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Digital photography has already established its irrefutable importance in today's world. It is becoming an indispensable tool in various fields. In dentistry specifically, photography can be employed in several ways that can be beneficial to the patient and the dental community. It allows a simple and clear depiction of an otherwise abstract concept, but high-quality pictures are always required. The evolution of mobile cameras has made an enormous impact on digital photography and its accessibility: high-quality pictures can now be easily taken. This article explains the assets of smartphone cameras' evolution and how it led to the conception of Smile Lite Mobile Dental Photography. Applications of dental photography are presented, such as documentation and communication with the laboratory technician and the patient. Mobile dental photography is not confined to dentistry but can also be used for artistic purposes. [ABSTRACT FROM AUTHOR]

Purpose: To compare the clinical outcome of single implants placed immediately after tooth extraction with implants placed 6 weeks after tooth extraction (immediate-delayed placement), and with implants placed after 4-month extraction and socket healing (delayed placement). Materials and methods: Two-hundred and ten (210) patients requiring a single implant-supported crown to replace a tooth to be extracted were randomised to receive immediate post-extractive implants (70 patients), immediate-delayed implants at 6 weeks (70 patients), and delayed implants after 4 months of healing (70 patients) according to a parallel group design. When needed, patients of the immediate and immediate-delayed group had the socket grafted with a bone substitute and covered with a resorbable membrane at implant placement. Sockets randomised to delayed implants were grafted in the same manner if poorly preserved or in the aesthetic areas (from second upper to second upper premolars). Implants inserted with at least 25 Ncm torque were left to heal unloaded for 4 months, whereas those inserted with less than 25 Ncm were left to heal unloaded for 6 months. Temporary crowns were delivered and were to be replaced by definitive ones after 4 months. Outcome measures were crown and implant failures, complications, peri-implant marginal bone level changes, aesthetically assessed using the pink esthetic score (PES), and patient satisfaction recorded by blinded assessors. Patients were followed up to 1 year post-loading. Results: One year after loading, three patients dropped out from the immediate group, five from the immediate-delayed group, and six from the delayed group. Four implants (6%) failed in the immediate, four (6.2%) in the immediate-delayed, and one (1.6%) from the delayed group (P (chisquare test) = 0.369). Apart from the crowns (which failed due to implant losses), no other crown had to be remade. Six immediate, six immediate-delayed and four delayed implants were affected by one complication each (P (chi-square test) = 0.792). Mean peri-implant marginal bone loss after 1 year was -0.25 ± 0.17 mm (CI 95% -0.29; -0.20) at immediate, -0.29 ± 0.14 mm (CI 95% -0.32; -0.25) at immediate-delayed, and -0.31 ± 0.16 mm (CI 95% -0.35; -0.27) at delayed placed implants (P (Kruskal-Wallis test) = 0.015). One year after loading, the mean total aesthetic score was 12.52, 12.49 and 11.78 at the immediate, immediate-delayed and delayed groups, respectively (P (Kruskal-Wallis test) <0.001). All patients were fully satisfied both with function and aesthetics, and would undergo the same procedure again, with four exceptions (one from the immediate, one from the immediate-delayed and two from the delayed group), who were only partially satisfied with aesthetics (P = 0.785). Conclusions: No statistically significant differences for failures, complications and patient satisfaction were observed when placing single implants immediately, 6 weeks or 4 months after tooth extraction; nevertheless, failures were more frequent at immediate and immediate-delayed placed implants. Bone level changes were similar between the different procedures, but aesthetics were better results at immediate and immediate-delayed implants. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the types and quality of reporting of economic evaluations carried out in the clinical management of periodontal disease over 32 years from 1987 to 2019. Material and methods: A systematic search of articles from 1987 to 2019 was conducted using PubMed, Web of Science, The Cochrane Central Register of Controlled Trials, Health Technology Assessment Database and Embase. The quality of the economic evaluations was assessed based on the Consolidated Health Economic Evaluation Reporting Standard checklist. Due to considerable between‐study heterogeneity, a meta‐analysis was not performed. Results: Twenty one publications were included. 11 studies used cost‐effectiveness analysis, five used cost‐minimization analysis, four used cost–utility analysis and two used cost–benefit analysis. Comparators, choice of health outcomes, estimating resources and costs were fully reported in all studies. Many studies had inadequate reporting in terms of estimating resources and costs, choice of health outcomes, characterizing heterogeneity and study perspective. Conclusions: There has been an increase in health economics studies in the field of clinical periodontology over the past decade. Several studies did not report study perspective, and the health outcomes chosen were not relevant for some studies. Future studies should follow an economic evaluation checklist for high‐quality reporting and consistency. [ABSTRACT FROM AUTHOR]

Background: Knowledge about the magnitude of Oral Health‐Related Quality of Life (OHRQoL) impairment across dental patient populations is essential for clinical practice, public health and research. Within the project Mapping Oral Disease Impact with a Common Metric, this systematic review aimed to describe functional, pain‐related, aesthetic and broader psychosocial impact of oral conditions with a single metric using OHRQoL dimensions Oral Function, Oro facial Pain, Oro facial Appearance and Psychosocial Impact. Methods: A search using PubMed, EMBASE, Cochrane, CINAHL and PsycINFO was performed on 8 June 2017, and updated on 14 January 2019. Only publications in the English language were considered. To characterise the extent of available standardised and clinically relevant OHRQoL information, we determined the number of publications, dental patient populations, which are clinically similar, and patient samples within each population with four‐dimensional OHRQoL information using the Oral Health Impact Profile (OHIP) questionnaire. A quality assessment and a publication bias assessment were performed. Results: We identified 171 publications that characterised 199 dental populations and 329 patient samples with four‐dimensional OHRQoL information. The vast majority of populations were only characterised by one patient sample. Study quality was not related to OHRQoL magnitude, and substantial publication bias could be excluded. Conclusions: Standardised and clinically relevant information using the four OHRQoL dimensions Oral Function, Oro facial Pain, Oro facial Appearance and Psychosocial Impact was available for a significant number of dental patient populations. Findings can provide a framework to interpret OHRQoL impairment of individual patients, or groups of patients, for clinical practice, public health and research. [ABSTRACT FROM AUTHOR]

Background: Dental patient‐reported outcomes (dPROs) and their measures, dPROMs, are fundamental for evidence‐based dentistry. However when selecting, applying and evaluating an instrument with a focus on OHRQoL assessment for adults, several methodological considerations are essential to derive valid and meaningful results. Methods: In this review article, criteria for selecting the appropriate OHRQoL instrument, aspects of administering the instrument and how to evaluate resulting scores of single and multiple assessments are presented and critically assessed. Results: Oral disease–generic and dimension–generic instruments capturing the entire construct OHRQoL allow for best comparability of findings across different diseases, settings and populations, with the Oral Health Impact Profile (OHIP) being the most often used and methodologically best investigated one. It is available in several versions with the 5‐item version being the one with the lowest burden for the patient. Responses are given on a 5‐point ordinal rating scale, the recommended response scale for dPROMs. A 7‐day recall period allows for assessment of short‐term effects. Clinically relevant effects of item or instrument order or administration method on OHIP scores do not seem to be likely. OHIP summary and dimension scores can be compared to norms from general population or different patient populations. Change scores should be set into context with the minimal important difference of the instrument. Conclusion: OHIP‐5 has greatest potential to be used across all settings for assessment and evaluation of OHRQoL in adults. It allows a comprehensive characterising of patients suffering from oral diseases and of this impact using OHRQoL dimensions. [ABSTRACT FROM AUTHOR]

In daily practice, composites are the materials most commonly used for restorative dentistry. They are used for preventive seals, microinvasive restorations, build-ups and complex direct and indirect restorations in posterior sections. Indeed, it is in the anterior sections that composites have traditionally been used to the greatest effect, enabling clinicians to carry out complex restorations using direct techniques with notable esthetic and clinical results. Recent product developments combined with clinical research on stratification make it now possible to utilize new composites that have excellent opalescence and fluorescence characteristics and provide an excellent color range to choose from.1,2 It is however, a common complaint among clinicians that the layering techniques are rather complex and it is difficult to make the right color choice. Paradoxically, they say that the appearance on the market of sophisticated materials, designed to give ever better results in the medium and long term, only makes it more difficult to make the correct decision. Indeed, many of these colleagues, after the first buzz of enthusiasm, give up on the layering technique and opt for materials which they say are more simple or "mimetic." In the present article, the authors will discuss these topics and make suggestions on how to acheive high quality results every day, both from an esthetic and clinical point of view. However, predictability of the results is more important, as predictability provides advantages in terms of the quality of work and economy for clinicians and patients. [ABSTRACT FROM AUTHOR]

An editorial is provided which discusses dentists' and dental practitioners' roles on preventing the transmission of COVID-19 through following the U.S. Centers for Disease Control (CDC), including in treating a dental patient with COVID-19 and wearing personal protection equipment. Topics, including the mortality rate of COVID-19, disease symptoms, dental health care hygiene and the prevalence of the disease throughout the world, are discussed.

Restoring the loss of periodontal soft and hard tissues represents a unique challenge for the dental team. The interdental papillae in the esthetic zone can be a dilemma for both the patient and the therapist. A multidisciplinary approach is critical for the successful treatment of lost papillae. This article reports on the successful long-term papillae reconstruction using a combined approach: Plastic surgery and restorative dentistry in one case and restorative dentistry alone in another case. [ABSTRACT FROM AUTHOR]

Clinical and radiographic healing observations were categorized into four patterns: rapid, typical, delayed, and adverse. While considerable overlap of characteristics was noted between the categories, singular factors or combinations of factors enabled pattern identification. The factor primarily associated with the rapid healing pattern was the appearance of bone in the former defect adjacent to the membrane at removal. In contrast, the adverse healing pattern depicted surface necrosis or loss of tissue height at membrane removal. One hundred random sites were evaluated, revealing 13% rapid healing patterns, 76% typical healing patterns, 8% delayed healing patterns, and 3% adverse healing patterns. With favorable patient compliance with oral hygiene and follow-up care, the rapid and typical healing pattens became clinically successful cases. The level of clinical success varied with the delayed healing pattern; the adverse pattern failed to achieve the therapeutic objective. [ABSTRACT FROM AUTHOR]

High expectations may contribute to stress in the patient and dentist during dental treatment. Esthetic and restorative results can be predicted for laminate veneers by using a powder blower and a liquid dispenser preoperatively to form self-cured resin veneers. Trial veneers are formed in a precision "salt and pepper" technique that conserves materials and time. The trial veneers are placed, without tooth preparation, on the treatment site so that the patient can preview the planned treatment and so that the dentist can explain proposed treatment in a reversible procedure. This may circumvent misunderstandings between dentist and patient and allow the consideration of alternate treatment plans. [ABSTRACT FROM AUTHOR]

The article discusses esthetic restoration for anterior teeth with the use of a ceramo-metal restoration having a labial butt-joint. It notes the prerequisite for the fabrication of a natural-looking anterior restoration which include a proper and appropriate preparation of the finish line area of the abutment. It also presents a step-by-step instruction for the build-up and correction of this restoration which include the application of a spacer on the stone die, the exposition of labiogingival shoulders without covering it with wax, and the application of shoulder powder which could become the butt-joint porcelain shoulder.

The article discusses the endosseous implants to patients which could be applied to patients after thorough examination and considerations to existing contraindications including the presence of severe atrophy of the alveolar process, cranial run of the mandibular canal, and large sinuses. It notes the significance of good tissue compatibility for long-term success of an implant and the operation mechanism using the panoramic layer projection. Other alternatives to improve endosseous implantation which include the use of tantalum screws and titanium alloy blades are also elaborated.

The article presents a description of some factors that influence patient motivation. The factors include reinforcing value, empathy, patient expectations, readily accessible incentives, and demand characteristics. Dental practitioners are suggested to use these factors to increase patient motivation. A dentist can increase patient motivation by administering reinforcement for adequate oral hygiene practices. The dentist is suggested to show that he is understanding the patient at the cognitive and emotional level. Patient expectations are formed from previous experiences. It is recommended that incentives should be provided to dentists for motivating patients. Demand characteristics refer to individual's responsiveness in the dental setting.

For a mother-to-be, pregnancy presents an opportunity to improve not only her health and well being but also that of the immediate family, particularly the newborn infant. The National Consensus Statement of the Oral Health Care During Pregnancy Expert Group together with both governmental and non-governmental guidelines indicate that dental care is both safe and effective during pregnancy. These statements and guidelines may not be widely understood across all healthcare providers that form the perinatal care team, and confusion seems to exist among the general public regarding the safety of and necessity for dental care during pregnancy. Only about half of pregnant patients seek care, even those with dental problems. Previous articles in this series have reviewed appropriateness of dental care during a healthy pregnancy and specific steps to be taken in consideration of the altered physiology brought on by pregnancy and the increased risk associated with oral diseases such as changes in periodontal status, dental caries, and acid erosion; communication through the technique of motivational interviewing with patients who are either planning to become or are pregnant; and collaboration with the perinatal team of providers to ensure improved health outcomes for mother and baby. This final article in the series addresses considerations during and after pregnancy to ensure mother and child may follow a pathway to a future of good oral health. [ABSTRACT FROM AUTHOR]

Background: The Minamata Convention embodies a worldwide reduction in the production and use of mercury and mercury-containing products and processes, including a phase-down of dental amalgam. This will change the approach to the use of direct restorative materials in the near future. There is little research as to the influence of clinical factors on dentists' decision-making which may be of use when determining the impact of any change.Methods: An online survey relating to aspects of and attitudes to the use of direct restorative materials was distributed to all dentists who were members of the Australian Dental Association and/or members or fellows of the Royal Australasian College of Dental Surgeons. Data were statistically analysed.Results: There were 408 respondents to the survey. Eighty-seven per cent of respondents (strongly) disagreed that amalgam was a technically more difficult material to place compared with resin composite, 82% (strongly) disagreed that placement time for amalgam was longer than that for resin composite and 69% (strongly) disagreed that amalgam was more difficult to finish than resin composite. Eighty-three per cent of respondents stated they were confident in their ability to place amalgam restorations. Where physical properties were of importance, indirect restorations were preferred (e.g. parafunction) 54%. The factors considered most important when choosing a direct restorative material included moisture control and aesthetics; least important factors were cost and time to place.Conclusions: There is consensus that amalgam is not more technically difficult to use, place or finish than resin composite and vice versa. There is recognition that both amalgam and resin composite have limitations in terms of physical properties. When choosing a direct restorative material, clinical factors considered to be of greatest importance are moisture control, aesthetics and the need to apply minimally invasive approaches. There is little difference in the opinions of users and non-users of amalgam with respect to these findings. [ABSTRACT FROM AUTHOR]

Objectives: a. To assess the dental anxiety among patients visiting dental clinics of a teaching institution. b. To evaluate different factors associated with the dental anxiety. Methodology: A cross sectional study was carried out at the Aga Khan University Hospital dental clinics from September 2008-November 2008. A total of 174 otherwise physically healthy males and females patients who presented for the dental treatment were asked to get inducted in the present study through an informed consent. Data was collected using a selfadministered questionnaire which comprised of three parts. The first part of the questionnaire consisted of demographic information; the second pan of it assessed the level of dental anxiety; whereas the last part evaluated different factors related to the dental anxiety. Results: There were 174 participants (88 males and 86 females) in the study. The mean age of the participants was 35 ± 15years. A statistically significant association was found between the age and dental anxiety, as younger patients reported higher level of dental anxiety (p = 0.046). Dental anxiety was more prevalent among females than males; however the association was not found to be statistically significant. Factors such as bleeding during treatment (p = < 0.01), local anesthetic injection (p = < 0.01), appearance of dental chair (p = < 0.02), fear of pain during the use of dental drill (p = < 0.01) were significantly associated with dental anxiety. Conclusions: Dental anxiety was found to be associated with young age, female gender and need of local anesthesia. [ABSTRACT FROM AUTHOR]

Many patients with dental anxiety avoid dental visits. Listening to music is an effective method to reduce anxiety. Our objective was to examine the effects of musical audition in reducing anxiety and perceived pain in a sample of Romanian dental patients. We expected to find significantly reduced anxiety in the two intervention groups, and significantly lower levels of perceived pain in the intervention groups compared with the control group. The 123 participants involved were randomly assigned in control (CG-no music - 38 participants), the symphonic (41 participants), and lounge music groups (44 participants). The subjective level of anxiety was measured on a 10-points Likert scale (10 - very tensioned), whereas the objective level of anxiety was measured using the pulse rate. Perceived pain was also measured on a 10-points Likert scale (10 - very painful). Results indicate that the musical audition had no effect upon the reduction in subjective anxiety, irrespective of the type of music. This may reflect that the only variable that had an effect on subjective anxiety is ending the dental procedure. Objective levels of anxiety present a decreasing pattern in both experimental groups with no significant decrease in the control group. The severity of the intervention is a significant predictor of perceived pain, suggesting that the complexity of the dental procedure is the only variable that influences retrospectively perceived pain. Future studies should test alternative methods (music preferred by patients, or music that previously worked for them as relaxation method). [ABSTRACT FROM AUTHOR]

Objective While research in terms of patient-centered care in implant therapy is growing, few studies have investigated patients' initial perceptions prior to consultation with the implant dentist. The aim of this cross-sectional study was to capture patients' initial information level, perceptions, as well as expectations from the implant therapy. Method A 34-item questionnaire was developed to investigate patients' preoperative information, perceptions and expectations from treatment with Dental Implants. The study was conducted in three locations (Hong Kong, SiChuan and JiangSu) during 2014-2015 with 277 patients. Results The main information source about implant therapy was the dentist or hygienist for less than half of the patients ( n = 113, 42%). About 62.8% of participants considered that they were in general informed about implants, but only 17.7% felt confident with the information they had. More than 30% of the sample appeared to maintain dangerous misperceptions about Dental Implants: 'Dental Implants require less care than natural teeth'; 'Treatment with Dental Implants is appropriate for all patients with missing teeth'; 'Dental Implants last longer than natural teeth'; and 'Treatments with Dental Implants have no risks or complications.' Patients were divided when asked whether 'Dental Implants are as functional as natural teeth' (agreement frequency = 52.7%). Expectations from treatment outcome were commonly high, while there was a significant correlation between the overall mean of perception scores and outcome expectation scores ( r = 0.32, P < 0.001). Overall, younger subjects (<45 years) and those with higher education level (bachelor and postgraduate) tended to present more realistic perceptions and lower outcome expectations. Conclusion The majority of patients in this study presented relatively realistic perceptions. However, an alarming portion of the sample presented with inaccurate perceptions and unrealistic expectations, which the dental team would need to diagnose and correct prior to initiating implant treatment. [ABSTRACT FROM AUTHOR]

Introduction: The importance attached to ethical practice and related informed consent varies among health professionals and is further influenced by working environments, level of knowledge, experience and societal values and beliefs. The objective of this study is to evaluate the ethical conduct of professors, undergraduates and graduate students through questionnaires answered by patients. Methods: One hundred twenty (120) patients at the dental clinics of three different dental schools in São Paulo State were interviewed based on objective and discursive questions about signed informed consent, participation in scientific research, photographs during treatment, requested saliva samples, tooth donation requests, and information about tooth destination after removal. A frequency distribution (absolute and percentage values) was used for a statistical analysis of the data. Results: In all, 65.8% of the patients had given signed informed consent for treatment and 12.5% had not done so; 10.8% did not know if they had participated in scientific research; 54.2% were photographed during dental procedures and 47.1% of them had signed an authorization form; 6.6% were requested to provide a saliva sample and 66.6% of them had signed an authorization form to that effect; 16.1% had a tooth donation requested and 64.4% of them had signed an authorization form to that effect; and 61.3% did not know the destination of the tooth after removal, when donation was not requested. Conclusions: The majority of the patients had signed an informed consent form for treatment, photographs, saliva samples and tooth donation. This demonstrated ethical conduct towards patients on the part of professors, undergraduates and graduate students. [ABSTRACT FROM AUTHOR]

Background: The aims of this study were to examine variations in levels of access to public oral health services in New South Wales by teenagers from 2004-05 to 2014-15 and to determine whether more teenagers have been treated with preventive dental items in keeping with the strategic shift statewide towards prevention and early intervention.Methods: This study involved an analysis of a subset of the New South Wales Oral Health Data Collection for teenagers treated in the New South Wales Public Oral Health Service in the financial years 2004-05 to 2014-15. Relevant Australian Dental Association dental service item groups are reported for teenagers by year as a percentage of total visits delivered in that year.Results: The utilization of the New South Wales Public Oral Health Service by teenagers has remained relatively stable over the 11 years at approximately 6%, while the provision of some preventive items increased over the time period.Conclusions: There were important differences found in access by teenagers to preventive items by socio-economic status and rurality, and these differences will be targeted over the coming years by New South Wales Public Oral Health Services and better monitored by a new electronic oral health record being implemented statewide from 2016. [ABSTRACT FROM AUTHOR]

The article presents the American Academy of Pediatric Dentistry (AAPD) guidelines on management of dental patients with special health care needs. Designed for health care providers, parents, and other organizations, the suggestions include treatment recommendation for oral conditions, behavior guidance, and appointment scheduling methods.

The article focuses on the collaboration of dental professionals in Europe to treat esthetically challenged dental patients. Topics discussed includes treatment of injured , non injured and missing teeth; creation of appropriate space during dental implants and a case on appropriate and functional position of maxillary central incisors.

The article talks about alcohol misuse found in dental patients. It states that dental professionals must adopt a preventive approach towards patient's oral care. Topics include impact of alcoholism on oral and general health, guidelines of safe drinking in Great Britain, and medical history of alcoholism.

Background: Noise is a source of pervasive occupational hazard for practicing dentists and the patients. The sources of dental sounds by various dental equipments can pose as a potential hazard to hearing system and add to the annoyance levels of the patients. The aim of the study was to analyze the noise levels from various equipments and evaluate the effect of acoustic noise stimulus on dental fear and annoyance levels among patients attending different dental clinic setups in Jaipur, India. Methodology: The sampling frame comprised of 180 patients, which included 90 patients attending 10 different private clinics and 90 patients attending a Dental College in Jaipur. The levels of Acoustic Noise Stimulus originating from different equipments were determined using a precision sound level meter/decibulometer. Dental fear among patients was measured using Dental Fear Scale (DFS). Results: Statistical analysis was performed using chi square test and unpaired t-test. The mean background noise levels were found to be maximum in the pre-clinical setup/ laboratory areas (69.23+2.20). Females and the patients attending dental college setup encountered more fear on seeing the drill as compared to the patients attending private clinics (p<0.001). Conclusion: The sources of dental sounds can pose as a potential hazard to hearing system. It was analyzed that the environment in the clinics can directly have an effect on the fear and annoyance levels of patients. Hence it is necessary control the noise from various dental equipments to reduce the fear of patients from visiting a dental clinic. [ABSTRACT FROM AUTHOR]

The article presents suggestions for managing a patient suffering from aphthous ulcers that causes non-contagious mouth ulcers. It mentions that the pain severity in this disease depends on the size of the lesions. It also mentions that the disease can be diagnosed by conducting complete extraoral and intraoral examinations. It informs that the disease can be treated by applying benzydamine hydrochloride mouthrinse for two weeks or until ulcers heal.

The most frequent mechanical complications of bar-retained implant overdentures (IODs) are fracture of the dentures, loosening of the bar screws, and the need to reactivate the retentive clips. When a bar-retained IOD with an acrylic resin base fractures, the existing bar attachment should be removed to fabricate a new overdenture. So far, no method has been previously described for remaking a fractured mandibular bar-retained IOD without removing the existing bar attachment. This article describes fabrication of a fractured mandibular bar-retained IOD with distally placed ball attachments using attachment transfer analogs. The described technique allows the patient to use the existing overdenture temporarily until the new overdenture is delivered. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to evaluate and compare the importance of amount of gingival display on smile esthetics and facial attractiveness in males and females with different facial forms by orthodontists as well as lay person. Materials and Methods: Frontal photographs of 18 male and female patients (9 male and 9 female) each, at a posed smile, seeking treatment in the Department of Orthodontics and Dentofacial Orthopedics were obtained. The photographs were divided in 3 groups based on their facial forms (Short face, Average face and Long face) and were altered by moving the dentition within the lip frame of the captured photograph to bring about different gingival display at smile. The pictures were divided into six groups with gingival exposures of 0 mm, 1 mm, 2 mm, 3 mm, 4 mm and 5 mm. The pictures were rated for attractiveness by four sets of evaluators - male and female Orthodontists and male and female lay evaluators. The statistical analysis methods used for the study included Mean score calculation, standard deviation and Analysis of variance: [test (Mono- Variance)]. The Student t test (two tailed, independent) has been used to find the significance of rating scores between lay person and orthodontist, and also between males and females evaluators. Results: No significant difference in ratings of gingival display in the 3 groups of photographs was noted by lay person and orthodontists. The results point to the fact that the influence of amount of gingival display on smile esthetics was independent of the facial form. It was also observed that gingival display of 0 mm to 2 mm was acceptable to both the lay person and the orthodontists. Conclusion: As the amount of gingival display increased, the ratings for facial attractiveness by both orthodontists and lay person decreased. Higher scores were given by both orthodontists and lay person for photographs which showed gingival display of 0-2 mm, suggesting this value to be most acceptable. [ABSTRACT FROM AUTHOR]

Objective: The study was to identify the number, type of bacteria and to compare the results of bacterial contamination isolated from skin under rings, watches among clinical and non-clinical dental staff. Methods: A cross-sectional study was conducted on 40 volunteers in which 20 were clinical dental staff and 20 were non-clinical dental staff. 6 skin sites were sampled from each volunteer; the skin directly under the ring, the same site on finger of the other hand, the skin under the watch face, similar site on the wrist of the other hand, the inner surface of each ring and inner surface of the watch. Results: There was significantly greater number of bacteria isolated from under the skin surface of ring (p= 0.017) among the non-clinical staff compared with clinical dental staff. Whereas, there was a significantly greater number of bacteria isolated from skin surface of watch (p= 0.000) and inner surface of ring (p= 0.001), inner surface of watch (p= 0.023) among the non-clinical staff compared with clinical dental staff. Conclusions: Rings and watches increased the frequency of hand contamination among both clinical and non-clinical dental staff. Although it is higher among non-clinical staffs, still it serves as a potential source of infection among clinical staff as well. Thus it is recommended to remove the watch and ring before starting any clinical procedure and proper hand washing after clinical procedure. [ABSTRACT FROM AUTHOR]

The article presents information related to iOC Intraoral Scanner and invisalign as a method for straightening teeth. It states that this technology would help patients to easily view the simulated alignment of their teeth at the chair. Integration of iOC Scanner and Invisalign provides an important application and various advantages for digital scanning within the orthodontic practice.

Objectives . The aim of this study was to evaluate patient experiences of inconvenience and treatment need while waiting for dental treatment. Materials and methods. A systematic sample of 210 patients with varying lengths of waiting time was drawn from the waiting list for non-emergency treatment in the City of Turku. A questionnaire covering socio-demographic background was mailed to the patients. The level of inconvenience caused by waiting was assessed by a linear visual analogue scale (0-100). Results. A total of 112 subjects (60%) completed and returned the questionnaire and 109 (58%) gave permission to collect data from their patient records. The average inconvenience score was 42.9, with those who had waited for 3 months or less reporting less inconvenience than those that had waited for 4 months or more. There was not a straightforward linear correlation between length of waiting time and level of inconvenience experienced. Experiences of inconvenience were independent of socio-demographic background. The patient-reported maximum acceptable waiting time for non-urgent dental treatment was 45.8 days. Fewer than half (42.0%) of the subjects had received treatment while waiting for comprehensive care; women (51.7%) significantly ( p < 0.05) more often than men (31.5%). Fillings and unspecified emergency treatments were the most commonly needed treatment. Conclusions. Waiting for dental treatment appears to be well-tolerated, as long as the waiting time remains reasonable. Treatment providers seem to have few means with which to rank dental patients into several queues with different urgencies. [ABSTRACT FROM AUTHOR]

Interprofessional education (IPE) should help to promote a team-based approach to professional practice but there are barriers to its implementation including professional identity. The aim of this study was to use a qualitative research methodology to explore dental and dental care professional (DCP) students' perceptions of professional roles and identities in the dental team. Data were collected by means of focus groups from a purposive sample of dental and DCP students and were audio recorded, transcribed and analysed using an explanatory framework. Five common themes emerged around the issue of professional roles and identity in the dental team. The results indicate that professional identity was an important factor in team development and was determined by direct responsibility for patient care and by the amount of clinical experience acquired. Professional identity within a team context was perceived as different from professional identity per se. Dental students were found to lack confidence in their role as team leaders which was related to their lack of knowledge of team roles, responsibilities and experience. The role of the dental technician was perceived as 'outside' the dental team due to lack of patient interaction. [ABSTRACT FROM AUTHOR]

Oral surgery is often an unpleasant experience for a patient and if managed inadequately can be a cause for complaint or a claim in negligence. A practitioner can reduce their risk of complaints, claims or even regulatory body investigations by following some straightforward risk management strategies. Effective communication skills deployed throughout the interaction with the patient, especially during the consent process, are a pre-requisite, as is a proper understanding of the law on consent. An honest reflection by the practitioner on their competence to carry out a procedure, considering their skills, the equipment and support available will result in fewer medico-legal cases. In this article, each stage of the patient's journey is discussed and risk management advice offered for a range of procedures that are regularly encountered in general dental practice. [ABSTRACT FROM AUTHOR]

There is no commonly accepted standardized terminology for oral diagnoses. The purpose of this article is to report the development of a standardized dental diagnostic terminology by a work group of dental faculty members. The work group developed guiding principles for decision making and adhered to principles of terminology development. The members used an iterative process to develop a terminology incorporating concepts represented in the Toronto/University of California, San Francisco Creighton University and International Classification of Diseases (ICD)-9/1 0 codes and periodontal and endodontic diagnoses. Domain experts were consulted to develop a final list of diagnostic terms. A structure was developed, consisting of thirteen categories, seventy-eight subcategories, and 1,158 diagnostic terms, hierarchically organized and mappable to other terminologies and ontologies. Use of this standardized diagnostic terminology will reinforce the diagnosis-treatment link and will facilitate clinical research, quality assurance, and patient communication. Future work will focus on implementation and approaches to enhance the validity and reliability of diagnostic term utilization. [ABSTRACT FROM AUTHOR]

The introduction of orthodontic therapists in 2007 has led to significant changes to the delivery of orthodontic treatment in tile UK. This article outlines the author's experience of training therapists on the Yorkshire Orthodontic Therapy Course and discusses challenges faced by this new way of providing orthodontics in the UK. [ABSTRACT FROM AUTHOR]

Background/purpose: Scores of the Oral Salutogenic Score (OSS) and Medical Outcomes Study Short Form-20 (MOS SF-20) of university students in Taiwan and Japan were determined to compare the oral and general health status of students in these 2 countries. Materials and methods: The oral health of students enrolled in 1 national university and 1 private university from each country were examined by trained dentists. Student ages ranged 18-25 years with 674 (371 males and 303 females) from Taiwan and 1117 (506 males and 611 females) from Japan. For convenience, 1 national university and 1 private university from each country were chosen, and students not majoring in oral health were investigated using a selfadministered questionnaire filled out by all students. The questionnaires consisted of the MOS SF-20 and OSS. The students' oral-health conditions were examined by 10 dentists in Taiwan and Japan after undergoing training on private university students in each country. Results: As to questions concerning general health, 20% of Japanese university students answered "excellent" compared to only 5-10% of Taiwanese university students. Values of the decayed, missing, and filled permanent teeth (DMFT) index were 4.8 and 5.0 for male and female Japanese students, and 5.9 and 8.0 for Taiwanese ones. Values of the DMFT index of the first permanent molar were 2.1 and 2.3 for male and female Japanese students, which were lower than those of Taiwanese (2.3 and 2.9, respectively) (adjusted odds ratio: 13.1; 95% confidence interval: 3.9-44.3). The proportion of Taiwanese students with swollen gums was higher than that of Japanese students (adjusted odds ratio: 5.3; 95% confidence interval: 4.1-6.7). The proportion of Taiwanese students who had access to a family dentist was lower than for Japanese students (adjusted odds ratio: 5.3; 95% confidence interval: 4.1-6.7). Indices of health perception on the MOS for Taiwanese (51.8-58.2%) were lower than those of Japanese students (69.3-72.3%). The Japanese student's physical functioning, social functioning, health perceptions, and pain scores were significantly better than those of Taiwanese students (P <0.001). The Taiwanese student's mental health score was significantly higher than that of Japanese students (P <0.05). Conclusion: The status of oral and general health of Taiwan students was worse than that of their Japanese counterparts. This might have been due to differences in regularity of visiting family dental services, health perceptions, public oral-health policies, preventive strategies during early life stages, and health perceptions of students. [ABSTRACT FROM AUTHOR]

The article features Laura Horton, owner of a treatment coordinator (TCO) firm. It says that Horton began her career as a dental receptionist and then passed the dental nurse National Certificate course. Horton admits that she did not know TCO when she was interviewed for this role, but says she loved doing her job, meeting new people and helping scared patients become confident. It mentions that Horton used the free social networking sites Facebook and Twitter to launch her business.

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Commissioned by NHS Education South Central (NESC) Postgraduate Dental Deanery, this work provided an external, independent formative evaluation of the Dental Therapists Vocational Training (TVT) scheme in its first year of operation. Undertaken between March-September 2009, the evaluation engaged with all those involved in the TVT scheme: the newly qualified dental therapists (n = 9; group discussion and questionnaire; portfolio extracts) and interviews with their trainers (n = 9), Associate Postgraduate Dental Dean and TVT Scheme Adviser. Most of those on the scheme did not feel well prepared for work at the point of initial qualification and benefitted from enhancement of confidence and skills. Although the number of treatments undertaken by each of the trainees varied considerably, there was commonality in terms of treatment types. Benefits for trainers included the opportunity to work with a dental therapist and develop a better understanding of their role. They praised the trainees' skills with nervous patients and children and their preventative work. A therapist on the team released the dentist for more complex treatments. Challenges related to the recruitment of trainees and trainers, the relative lack of knowledge about the work of dental therapists, concerns about maintaining the range of therapy skills and issues about UDA (unit of dental activity) distribution. There was widespread support for a mandatory TVT scheme. This scheme could be improved by providing further guidance on the amount and type of clinical experience required. [ABSTRACT FROM AUTHOR]

This paper reviews the important parameters deemed useful in the diagnosis and management of periodontal disease in general dental practice. We aim to highlight the importance of these when making a diagnosis and the necessary treatment undertaken in general dental practice before considering referral to specialist services. We also provide guidelines to assist the referral of patients for periodontal treatment in specialist care settings. [ABSTRACT FROM AUTHOR]

Crown-lengthening surgery (CLS) consists of recontouring and repositioning the gingival margin as well as the alveolar crest. This technique results in the increase of the clinical crown height of teeth, which can consequently be advantageous in terms of improving retention and resistance, as well as aesthetics. The aim of this article is to demonstrate the uses of the diagnostic wax set-up and the subsequent production of surgical stents and templates to provide the patient with an initial intra-oral diagnostic mock-up for the process of obtaining consent, as well as acting as a useful guide for gingival and osseous recontouring in order to achieve a predictable, healthy and stable dento-gingival complex with pleasing aesthetics. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the effect of maximum bite force (mBF) on marginal bone loss (MBL) around mini-implants in edentulous patients wearing mandibular overdentures with two retention systems: ball and bar. Material and methods: Forty-five totally edentulous patients were selected from a public health center. All of them received two mini-implants (1.8 × 15 mm; Sendax®) in the anterior mandible using a minimally invasive technique. A single randomization was performed to allocate the patients in two groups. Group I ( n=22) received two single ball-type mini-implants and Group II ( n=23) received two mini-implants splinted with a prefabricated bar. The mBF was recorded using a press-sensitive sheet Dental Prescale® (Fuji) and MBL using standardized radiographs of each mini-implant at the baseline and 5, 7, 10, and 15 months after surgery; the values were compared between groups. Results: Two members of Group I failed to complete the study, decreasing the number of participants to 20. There was no relationship between the mBF and the MBL of the mini-implants (Spearman's ρ rs=0.147; P=0.378). At the 15-month follow-up, the average mBF for Group I (ball) was 247.53 ± 132.91 N and that of Group II (bar) only 203.23 ± 76.85 N (Mann–Whitney test; P=0.586). The MBL values were also higher for Group I (1.40 ± 1.02 mm) than Group II (0.84 ± 0.66 mm) during the entire 15-month follow-up period (Mann–Whitney test ; P=0.077). Conclusions: No relationship was found between mBF and MBL for patients wearing overdentures retained on mini-implants using bar or ball attachment systems. To cite this article: Jofré J, Hamada T, Nishimura M, Klattenhoff C. The effect of maximum bite force on marginal bone loss of mini-implants supporting a mandibular overdenture: a randomized controlled trial. Clin. Oral Impl. Res. 21, 2010; 243–249. doi: 10.1111/j.1600-0501.2009.01834.x [ABSTRACT FROM AUTHOR]

Patients sometimes appear for dental appointments after consuming alcohol or marijuana. There is presently no consensus standard of care in this area, and dentists vary in their responses to such patients. This paper includes interviews with practitioners and a review of the relevant biochemical and physiological science. The ethics of various ways to handle this challenging situation are examined, and evidence-based recommendations for dental practice are offered. While there is reason for caution, the authors conclude that a blanket "do not treat" policy is unwarranted. Informed consent and transportation safety issues pose significant moral challenges when a dental patient is "high." [ABSTRACT FROM AUTHOR]

The author presents a personal narrative of her experiences as a dental assistant from dental care provider Northridge Dental Group dealing with colleagues and various patients.

Objectives: Attached gingiva is important for maintaining periodontium in a healthy state. The present study tries to find the normal values of width of attached gingiva in a periodontally healthy Indian population. Material and Methods: The width of attached gingiva was measured with a periodontal probe in periodontally healthy patients attending the periodontics department. Descriptive statistical analysis was done to get the mean, which will represent the normal values of width of attached gingiva for the population. Results: Female patients had a greater width than males and the 20 to 30 year old group had the greatest width of attached gingiva. The mean values of attached gingiva varied in different areas of the mouth with greatest width in maxillary central incisors and least in mandibular molars. Conclusion: Width of attached gingiva varies with age, gender and in different areas of the mouth. [ABSTRACT FROM AUTHOR]

Background Dental disease is more common among people with intellectual disabilities than in the general population. Improvements in oral health require individuals to engage in daily oral hygiene and regular visits to a dental practitioner; both may be challenging for the individual with intellectual impairment. Materials and Methods A review of policies relating to behaviour management and physical restraint for individuals with intellectual disabilities and challenging behaviours was undertaken. Published studies of behaviour management in individuals with intellectual disabilities attending for dental treatment were reviewed. Reference to studies of children with average IQ and other populations were made where appropriate. Results There is little published evidence regarding behaviour management for people with intellectual disabilities who require dental treatment. Current policies place great emphasis on pharmacological management and restrictive behaviour management techniques. There is a paucity of studies which have employed a functional analysis framework. There are few incentives for dentists to implement positive approaches to behaviour management as current systems of payment reward the completion of numbers of treatments and thus there is an incentive to complete treatments quickly rather than to spend time with patients. Conclusions There is a need for research addressing the behaviour management of individuals with intellectual disabilities who require dental treatment, particularly the efficacy of non-restrictive techniques and the provision of incentives that reward the use of positive behaviour management among dentists. The use of restrictive techniques should be carefully monitored for compliance with best practice guidelines. [ABSTRACT FROM AUTHOR]

Objective: To determine whether there are differences in self-awareness and perception of an individual's own profile among various groups. Materials and Methods: Laypeople, orthodontic patients, and first (D1) and third-year dental (D3) students were surveyed (n = 75 each). The participants answered a questionnaire regarding how they felt about their own profile and teeth. They also chose from among various silhouettes the one that most resembled their own profile. Profile photos of participants were analyzed by two orthodontists who matched the individual to the depicted silhouettes. Agreement between participants and experts was evaluated using the Kappa statistic. Differences among groups in identifying their own profiles and differences among profile types in satisfaction with their appearance were compared using χ². Results: Overall agreement between the individuals' perceptions of their own profiles and evaluation by orthodontists was 53% (κ = .15). The four groups were different in their ability to recognize their own profile (P < .05). D3s were most accurate (64%, κ = .28), followed by D1s (57%, κ = .10), orthodontic patients (48%, κ = .19), and laypeople (43%, κ = .04). Individuals who considered themselves as having a Class II or III profile were less satisfied with the appearance of their profiles (P < .05). Those who considered themselves as having a Class III profile were also less happy with the appearance of their teeth (P < .05). Conclusions: This study suggests that about half the population cannot characterize their own profile. However, subjects who perceived their own profiles as being different from average were more likely to be unhappy with their facial appearance. [ABSTRACT FROM AUTHOR]