Making sense of sensibility: part 2.

To reach an accurate endodontic diagnosis, it is important for clinicians to understand how to undertake pulpal sensibility tests correctly, how to interpret their results and how to understand their limitations. Part one of this series defined different terms relevant to pulp testing and detailed the diagnostic uses and diagnostic accuracy of pulp testing methods. This section describes clinical techniques for commonly used pulp tests and highlights their limitations and correct interpretation of their results.

Making sense of sensibility: part 1.

Thermal and electric pulp sensibility tests are commonly used by the majority of clinicians when diagnosing endodontic disease. These tests indirectly determine the state of pulpal health by assessing the response of the Aδ nerve fibres within the pulp-dentine complex. A positive response to sensibility testing indicates that the nerve fibres are functioning but does not give any quantitative information on nerve function, pulpal blood flow or histological status of the dental pulp.

Sociodemographic trends in a UK temporomandibular joint disorder clinic.

Introduction Temporomandibular disorders (TMD) are a common source of facial pain, resulting from an interaction of biopsychosocial factors. However, social risk factors related to TMD have been researched very little, particularly in patients attending a tertiary care service.Aims To review sociodemographic trends among patients referred to a UK tertiary TMD clinic for specialist management.

The Six-Year-Old 'Adult'.

Children are not miniature adults, yet when a child celebrates their sixth birthday, little do they know that, with the arrival of their first 'adult' tooth, they are about to gain their first real experience of being a 'grown-up'. The age of six is a key milestone in the mental, physical and emotional wellbeing of children, with most children in the UK having commenced primary school education by their fifth birthday. Six-year-olds are about to enter the most critical period in their dental development, the mixed-dentition phase, where their mouths are in a near continuous state of flux.

Patient-reported outcome measure for children and young people with amelogenesis imperfecta.

Background Amelogenesis imperfecta (AI) is a genetic enamel defect that can affect both the primary and permanent dentition. It has a range of clinical phenotypes, and children and young people often present with challenging oral health needs. Patient-reported outcome measures (PROMs) can identify key patient concerns.

Necrotising periodontal diseases and alcohol misuse - a cause of osteonecrosis?

'Necrotising periodontal diseases' is an umbrella term for necrotising gingivitis, necrotising periodontitis, necrotising stomatitis and noma. These rapidly destructive conditions are characterised by pain, interdental ulceration and gingival necrosis which, if left untreated, can result in osteonecrosis. Research indicates that patients with a history of alcohol misuse are at an increased risk of malnutrition, which negatively affects the immune response and predisposition to necrotising periodontal diseases.

A two-centre study assessing the impact of the COVID-19 pandemic on orthodontic patients in secondary care.

Objective: To evaluate the impact of the coronavirus pandemic on patients in active orthodontic treatment.

Design: Digital online survey.

Setting: Two secondary care orthodontic departments in the United Kingdom.

Molar Incisor Hypomineralisation: Current Knowledge and Practice.

Background: Molar incisor hypomineralisation (MIH) is a common developmental dental condition that presents in childhood. Areas of poorly formed enamel affect one or more first permanent molars and can cause opacities on the anterior teeth. MIH presents a variety of challenges for the dental team as well as functional and social impacts for affected children.

Dental foundation training in the COVID-19 era - the national recruitment lottery.

National recruitment has radically transformed the selection and allocation of dental graduates to dental foundation training (DFT) schemes across England, Wales and Northern Ireland, with recruitment in Scotland via a separate, independent process. It has been reported as a mostly positive change to the previous deanery-led model, in which nepotism allegedly featured too widely. A candidate's ranking is typically based on performance across two face-to-face assessments and a situational judgement test (SJT).

A Short Form of the Children's Experiences of Dental Anxiety Measure (CEDAM): Validation and Evaluation of the CEDAM-8.

Background: The Children's Experiences of Dental Anxiety Measure (CEDAM-14) is a child-centred measure of dental anxiety which assesses a range of behaviours, thoughts and feelings/physical symptoms related to dental anxiety. A short form of the CEDAM-14, which places less time burden on patients and clinicians, could promote the feasibility and applicability of the CEDAM in clinical settings. The aim of the study was to develop a short version of the CEDAM that can be used to assess children's dental anxiety in clinical practice.

Audit of flumazenil use in special care and oral surgery sedation services.

Background The National Patient Safety Agency (2008) has advised against routine reliance on flumazenil for reversal of sedation and encourages regular audit to help identify issues with excessive dosing of midazolam. This multi-centre audit of flumazenil use across both community-based special care and dental hospital oral surgery specialist services was conducted to compare practice against that reported from other UK sedation services.Methods A six-year retrospective audit was conducted using controlled drug records and patient case notes.

Evaluation of a new paediatric dentistry intravenous sedation service.

Introduction Intravenous sedation (IVS) with propofol offers an alternative to inhalation sedation or general anaesthesia (GA) for dentally anxious young people who require treatment. It offers a greater level of anxiolysis than inhalation sedation and reduced morbidity when compared with GA.Methods Data were collected prospectively from a convenience sample of children requiring IVS.

Reoperation in Zygomatico-orbital Trauma: A Review of Patients With Suboptimal Outcomes Following Initial Repair.

Introduction: Treatment to restore anatomy, function, and aesthetics after trauma should involve as little surgical insult as possible. As such, repeated procedures may suggest failed initial management. To date, no predictive factors for failure of primary surgery have been identified.

Patients' narratives of orthognathic treatment for facial asymmetry: a qualitative study.

To explore patients' experiences of orthognathic treatment for facial asymmetry and their adaptation to facial changes after surgery, we did a qualitative, cross-sectional study of patients after treatment for non-cleft asymmetry at two UK sites. A total of 15 patients aged 19-40 years were approached after being identified using patient databases and clinical notes. Individual and photo-elicitation interviews were conducted covering experiences prior to treatment, during treatment, and after surgery.

Should we root treat children's first permanent molars?

Study selection Medline via PubMed and Embase were searched on 6 November 2019 and all studies up to this date were included, including case reports and case series. This was noted as being due to the limited number of studies available in this research area. The outcome measured was clinical success, which was defined as the tooth being present and an assumption that it was sound and asymptomatic at the end of the study.

School dental screening programmes for oral health: Cochrane systematic review.

Objective To evaluate the effectiveness of school dental screening in improving oral health status and the use of dental services. This review is an update of the original review published in 2017. As you would expect of a Cochrane review, the methodology was of high quality.

Clinical presentations on a facial pain clinic.

Introduction The complex nature of facial pain conditions creates a diagnostic challenge which may necessitate specialist referral.Aim To identify the case mix presenting to a specialist tertiary care facial pain clinic.Methods A retrospective review of 112 patient records was undertaken.

The role, efficacy and outcome measures for teriparatide use in the management of medication-related osteonecrosis of the jaw.

Medication-related osteonecrosis of the jaw (MRONJ) is a complex disease which can be associated with multiple morbidities and is challenging to treat. This review evaluates the literature on the role and efficacy of teriparatide (TPTD) as a treatment for MRONJ. The clinical, radiological, histopathological and serological parameters used to assess treatment response have been described.

Determinants of children's oral health-related quality of life following aesthetic treatment of enamel opacities.

Objectives: To identify clinical and psychosocial predictors of oral health-related quality of life (OHRQoL) in children with molar incisor hypomineralisation (MIH) following aesthetic treatment of incisor opacities.

Methods: Participants were 7- to 16-year-old children referred to a UK Dental Hospital for management of incisor opacities. Prior to treatment (T), participants completed validated questionnaires to assess OHRQoL and overall health status (C-OHIP-SF19), and self-concept (Harter's Self-Perception Profile for Children [SPPC]).

A service evaluation of an intervention to increase application of topical fluoride varnish in general dental practice in South Yorkshire.

Purpose: Dental caries is still common in children in the UK despite many available preventative interventions. Application of topical fluoride varnish can reduce caries experience. National and international guidance recommends at least twice-yearly application of topical fluoride varnish, however guidance is not always followed.

'I Would Rather Be Having My Leg Cut off Than a Little Needle': A Supplementary Qualitative Analysis of Dentally Anxious Children's Experiences of Needle Fear.

Fear of needles is common in childhood, with up to 50% being affected to some degree. In individuals who are dentally anxious, the prevalence may be as high as 91%. Fear of needles, and therefore intra-oral injections can have negative impacts on children's quality of life and healthcare experiences, including a requirement for pharmacological methods to facilitate dental treatment.

Molar incisor hypomineralisation and dental anomalies: A random or real association?

Background: Clinical observations suggest molar incisor hypomineralisation (MIH) may present with other dental conditions.

Aims: The study aimed to determine the prevalence and variety of dental anomalies in children presenting with MIH.

Design: A convenience sample of children referred to a UK dental hospital was recruited.

Conflicting demands that dentists and dental care professionals experience when using social media: a scoping review.

Introduction There are many conflicting demands for dentists and dental care professionals (DCPs) when using social media, for example between using social media for marketing and as professional provider of information. To gain a fuller understanding of how dentists/DCPs should optimally use social media, these conflicting demands need to be explored. The aim of this scoping review was to map out the current state of the literature describing the conflicting demands encountered by dentists and DCPs when using social media and the approaches used to manage these conflicting demands.