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Introduction Orthodontic service provision relies on good organisational systems for high standards of patient care and safety. Human factors (HFs) are non-technical skills associated with communication, leadership and teamwork, important for safe patient care. This investigation explored attitudes and understanding of HFs within orthodontic clinical training in the United Kingdom.Materials and methods A questionnaire-based qualitative and quantitative analysis including members of the orthodontic clinical team was undertaken at two teaching centres. A modified Operating Rooms Managements Attitudes questionnaire was used with a 5-point Likert scale. Participants indicated agreement or disagreement with statements around nine themes: leadership structure; confidence assertion; information sharing; stress; fatigue; teamwork; work values; error-procedural compliance; and organisational climate. Internal consistency among themes was assessed with Cronbach's alpha and differences in responses with chi-squared tests at 5%.Results In total, 80 responses were received from 96 invitees. Positive attitudes towards teamwork, error-procedural compliance, and organisational climate were found. Orthodontic consultants, trainees, and nurses recognised that human error is not a sign of incompetence. Stress and fatigue were less acknowledged by consultants and trainee groups. Trainees, nurses and therapists valued information sharing over the consultant group. Orthodontic trainees and nurse responses suggested further training might be required in leadership structure, confidence assertion, and work values.Conclusions Differences in attitudes and understanding of HFs within different professional groups in the orthodontic team exist., (© 2023. The Author(s), under exclusive licence to the British Dental Association.)

There is an association between increased overjet and risk of trauma to the maxillary incisor teeth in children and adolescents. It would therefore seem sensible to recommend overjet reduction as early as possible to help reduce this risk. However, orthodontic outcomes are essentially the same whether you start treatment in the early or late mixed dentition, while early treatment carries a heavier burden on compliance - taking longer and involving more appointments. This article explores the complex association between early overjet reduction and dental trauma in the context of current best evidence. Careful case selection is advised when justifying early intervention for increased overjet based on reducing trauma risk., (© 2022. The Author(s).)

Early orthodontic treatment in the mixed dentition aims to simplify definitive treatment in the permanent dentition. In Class III cases, this can be an effective strategy for the management of a local anterior crossbite, using either a removable or simple fixed appliance. For more significant Class III malocclusions, the decision to intervene early is a more difficult one. Traditionally, orthodontists in the UK have been reluctant to embark on early treatment in the presence of a skeletal Class III relationship but there is now some evidence that in selected cases, the use of protraction headgear can be a successful method of avoiding the need for later surgery. Although growth prediction in Class III cases is notoriously difficult, in the presence of maxillary retrognathia, the general dental practitioner should consider early referral of Class III cases to a specialist orthodontist., (© 2022. The Author(s).)

Background: The prosthetic margin location relevant to the free gingival margin may influence the incidence of secondary caries due to the differences that exist between the micro-environment within the gingival crevice compared to the rest of the oral environment., Objective: The purpose of this study was to systematically review the effect of prosthetic margin placement on caries susceptibility of abutment teeth., Method: Two independent authors identified cohort studies using MEDLINE, EMBASE, CDSR, CENTRAL, Google Scholar and Scopus through March 2012. Reference lists were also scanned. Included studies had to report on caries incidence with regard to location of prosthetic margins, with a minimum follow-up period of two years., Results: A total of 5,541 references were identified and, after application of the inclusion criteria, 22 studies were included in the systematic review. Random-effects meta-analysis could be made in two studies, in which secondary caries incidence did not differ between margins placed subgingivally compared to equi- or supragingivally placed margins for a follow-up period up to ten years. Indications were found of a possible lower secondary caries rate at 15 years of follow up, based on one study., Conclusion: This systematic review and meta-analysis failed to detect a significantly different secondary caries rate of subgingivally located prosthetic margins in the short to mid-term (≤10 years). Due to the small number and the limitations of the included studies the results do not provide conclusive evidence as to the effect of prosthetic margin placement on the incidence of secondary caries.