Pain management is the key to providing successful root canal therapy. All patients hope for a painless procedure and look forward to being free of their symptoms when treatment is complete. However, managing pain throug...Pain management is the key to providing successful root canal therapy. All patients hope for a painless procedure and look forward to being free of their symptoms when treatment is complete. However, managing pain throughout endodontic therapy can be challenging and improving awareness of various analgesic techniques can make a significant difference to both patient and practitioner. This article should provide some insight into these methods and use current literature to discuss how they can be delivered in a clinical setting. By doing so, practitioners can utilize these techniques to make endodontic treatment a more comfortable procedure. Clinical relevance: This article aims to improve the reader’s awareness of the various clinical, pharmacological and behavioural analgesic techniques that can be used to help control presenting symptoms, reduce iatrogenic-induced pain and manage post-operative discomfort in the endodontically compromised patient.
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 a brief overview of chemotherapy and targeted therapy.
In the past decade there has been a rise of osteonecrosis of the jaws (ONJ) predominately related to bisphosphonate therapy and osteoradionecrosis secondary to radiotherapy. However, osteonecrosis can occur in the absenc...In the past decade there has been a rise of osteonecrosis of the jaws (ONJ) predominately related to bisphosphonate therapy and osteoradionecrosis secondary to radiotherapy. However, osteonecrosis can occur in the absence of these agents. A case of idiopathic osteonecrosis of the maxilla is reported and the literature discussed. Clinical relevance: It is not always possible to make a definitive diagnosis.
The correction of severe dentofacial discrepancies involving a combination of orthodontic and surgical therapies (termed ‘orthognathic treatment’) is commonplace. There is an abundance of evidence within this field but i...The correction of severe dentofacial discrepancies involving a combination of orthodontic and surgical therapies (termed ‘orthognathic treatment’) is commonplace. There is an abundance of evidence within this field but it is often inconsistent. This article is an evidence-based overview of such treatments and is aimed at the general dental practitioner. It will cover: the timing of treatment; the indications and risks associated with different surgical osteotomies; the magnitude of surgical movements that can be achieved with these procedures; and the importance of mandibular autorotation when planning treatment. Orthognathic treatment is considered to be the gold standard for comprehensive correction of severe dentofacial discrepancies. It is undertaken by a multidisciplinary team of clinicians involving, but not exclusive to, consultants in orthodontics and oral and maxillofacial surgery in secondary and tertiary medical centres throughout the United Kingdom. Clinical relevance: It is imperative that general dental practitioners have a good understanding of orthognathic treatment in order to recognize when such treatments are indicated, to inform the patient of possible treatment modalities and to be able to discuss associated risks in order to make appropriate referrals. Since treatment timing and magnitude of surgical movements have a profound effect on stability of the treatment result, these must be carefully considered by all clinicians involved in patient care to minimize relapse potential.
Isolated bilateral macrodontia of the mandibular second premolars is a rare condition. We believe that the case reported here is the first in which isolated bilateral macrodontia of the mandibular second premolars presen...Isolated bilateral macrodontia of the mandibular second premolars is a rare condition. We believe that the case reported here is the first in which isolated bilateral macrodontia of the mandibular second premolars presents with numerous dental anomalies affecting other teeth. A 14-year-old boy was referred to the Paediatric Dental Department of King’s College Hospital with a partially erupted mandibular left second premolar. Clinical and radiographic examination subsequently revealed macrodontia of both mandibular second premolar teeth and multiple other dental anomalies. This report discusses the presentation and multidisciplinary management of this case. Clinical relevance: This case report describes an already rare condition made even more extraordinary owing to its presentation with multiple other dental anomalies.
This article will focus on the antiplaque efficacy of mouthwashes. An antiplaque agent inhibits the formation of plaque and also reduces gingivitis. There is good evidence that chlorhexidine digluconate, used in the corr...This article will focus on the antiplaque efficacy of mouthwashes. An antiplaque agent inhibits the formation of plaque and also reduces gingivitis. There is good evidence that chlorhexidine digluconate, used in the correct concentrations, is the gold standard agent against which all others should be measured. It does, however, have some unwanted side-effects. One of the major problems for antiplaque mouthwashes is that they have a much reduced effect on established plaque within the oral environment. Although they can flow into the biofilm channels and kill bacteria in the superficial layers of dental plaque, they cannot penetrate the biomass and inhibit the pathogenic bacteria adjacent to the tooth surface and gingival margin. There is no evidence that they prevent the progression of periodontitis. Clinical relevance: The evidence supporting the use of ‘over the counter’ antiplaque mouthwashes is evaluated. This provides guidance for dentists and dental care professionals of when it is appropriate to recommend mouthwash use to their patients.
Denture stomatitis is a benign condition, usually asymptomatic, that can affect edentulous patients. Studies have reported a prevalence of denture stomatitis affecting over 75% of denture wearers and, whilst the aetiolog...Denture stomatitis is a benign condition, usually asymptomatic, that can affect edentulous patients. Studies have reported a prevalence of denture stomatitis affecting over 75% of denture wearers and, whilst the aetiology may be multifactorial, Candida albicans has a strong association with the condition, along with denture trauma and poor denture hygiene being associated local risk factors. This paper describes the aetiology, diagnosis and treatment of denture stomatitis, with the aim of helping clinicians to provide appropriate management of this condition. Clinical relevance: Denture stomatitis can be a recurrent problem amongst denture wearers and is often asymptomatic to the patient. Dental practitioners should be able to identify and manage this condition. Clinical relevance: Denture stomatitis can be a recurrent problem amongst denture wearers and is often asymptomatic to the patient. Dental practitioners should be able to identify and manage this condition.
This paper, the second of a series of two, provides an introduction to treatment planning in implant dentistry for the general dental practitioner. Clinical relevance: Appropriate training has made implant placement and...This paper, the second of a series of two, provides an introduction to treatment planning in implant dentistry for the general dental practitioner. Clinical relevance: Appropriate training has made implant placement and restoration a routine treatment option in general practice.
Resin-bonded bridges (RBBs) have an important role to play in the minimally invasive prosthodontic replacement of missing teeth. This treatment modality is perceived to have a high clinical failure rate by some practitio...Resin-bonded bridges (RBBs) have an important role to play in the minimally invasive prosthodontic replacement of missing teeth. This treatment modality is perceived to have a high clinical failure rate by some practitioners, which may be associated with poorly planned and executed designs and adhesive techniques. This paper, the first part of a two-part series, discusses the important planning stages in the successful provision of RBBs, including assessment, appropriate abutment selection and design considerations. The second part of this series will focus on the clinical stages of RBB provision. Clinical relevance: This paper aims to provide the general dental practitioner with a guide to appropriate case selection and an overview of the planning stages involved for the provision of RBBs.