This article is an exploration of some of the causes of stress within the dental profession and a discussion on how some of the models and philosophies of NLPt could help improve the levels of psychological wellbeing wit...This article is an exploration of some of the causes of stress within the dental profession and a discussion on how some of the models and philosophies of NLPt could help improve the levels of psychological wellbeing within the profession. Some of the fundamental concepts of NLPt are explored, with particular reference to their application in regard to stress. It is concluded that NLPt could provide a robust methodology for reducing psychological distress within the profession, by helping dentists to understand the concept of unuseful constructs, to improve behavioural choice and to discover the possibility of a more resourceful way of being. CPD/Clinical Relevance: Dentists under stress do not perform well; judgement is impaired, motivation is reduced and poor decisions can be made which impact directly on patient care.
A MEDLINE search early in 2015 revealed more than 250,000 papers on head and neck cancer; over 100,000 on oral cancer; and over 60,000 on mouth cancer. Not all publications contain robust evidence. We endeavour to encaps...A MEDLINE search early in 2015 revealed more than 250,000 papers on head and neck cancer; over 100,000 on oral cancer; and over 60,000 on mouth cancer. Not all publications contain robust evidence. We endeavour to encapsulate the most important of the latest information and advances now employed in practice, in a form comprehensible to healthcare workers, patients and their carers. This series offers the primary care dental team in particular, an overview of the aetiopathogenesis, prevention, diagnosis and multidisciplinary care of mouth cancer, the functional and psychosocial implications, and minimization of the impact on the quality of life of patient and family. Clinical Relevance: This article offers the dental team an overview of the multidisciplinary team (MDT; or multi-speciality team) and its roles, and an overview of the implications of therapies that are discussed more fully in future articles in the series.
Chlorhexidine is an effective antiseptic which is widely used in dentistry. Over recent years, it has also been used in other healthcare products as well as in cosmetics. Anaphylaxis to chlorhexidine has been increasingl...Chlorhexidine is an effective antiseptic which is widely used in dentistry. Over recent years, it has also been used in other healthcare products as well as in cosmetics. Anaphylaxis to chlorhexidine has been increasingly reported throughout the world, including two incidents in the UK where chlorhexidine-containing mouthwash had been used to wash tooth sockets following recent tooth extraction. Chlorhexidine is under-recognized as a cause of anaphylaxis and dentists should be aware of its potential for serious adverse effects. Dentists need to consider whether the washing out of a tooth socket with chlorhexidine solution should be avoided in the treatment of established dry socket. On current evidence the potential risks of using chlorhexidine as irrigation solution for treating an established dry socket appears to outweigh any known benefit. CPD/Clinical Relevance: Chlorhexidine has the potential to cause anaphylaxis in the dental surgery.
Syphilis is on the increase globally. While recognized more frequently in patients with, HIV/AIDS, it is not unusual among immune competent individuals sometimes presenting with unusual manifestations and/or behaviour. T...Syphilis is on the increase globally. While recognized more frequently in patients with, HIV/AIDS, it is not unusual among immune competent individuals sometimes presenting with unusual manifestations and/or behaviour. This paper reviews the history and clinical features of syphilis and draws attention to the oral manifestations. CPD/Clinical Relevance: Syphilis should be in the differential diagnosis of oral ulcers or unusual oral lesions.
Burning mouth syndrome (BMS) is a rare but impactful condition affecting mainly post-menopausal women resulting in constant pain and significant difficulty with eating, drinking and daily function. The aetiology of BMS r...Burning mouth syndrome (BMS) is a rare but impactful condition affecting mainly post-menopausal women resulting in constant pain and significant difficulty with eating, drinking and daily function. The aetiology of BMS remains an enigma. Recent evidence suggests it likely to be neuropathic in origin, the cause of which remains unknown. There is no cure for this condition and the unfortunate patients remain managed on a variety of neuropathic pain medication, salivary substitutes and other non-medical interventions that help the patient 'get through the day'. Some simple strategies can assist both clinician and patient to manage this debilitating condition. CPD/Clinical Relevance: The dental team will recognize patients presenting with burning mouth syndrome. They are difficult patients to manage and are often referred to secondary care and, ultimately, depend on their general medical practitioners for pain management.
Controversy exists surrounding resin-bonded bridges (RBBs), particularly with regards to abutment preparation. Should the abutments be prepared? If the abutments are prepared what design should be adopted? If there is to...Controversy exists surrounding resin-bonded bridges (RBBs), particularly with regards to abutment preparation. Should the abutments be prepared? If the abutments are prepared what design should be adopted? If there is to be no preparation, will there be space for the restoration? Many factors need consideration when planning for this treatment. This article aims to explore the effect of abutment preparation. In this regard, a literature review was conducted to present the latest available evidence. CPD/Clinical Relevance: Minimal intervention is key in modern dentistry, so clinicians must be able to make confident decisions in the provision of minimally invasive treatments like the RBB and be aware of the latest evidence.
This report provides important background information on osteoporosis (OP) and bone complications of cancer for the dental team, and discusses why bisphosphonate (BP) therapy is vital for patients with the two conditions...This report provides important background information on osteoporosis (OP) and bone complications of cancer for the dental team, and discusses why bisphosphonate (BP) therapy is vital for patients with the two conditions. It also addresses several questions, including in particular: 'Is withholding BP therapy the best way to prevent osteonecrosis of the jaw (ONJ) occurrence?' Also,'Of the two, which is more important: ONJ or OP fracture prevention?' CPD/Clinical Relevance: BP therapy offers OP patients the promise of a fracture-free life and the prevention of fracture-related pain, disability, loss of qualify of life (QOL) and the shortening of life. Without BP therapy, the lifetime risk of fracture occurrence in OP patients is as high as 1 in 2 women and 1 in 5 men; whilst using it, the relative risk of ONJ occurrence is as low as between 1 in 10, 000 and 1 in 100, 000. To cancer patients with bone complications, it offers the much needed pain relief and improvement in QOL. In cancer patients, the risk of ONJ is almost 100 times higher but, despite that, oncologists advocate BP therapy for virtually all the patients. Therefore, when prescribed, BP therapy merits the whole-hearted support of the dental team.
Clinicians are often faced with endodontic cases that are significantly more challenging than the primary root canal treatment of mature adult teeth. This paper outlines some of the common treatment modalities which can...Clinicians are often faced with endodontic cases that are significantly more challenging than the primary root canal treatment of mature adult teeth. This paper outlines some of the common treatment modalities which can be employed in situations in which either primary treatment has failed, or there is iatrogenic damage or unusual anatomy. CPD/Clinical Relevance: This paper will provide the reader with advice and techniques for undertaking orthograde endodontic retreatment, hemisection, endodontic surgery and management of teeth with incompletely formed roots.
This article aims to discuss the use of short dental implants in cleft patients, the construction of an implant-retained obturator and the use of a Createch milled titanium bar with three Locator overdenture attachments...This article aims to discuss the use of short dental implants in cleft patients, the construction of an implant-retained obturator and the use of a Createch milled titanium bar with three Locator overdenture attachments incorporated within the bar. CPD/Clinical Relevance: Implant-retained obturators offer a possible solution for treating patients with isolated cleft palate who are struggling with dentures due to the unfavourable soft and hard tissue profile. This paper demonstrates how to manage such patients and shows all the clinical and laboratory stages involved.
This case report describes treatment for a patient with microstomia and the development of the index of oral access for restorative dental treatment (IOA). CPD/Clinical Relevance: An understanding of the causes of micros...This case report describes treatment for a patient with microstomia and the development of the index of oral access for restorative dental treatment (IOA). CPD/Clinical Relevance: An understanding of the causes of microstomia and challenges encountered when treating microstomia patients with an index to aid diagnosis and treatment planning.
This article considers a possible solution to prevent or manage spontaneous alveolar bone growth in ankylosed, infraoccluded teeth in adolescents after elective decoronation, allowing replacement resorption to take place...This article considers a possible solution to prevent or manage spontaneous alveolar bone growth in ankylosed, infraoccluded teeth in adolescents after elective decoronation, allowing replacement resorption to take place, preserving the surrounding alveolar bone and enabling vertical bone development coronal to the decoronated segment. CPD/Clinical Relevance: To illustrate the advantages of decoronation allowing subsequent replacement of infraoccluded ankylosed teeth with implant-retained restorations and minimal aesthetic compromise.