bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pain part 8: burning mouth syndrome
Authors: Beneng Kiran , Renton Tara 
Published: August 2017

Burning mouth syndrome (BMS) is a rare but impactful condition affecting mainly post-menopausal women resulting in constant pain and significant difficulty with eating, drinking and daily function. The aetiology of BMS remains an enigma. Recent evidence suggests it likely to be neuropathic in origin, the cause of which remains unknown. There is no cure for this condition and the unfortunate patients remain managed on a variety of neuropathic pain medication, salivary substitutes and other non-medical interventions that help the patient ‘get through the day’. Some simple strategies can assist both clinician and patient to manage this debilitating condition.CPD/Clinical Relevance: The dental team will recognize patients presenting with burning mouth syndrome. They are difficult patients to manage and are often referred to secondary care and, ultimately, depend on their general medical practitioners for pain management.
Mouth cancer for clinicians part 9: the patient and care team
Authors: Kalavrezos Nicholas , Scully Crispian 
Published: August 2017

A MEDLINE search early in 2015 revealed more than 250,000 papers on head and neck cancer; over 100,000 on oral cancer; and over 60,000 on mouth cancer. Not all publications contain robust evidence. We endeavour to encapsulate the most important of the latest information and advances now employed in practice, in a form comprehensible to healthcare workers, patients and their carers. This series offers the primary care dental team in particular, an overview of the aetiopathogenesis, prevention, diagnosis and multidisciplinary care of mouth cancer, the functional and psychosocial implications, and minimization of the impact on the quality of life of patient and family. Clinical Relevance: This article offers the dental team an overview of the multidisciplinary team (MDT; or multi-speciality team) and its roles, and an overview of the implications of therapies that are discussed more fully in future articles in the series.
Mouth cancer for clinicians part 10: cancer treatment (surgery)
Authors: Kalavrezos Nicholas , Scully Crispian 
Published: August 2017

A MEDLINE search early in 2015 revealed more than 250,000 papers on head and neck cancer; over 100,000 on oral cancer; and over 60,000 on mouth cancer. Not all publications contain robust evidence. We endeavour to encapsulate the most important of the latest information and advances now employed in practice, in a form comprehensible to healthcare workers, patients and their carers. This series offers the primary care dental team in particular, an overview of the aetiopathogenesis, prevention, diagnosis and multidisciplinary care of mouth cancer, the functional and psychosocial implications, and minimization of the impact on the quality of life of patient and family. Clinical Relevance: This article offers the dental team an overview of surgery for the treatment of mouth cancer.
Mouth cancer for clinicians part 11: cancer treatment (radiotherapy)
Authors: Kalavrezos Nicholas , Scully Crispian 
Published: August 2017

A MEDLINE search early in 2015 revealed more than 250,000 papers on head and neck cancer; over 100,000 on oral cancer; and over 60,000 on mouth cancer. Not all publications contain robust evidence. We endeavour to encapsulate the most important of the latest information and advances now employed in practice, in a form comprehensible to healthcare workers, patients and their carers. This series offers the primary care dental team in particular, an overview of the aetiopathogenesis, prevention, diagnosis and multidisciplinary care of mouth cancer, the functional and psychosocial implications, and minimization of the impact on the quality of life of patient and family. Clinical Relevance: This article offers the dental team an overview of the use of radiotherapy, and its effects on the mouth and other tissues.
The management of the dilacerated impacted maxillary central incisor
Authors: Prado Naomi , Malik Ovais , Waring David 
Published: August 2017

The clinical problem of how best to manage a dilacerated, impacted maxillary central incisor will only be encountered rarely. The treatment aim should be to achieve results that are indistinguishable from normal appearance in a way that is appropriate for the patient. This article discusses the incidence of dilacerations in maxillary incisors and describes the treatment approaches available – orthodontic alignment or surgical removal and management of the resulting space, considering orthodontic repositioning, autotransplantation and various prosthetic replacements. Treatment indications, advantages and disadvantages, restorative and surgical implications, as well as the evidence-base relating to the various treatment modalities will be presented, along with clinical case examples. CPD/Clinical Relevance: This paper discusses a problem that, if not managed appropriately, can lead to poor results for the patient. Even for practitioners who may not undertake the treatment mentioned, it will enable them to have more in-depth discussion with their patients should the situation arise.
Amyloidosis presenting as macroglossia and restricted tongue movement
Authors: Dawoud Basim ES , Taylor Jennifer , Ariyaratnam Senathirajah , Pemberton Michael N 
Published: August 2017

Amyloidosis (AL) is a well recognized cause of macroglossia. A case of localized deposition of systemic amyloidosis secondary to multiple myeloma is reported in a 63-year-old female presenting with restricted tongue movement in the dental setting. Amyloidosis secondary to multiple myeloma is well documented in the literature, with amyloid deposits being found at various sites throughout the oral cavity and systemically. This case emphasizes the importance of a full oral soft tissue examination, including the need to examine mobility of the tissues, as it was the restricted movement of the tongue that ultimately alerted the clinician to the diagnosis. This report also highlights other dental implications of managing patients with multiple myeloma and amyloidosis. CPD/Clinical Relevance: To provide an understanding of what multiple myeloma and amyloidosis are whilst, importantly, relating this to how these conditions can impact on routine dental treatment.
The role of the GDP in assessment and management of the early orthodontic referral
Authors: Flett Andrew MC , Sandler Jonathan 
Published: August 2017

Many of the orthodontic patients in the UK are treated in early adolescence. This occurs when most of the permanent dentition has erupted and after the general dental practitioner (GDP) has had the opportunity to assess the patient using the index of orthodontic treatment need (IOTN). There are certain types of malocclusion that present before this age and would undoubtedly benefit from earlier referral. CPD/Clinical Relevance: To describe the malocclusion and dental anomalies that benefit from ‘early’ orthodontic assessment and active intervention.
A guide to deep neck space fascial infections for the dental team
Authors: Main Barry , Collin John , Coyle Margaret , Hughes Ceri , Thomas Steven 
Published: August 2017

The majority of serious dental infections can be prevented by early treatment of the local pathology. Patients with potentially life-threatening neck space infections arising from the oral cavity may, however, still present in dental practice. This paper outlines the pertinent surgical anatomy and pathophysiology, signs and symptoms, and key early-stage management of these severe infections. CPD/Clinical Relevance: The dental team should be able to assess patients presenting with potential neck space involvement from a dental or oral infection. They should be able to instigate appropriate early treatment, and identify those requiring prompt referral for assessment and management.
Natural rubber latex allergies from dental local anaesthetic: a review and guidance for the dental practitioner
Authors: Thomas Joel , Bell Christopher 
Published: August 2017

Natural rubber latex (NRL) is present within many dental products including local anaesthetic (LA) cartridges. Patients with NRL sensitivity are at risk of developing type I and type IV allergic reactions from exposure to these products. Evidence from current literature is inconclusive yet highly suggestive that NRL contamination may occur in medicines stored within vials containing natural rubber components. It would therefore be prudent to avoid using such products in patients with a known NRL allergy. For dental practitioners this applies to LA cartridges and is easily achievable, as manufacturers now produce products not made with NRL. This article aims to provide guidance for dental health professionals regarding the use of LA in patients with a known NRL hypersensitivity. CPD/Clinical Relevance: NRL allergies are a rising concern amongst medical professions and these reactions should be avoided wherever possible.
The importance of prompt referral when tooth roots are displaced into the maxillary antrum
Authors: Beech Andrea N , Farrier Jeremy N 
Published: August 2017

When an upper tooth is extracted a possible complication is the creation of an oro-antral communication with the added risk of displacement of tooth roots into the antrum. We present a case of a displaced palatal root of an upper first molar tooth which was found in a superior position in the maxillary antrum having been left in situ for 6 weeks. The root was in a high risk position for complications such as sinusitis, mucocoele formation and the more serious septic thrombosis of the cavernous sinus. This case report describes its safe endoscopic removal and highlights the importance of prompt referral and treatment for similar cases. CPD/Clinical Relevance: Displaced roots in the maxillary antrum during routine extraction can result in complications ranging from sinusitis to more severe complications if not managed appropriately.
A new perspective on dentine hypersensitivity – guidelines for general dental practice
Authors: Gillam David G 
Published: August 2017

The aim of this review is to update dental professionals on the issues and challenges associated with the clinical management of dentine hypersensitivity (DH) and to provide simple guidelines based on presenting clinical features that may help them successfully manage the condition in their day-to-day clinical practice. Details on the management of DH have been previously published in Dental Update which indicated that there was a need for such guidelines. The authors of these guidelines also suggested that, despite the various published clinical studies, there does not currently appear to be one ideal desensitizing agent that can be recommended for treating DH. A joint working relationship between the dental professional and the patient in changing the patient's behaviour is therefore essential if the condition is to be successfully treated.CPD/Clinical Relevance: Dentine hypersensitivity is a persistent and a troublesome clinical condition which at times is under diagnosed by dental professionals who may struggle to resolve the problem to their patients' satisfaction successfully. The recent UK Forum guidelines on the management of DH, based on the presenting features of the condition, provide practical recommendations, helping dental professionals to manage this persistent problem correctly.
The limitations of short-term orthodontics and why we still need specialists – a review of the current literature
Authors: Luqmani Sana 
Published: August 2017

Short-term orthodontics (STO) serves to align anterior teeth. It has become popular in cosmetic dentistry as an alternative to destructive veneers and lengthy conventional orthodontics. The aim of this article is to raise awareness of the clinical limitations of STO and highlight some of the difficulties encountered with orthodontic retention. It also gives an overview of accredited training available to dentists who wish to develop their orthodontic skills. CPD/Clinical Relevance: Greater awareness of the clinical limitations of short-term orthodontics will aid GDPs in appropriately selecting their cases and obtaining informed consent from patients. In addition, the article serves as encouragement for those GDPs wishing to develop their orthodontic skills and pursue further accredited training.
Gingival depigmentation by free gingival autograft: a case series
Authors: Pakhare Vikas V , Bajaj Pavan , Bhongade ML , Shilpa BS 
Published: August 2017

A pleasing smile is desired by all, and forms the main focus of aesthetic dentistry. However, pigmented gums can be a major cause of embarrassment for patients, especially those with a gummy smile. Attempts have been made to meet these cosmetic demands by various methods such as using a surgical blade, diamond burs, electrosurgery, cryosurgery or a laser, but with limited results. Therefore, in the present case series, a free gingival autograft was used for treating gingival melanin hyperpigmentation with a follow-up of six months with no signs of repigmentation. CPD/Clinical Relevance: This review outlines a method of free gingival autograft as a treatment modality for gingival pigmentation.
Severe fluorosis treated by microabrasion and composite veneers
Authors: Hoyle Philippa , Webb Lyndsey , Nixon Peter 
Published: August 2017

Dental fluorosis results from excessive intake of fluoride either from water resources or products in early childhood. It results in varying degrees of discoloration and pitting of the teeth. This article aims to highlight the conservative management techniques available for managing the aesthetic impact of fluorosis and highlights what can be achieved conservatively with the use of adhesive dentistry. CPD/Clinical Relevance: Fluorosis can have a huge impact on dental aesthetics, depending on its extent. This in turn can affect a patient's confidence and daily life immensely. In the past, severe fluorosis may have been managed in a more destructive manner with indirect restorations.
Periodontal treatment in patients with learning disabilities part 2: professional mechanical intervention
Authors: Kaka Shazia , Dickinson Chris 
Published: August 2017

The first part of this two part series discussed the potential barriers and risk factors that may lead to an increased incidence and severity of periodontal disease amongst patients with learning disabilities. Additionally, preventive strategies and tools that can be used by general dental practitioners, oral health promotion teams as well as specialists within the field to control and prevent disease progression were explored. To prevent periodontal disease progression and attain optimal periodontal health, a combination of prevention and professional mechanical instrumentation is usually required. The second part of the series concentrates on the role of the dental professional in implementing professional mechanical instrumentation to attempt to reduce the burden of disease further in this patient group. CPD/Clinical Relevance: Although research continues into which professional techniques for instrumentation are the most successful amongst patients with periodontal disease, very little data specifically explore the needs of patients with learning disabilities, despite their high unmet needs. This paper aims to report on any available data present to produce suggestions for care.
Inaccurate dental charting in an audit of 1128 general dental practice records
Authors: Brown Nathan L , Jephcote Victoria EL , Morrison James N , Sutton Jessye E 
Published: August 2017

Fourteen dentists at different practices in the UK assessed the dental charts of 1128 patients who were new to the dentist but not new to the practice; 44% of the dental charts were found to be inaccurate. Inaccuracy of the individual practice-based charts ranged between 16% for the best performing practices to 83% for the worst: 5% of dental charts had too many teeth charted and 5% had too few teeth charted; 13% of charts had missed amalgam restorations and 18% had missed tooth-coloured restorations; 5% of charts had amalgam restorations recorded but with the surfaces incorrect (eg an MO restoration charted but a DO restoration actually present); 9% of charts had tooth-coloured restoration surfaces incorrectly recorded. For 7.5% of charts, amalgams were charted but not actually present. Other inaccuracies were also noted. The authors reinforce the requirements of the GDC, the advice of defence organizations, and the forensic importance of accurate dental charts. CPD/Clinical Relevance: Dental charting forms part of the patient's dental records, and the GDC requires dentists to maintain complete and accurate dental records.
Antibiotic guardians: the role of the dental profession
Authors: Cope Anwen L , Lewis Michael AO 
Published: August 2017

The increasing emergence of antibiotic resistance is a major international public health problem. As a consequence, it is essential that steps are taken to conserve the effectiveness of existing antimicrobial agents. Consumption of antibiotics is the prime contributor to the development of resistance. General dental practitioners write almost 1 out of 10 prescriptions for antibiotics in primary care within the UK and therefore the prudent prescribing of antibiotics in dentistry has never been more vital. This paper outlines the impact of antimicrobial resistance on modern healthcare, describes the current use of antibiotics in general dental practice, and recommends pragmatic ways in which dental practitioners can evaluate and optimize their prescribing. CPD/Clinical Relevance: Dental professionals have a responsibility to both their patients and the wider community to prescribe antibiotics appropriately.
Diagnosis and management of chronic and aggressive periodontitis part 1: periodontal assessment and diagnosis
Authors: Chatzistavrianou Despoina , Blair Fiona 
Published: August 2017

Periodontal disease remains one of the most common diseases that affect the oral cavity. The differential diagnosis between chronic and aggressive periodontitis can be complex for some clinicians and the correct diagnosis is a key element in disease management. The three-part series will review periodontal clinical assessment and diagnosis, periodontal management and finally will discuss two clinical cases. This paper will focus on periodontal disease pathogenesis, periodontal clinical assessment and diagnosis. CPD/Clinical Relevance: This paper aims to provide the general dental practitioner with an understanding of periodontal disease pathogenesis and to highlight elements in the clinical assessment which will help to establish the diagnosis.
An implant-retained obturator – a case study
Authors: Puryer James , Forbes-Haley Claire 
Published: August 2017

This case describes the oral rehabilitation of a patient following maxillary hemi-section due to squamous cell carcinoma of the palate. Planned treatment was construction of a maxillary implant-supported obturator. Two dental implants were placed in his maxilla to aid the support and retention of an obturator. However, owing to bone availability, their angulation was suboptimal and compromised the retention of the obturator. This case describes alternative implant attachments to aid the retention and stability of implant-retained dentures constructed in cases with suboptimal implant placement. CPD/Clinical Relevance: This case highlights the importance of careful planning for implant placement, and reinforces the need to plan the prostheses before implant surgery. This case highlights possible difficulties that can arise if implants are non-ideally angulated, and how to adapt restorations to manage such difficulties in cases with maxillary removable prostheses.
The UK soft drinks industry levy: implications for dental health
Authors: Jones Colwyn , Craig Neil , Anand Neil 
Published: August 2017

A Soft Drinks Industry Levy on sugar-sweetened beverages (SSBs) was announced in the Westminster budget on 16 March 2016. The UK Government plans to introduce the SSB levy in 2018, with legislation enacted in 2017. The aim of the levy is ‘…..to give companies plenty of space to change their product mix’.The levy is a banded duty on soft drinks with less than 5 g/100 ml being classed as tax exempt, drinks with between 5−8 g/100 ml taxed at a basic level tax at 18 pence per litre, and drinks with greater than 8 g/100 ml taxed at a higher level of 24 pence per litre. The Office for Budget Responsibility forecast that the Soft Drinks Industry Levy will attract revenue of £500 million for 2019–2020, the second year of implementation. Unusually, the expected revenue raised will be hypothecated to fund physical activity and breakfast clubs in English schools.CPD/Clinical Relevance: The UK Soft Drinks Industry Levy on SSBs has the potential to reduce both childhood obesity and the prevalence and severity of tooth decay, although precise estimates of effect are unclear. The levy should be welcomed by the dental profession as a structural fiscal policy to improve both general and dental health.
A case for the defence!
Authors: Craig Aubrey 
Published: August 2017

This paper discusses the work of a mutual dental defence organization in assisting its members who request support in relation to professional difficulties. Various cases are discussed in terms of help and support provided, including an explanation of the outcome and how, where adverse, this could have potentially been prevented by the member. CPD/Clinical Relevance: To assist the dental profession's understanding of the work of a dental defence organization.
The use of implants in modern orthodontics
Authors: Bates Claire J , Chung Lucy 
Published: August 2017

Recent advances in the use of implants in orthodontics have greatly expanded the scope of tooth movement for the practising orthodontist. Not only in routine high anchorage demanding cases, but also in complex cases where few teeth are available to act as anchors. Implants in orthodontics are fast becoming another tool for the astute contemporary orthodontist to consider when providing anchorage reinforcement. Perhaps a growing evidence base may suggest that implants, as part of anchorage management, are the future, and that headgear may become consigned to history.
Synchronous straight-wire part 1: theory
Authors: Cole Charles , Hammond Jon 
Published: August 2017

Synchronous Straight-Wire (SSW) is the trademark of the authors Charles Cole and Jon Hammond. This paper is split into two parts. Part one introduces the SSW technique, explains the reasons for its development and outlines theory. Part two illustrates the technique and compares it to others. The aim of this paper is to introduce the SSW technique, which is designed to produce simultaneous synchronized movement and thereby improve efficiency. Complex concurrent movements require planning and co-ordination. An Appliance Configuration Table (ACT) facilitates this and enables the clinician to plan the required movements to correct tooth position fully before linking these to required forces for resolution. Forty cases treated using SSW are compared with other techniques. Efficiency of tooth movement is monitored using a treatment efficiency index (TEI). When compared with other techniques, SSW demonstrates improved efficiency. The technique offers a more efficient means of undertaking fixed appliance treatments and highlights the advantages of pre-programming the entire appliance (not just the brackets) and of using a coherent mechanism to facilitate 3-dimensional movements. Clinical Relevance: The Synchronous Straight-Wire (SSW) technique is a means of organizing simultaneous treatment events by synchronizing, rather than sequencing, tooth movement.