Primary dental journal最新文献

Patients diagnosed with a haematological malignancy who undergo haematopoietic stem cell transplant (HSCT) are likely to experience oral symptoms at different stages of their treatment. This can range from oral mucositis during conditioning regimes to graft vs host disease (GvHD) post-transplant for those who have undergone allografting. Oral mucosal chronic GvHD is a well-recognised complication of HSCT. An increased risk of oral malignancy in patients who have undergone HSCT requires frequent oral mucosal screening for these patients, so that oral mucosal disease is recognised, treated where applicable, and monitored accordingly both in the short term and long term. This article explores the oral manifestations of GvHD and the dental implications for patients, and it aims to provide an update for primary care dental professionals on the presentation, recognition and management of oral GvHD.

Candida is a common intra-oral commensal organism which, in certain circumstances, can become an opportunistic pathogen. Clinical manifestations in the oral cavity can be highly variable and all dental professionals should be familiar with its presentation and management. This paper explores the pathophysiology and presentation of oral candidosis, and examines the dental professionals' role in management of the condition.

Burning mouth syndrome is a form of chronic orofacial pain with an unclear but likely multifactorial aetiology with potential involvement of the central and peripheral nervous systems. No mucosal abnormalities are found on examination, and the diagnosis is one of exclusion. Potential management strategies may include use of topical medication, systemic medication, physical barriers, or psychological therapy. General dental practitioners may be one of the first health care professionals that patients will present to and therefore their role is seen as significant in the patient pathway. This article provides an overview for general dental practitioners on their role in the diagnosis and management of burning mouth syndrome.

Xerostomia, or a feeling of a dry mouth, is a common condition affecting just over a quarter of the population. A reduction in salivary flow can have a significant functional impact on patients. This paper reviews the most common causes of a dry mouth, the role of saliva in normal function, as well as the actions that can be taken by the primary dental care team to help support oral function.

Objective: To explore the role of endodontists in the management of molar incisor hypomineralisation (MIH) in children, focusing on the challenges of diagnosis, treatment, and interdisciplinary collaboration.

Methods: A review of the current literature and clinical approaches was conducted, emphasising the endodontic considerations regarding MIH.

Results: 37 relevant articles were identified. The findings suggest that selective caries removal and vital pulp therapy (VPT) are essential approaches to preserving the vitality of compromised first molars, although there is a scarcity of evidence addressing specifically the management of molars affected by MIH. Diagnosing pulpal conditions in children with MIH is challenging, as pulp tests may be unreliable. This can lead to exaggerated responses and an increased risk of misdiagnosis, resulting in unnecessary treatments like endodontic therapy or extractions. The involvement of endodontists is critical, especially when minimally invasive techniques are needed to preserve dental tissue. Endodontists face additional challenges related to pulp therapy in these patients due to subclinical pulp inflammation, which can impair anaesthesia effectiveness and reduce a child's cooperation.

Conclusion: Interdisciplinary collaboration between paediatric dentists and endodontists is essential for improving outcomes in MIH management. The development of advanced behaviour management skills and minimally invasive treatment approaches is recommended to enhance patient care.

Dealing with stress, negative feedback and unrealistic demands can be a daunting experience for the dental healthcare team, potentially resulting in job dissatisfaction and reduced performance levels. Learning how to cope with stressful situations and associated circumstances by developing advanced rapport skills in interventional healthcare can help in the management of stressful situations in dental practice. These skills can also help to decrease anxiety and level of pain experienced by the patient. This article outlines how stressful encounters can be managed in the dental practice environment by applying hypnotic techniques for anxious and stressed patients to better cope with dental interventions.

The incidence of developing a skin cancer is increasing in the UK. The vast majority of skin cancers occur on the head and neck, linked to the increased exposure to ultraviolet light from the sun. Dental healthcare practitioners are expert at examining the head and neck, although anecdotal evidence suggests a lack of confidence in screening for and in managing skin lesions. This article briefly describes the epidemiology, key features and management of various skin lesions, in addition to practical steps general dentists can take to screen for skin cancer. It also describes the various presentations of skin cancer, including in darker skin tones, and how dentists can manage such patients.

Background and aim: White spot lesions are a potential side effect of orthodontic treatment. This occurs frequently, with a prevalence ranging from 50% to 90%. The lesions typically occur on the labial surface of the gingival region of the tooth. Caries prophylaxis requires use of soluble fluoride to prevent demineralisation and stimulate remineralisation of enamel and dentine. The administration of fluoride varnish is a controlled and professional way of delivering high-fluoride concentrations that do not rely on patient compliance. This meta-analysis will assess the effectiveness of fluoride varnish in avoiding white spot lesions in orthodontics.

Materials: A thorough search was conducted on PubMed/Medline, Scopus, and Google Scholar databases using advanced search strategies, appropriate operators, and tags based on the title and abstract. Two reviewers worked independently to extract data and ensure accuracy and consistency.

Results: Eight randomised control trial articles involving 654 individuals were included. The findings revealed that fluoride varnishes significantly reduced white spot lesions on teeth. Patients who were treated with this substance had visibly reduced lesions (weighted mean difference = -0.54, 95% confidence interval = [-1.01 and -0.07], P < 0.001, I² = 85.9%).

Conclusion: Fluoride varnish significantly reduces the incidence of white spot lesions, but high heterogeneity among studies suggests cautious interpretation of the results.

This article highlights the perennial problems posed by the interdental col as well as their consequences for patients' dental health and for many aspects of general dentistry. When the interdental col is not considered properly during restorative procedures new problems can arise instead of resolving existing ones. Dental professionals must be constantly vigilant because any oozing of inflammatory gingival crevicular fluid, or frank bleeding, from the col regions can impact adversely on adhesive bonding, pulpal health, impression accuracy, and restoration cementation. This article emphasises the importance of patients accepting their responsibilities early on for gaining and maintaining their dental health by appropriate cleaning of their col areas. In addition, this article demonstrates practical and cost-effective adjustments of interproximal restorations that promote periodontal health. It highlights that restored teeth often need to be made anatomically different to natural teeth to reduce the likelihood of perpetuating problems of the col. Careful design and precise execution of interproximal restorations are both essential to prevent reproducing problems which often necessitated those restorations in the first place.This article also provides some practical hints on restoring teeth near the interdental col which will become ever more important in general practice following the imminent banning of dental amalgam.