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As a result of the caries prevalence of the Dutch population the character of the routine dental examination is changing. Caries screening remains relevant for high caries risk individuals but the interpretation of early caries lesions deserves more attention, especially the assessment of progression of caries lesions in time. Diagnosis of caries by dental practitioners in the Netherlands mainly consists of visual inspection in combination with bitewing radiography and both methods play an important role in the timing of bitewing radiographs and forthcoming recall visits for oral health examination. The content and frequency of the routine dental examination are discussed in relation to the individual risk prediction as relevant aspects of quality of dental care in the Netherlands.

In 1993 a representative sample of dental practitioners in the Netherlands was questioned on the use of antibiotics for the prevention of endocarditis in the previous year. Most of the responding dentists (67%) reported prescription of antibiotics for patients at risk. Some of them prescribed an antibiotic regimen that differed from the guidelines drawn up by the Dutch Heart Foundation. In 1992 only 47% of the responding dentists prescribed antibiotics for the prevention of endocarditis entirely according to these guidelines.

In 1993 a representative sample of dentists in the Netherlands was questioned on the use of antibiotics in the treatment of periodontitis. It was found dat 50% of the general practitioners had a positive attitude, 15% a negative one and 35% had an indifferent attitude towards the use of antibiotics in periodontal treatment. Almost 40% of them indicated the prescription of antibiotics for periodontal reasons in the previous year. Most of the dentists (71%) prescribed a combination of metronidazole and amoxicillin. The average prescription frequency in 1992 was 18 times. The prescription frequency and the choice of a combination of metronidazole and a broad spectrum penicillin in the treatment of periodontitis is discussed, emphasizing the importance of the traditional mechanical therapy, the disturbance of the colonization resistance by means of antibiotics and the worldwide concern about the usage of antibiotics.

The subgingival microflora of 71 Tanzanian and 77 Dutch prepurberty children was analyzed by dark-field microscopy. Spirochetes were observed in almost every Tanzanian child and in 66% of the Dutch children. The predominant spirochetes were small and medium sized; large spirochetes were infrequently observed in the rural Tanzanian children and at the bleeding sites of the Dutch children. Further differences in the %s of cocci, rods and fusiforms indicated that the subgingival microflora of Tanzanian children is different from that of Dutch children. Generally, spirochetes occurred at higher %s and frequency at bleeding sites than at non-bleeding sites in both populations. However, the non-bleeding sites in the Tanzanian children had a higher prevalence of spirochetes than the bleeding sites in Dutch children. It is concluded that spirochetes are members of the normal flora of prepuberty children, that in children gingivitis is associated with increased proportions of spirochetes and that the presence of spirochetes in the gingival crevice is not dependent upon gingival inflammation.