report that their ‘bite is wrong’ or that ‘their dental occlusion is abnormal’ with this causing them great difficulties. This strong belief about ‘their bite’ being the source of their problems leads to them demanding, and subsequently getting, various types of dentistry carried out by multiple dentists and ‘specialists’. Sadly, even after exhaustive, painstaking, careful treatment, none of the dental treatments manages to solve their perceived ‘bite problems’. This is because they suffer from a psychiatric illness involving a delusion into which they continue to lack insight, in spite of the failures of often sophisticated dental treatments.1,2,3 In summary, dental practitioners, or other specialists, who suspect that they might be dealing with such a problem should refer these patients early on for specialist management by an appropriate specialist within the secondary care settings, preferably before they get trapped into the time-consuming quagmire of their management. A ‘Phantom Bite Questionnaire’, which is available to download free, might help. Clinical relevance: This article aims to provide professionals in various fields with guidelines on detecting, diagnosing and managing patients with Phantom Bite Syndrome (PBS). This is desirable in order to prevent extensive, or unnecessarily destructive, or unstable dental treatment being undertaken on such patients in a vain attempt to solve their problems with ‘dentistry’ when, in fact, these are really due to underlying mental health issues.