[Smoking and lung cancer].

Since fifty years it is clear now that smoking of tobacco products is responsible for the lung cancer epidemic that is currently in progress worldwide. Although in the Western world a small decrease of lung cancer in males is found, the number of female patients is steadily increasing. Changes in tobacco production have resulted in exposition of smokers to other carcinogens.

[The fate of retained mandibular wisdom teeth].

Objective: To describe the fate of retained lower wisdom teeth.

Design: An inquiry by telephone was done in patients who were registered five years previously and who at that time had at least one lower wisdom tooth. Questions were asked regarding symptoms and treatment of these teeth.

[Hospital admission of nursing home patients considered but not carried out: role of the nursing home physician and the involved parties and various differences with realized hospital admissions].

The objective of the study was to establish in which way nursing home patients, for whom is refrained from hospitalization, differ from hospitalized nursing home patients. The question was also raised of how the decision to refrain from hospitalization is taken: which point of view and method the nursing home physician has, on which arguments decisions are based and which parties are involved and in which way. The design of the study was retrospective and descriptive.

[Reconstruction possibilities after tumor surgery in the head-neck region].

Surgery and radiotherapy are the most important primary modalities for treatment of head and neck cancer. After excision of a tumour, a considerable defect may remain. Reconstructive surgery may serve several purposes: closure of the defect and restitution of functions such as respiration, swallowing, speech and chewing.

[Mouth neoplasms: a review].

An overview is presented of the epidemiology, etiology, clinical and diagnostic aspects, treatment and possible prevention of oral cancer. The dental profession may play a key role in the early detection of cancer and possible precursor lesions such as leukoplakia and erythroplakia. Since the use of tobacco is considered to be the main etiologic factor in oral cancer the dentist can play an active role in its primary prevention by informing his patients about the adverse effect of tobacco use and by encouraging patients to enter tobacco cessation programs.

[Hematology and dentistry. Part V. Clinical manifestations of hematological malignancies in the oral cavity].

Haematological malignancies like acute and chronic leukemias, malignant lymphoma and plasma cell disorders may exhibit oral manifestation during their course. In this article the oral manifestation of a number of haematological malignancies presented in the oral cavity as well as the complications of the treatment are described.

[Practical aspects of local anesthesia. Infiltration anesthesia].

Local anaesthesia through infiltration is daily practiced in dentistry. Infiltration anaesthesia is effective in gums, mucosa and teeth, in the upper jaw and in the front part of the lower jaw. An amount of 0.

[Conduction anesthesia in and around the mouth].

Local infiltration anaesthesia is generally used in dentistry. The so-called nerve block anaesthesia is only routinely used for the mandible. The purpose of this article is to discuss the variety of blocks that can be used by dentists, oral and maxillofacial surgeons and anaesthesiologists.

[Allergic reactions to local anesthetics].

In this article type I and type IV allergic reactions evoked by local anaesthetics are discussed. Contact dermatitis (type IV) reactions are mainly caused by local anaesthetics of the ester-type like procaine. Both contact dermatitis and anaphylactic reactions (type I) can be caused by anaesthetics of the amide-type (e.

[Pharmacology of local anesthetics].

Over the past fifty years, many synthetic local anaesthetics have been developed with fewer side effects, increased specificity of action and a higher margin of safety than cocaine, the first local anaesthetic in clinical medicine. Although the route of administration may affect pharmacokinetics and pharmacodynamics, the present paper focuses on the general pharmacology of these useful compounds.

[Neuroanatomy and anaesthesiology].

The pathways of nociception, concerning dentogenic pain, are followed from the peripheral nociceptors to the cortex. The branches of the trigeminal nerve supply the semilunar ganglion. From this ganglion the trigeminal nuclei are reached, extending from the bottom of the third ventricle to the upper cervical segments.

[Hematology and dentistry. Part IV. Thrombosis and anticoagulant therapy].

In arterial thrombosis chronic use of acetylsalicylic acid is frequently prescribed. Venous thromboembolism is most often treated with short courses of heparin, followed by oral anticoagulants. All antithrombotic drugs cause hemorrhagic diathesis.

[Hematology and dentistry. Part III. Fibrin formation disorder].

After the formation of a platelet-plug, generation of fibrin is necessary for its stabilization. Both congenital and acquired deficiencies of clotting factors occur, leading to retarded formation of fibrin. In congenital disorders, preoperative correction is possible and necessary.

[Hematology and dentistry. Part II. Abnormalities of the vessel wall and blood platelets].

Haemostasis starts through adhesion of platelets to the subendothelium. Subsequently, ADP and prostaglandins are secreted by the adhered platelets, inducing aggregation of further platelets. The so formed platelet plug stops the bleeding.

[Hematology and dentistry. Part 1. Physiology and mechanisms of hemostasis].

In the dental office, adequate functioning of the haemostatic mechanism is essential in surgical procedures, e.g. tooth extractions.

[A screening tool for depression in the elderly in the general population: the usefulness of Center for Epidemiological Studies Depression Scale (CES-D)].

In community-based studies the CES-D is the most widely used screening instrument for depression in the elderly. In the Netherlands it is relatively unknown. Results of a literature-survey and empirical data of three groups of older respondents in the Netherlands are presented (n1 = 224, n2 = 116, n3 = 190).

[Patient care and ethics. VII. Ethics education in the university dental curriculum in the Netherlands].

Dentistry, which has developed independently alongside medicine for more than a hundred years now in the Netherlands, is rooted in a type of natural scientific and technological thinking that gained wide acceptance in the middle of the last century. This type of thinking has had far-reaching consequences for the whole field of medicine, including the independent development of dentistry. The social science side of dental training and the normative aspects of clinical practice have long been seriously neglected as a result of the dominance of the natural sciences.

[Patient care and ethics. VI. Expensive treatments and the very old patient].

On the basis of a case report in which a 92-year-old patient requests treatment with dental implants, the question is raised whether there is a moral justification to deny the wishes of the patient.

Surgical treatment of fracture-dislocations of the ankle joint with biodegradable implants: a prospective randomized study.

In a randomized study 43 patients with fracture-dislocations of the ankle joint were treated by open reduction and fixation with either steel or biodegradable implants. Results in both groups were favorable and the biodegradable material appears to be useful for some fracture-dislocations to obviate the need for a second operation.

[Patient care and ethics. The dentist in love with his patient].

A young dentist, who just started his practice, falls in love with a 24-year old woman, during an expensive treatment of several crowns and bridges. He gets confused if it is wise for him to continue this treatment. This question is discussed by a philosophical analysis of what is called the 'I-am-in-love-situation'.

[Patient care and ethics. IV. The terminal patient who concealed the truth].

In this article a case is discussed in which a dentist is placed in a dilemma. He is working on a comprehensive treatment but his patient has deliberately concealed his terminal state of health. By chance he was told about the actual health situation of his patient.

[Patient care and dental ethics. III. The advice of an acupuncturist for the removal of dental amalgam].

On the advice of an acupuncturist a patient requests her dentist to remove her amalgam fillings which are of a good quality. The question is discussed whether there is a moral justification to gratify the wishes of the patient.

[Patient care and dental ethics. The request of a patient for total extraction].

On the basis of a case report in which a patient requests total extraction while, from the view of dental care, there are possibilities to preserve the teeth, the question is discussed if there is a moral justification to gratify the wishes of the patient.

[The dental profession in The Netherlands before 1865].

The dental profession before 1865 has been described with the help of sources from the 19th century, in combination with prosopographical research. During this period, dentists had no exclusive rights in dentistry: other surgical professions were also involved both with its theory and practice. Their specialised colleagues comprised a group of 137 dentists, largely related to a few Jewish families.