bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management of patients with dental disease and mitochondrial disorders
Authors: Shakir Adam A , Turnbull Doug M , Adams James R 
Published: August 2017

This case report describes dental disease associated with mitochondrial disease (Leigh's disease) in a young adult. Normal preventive dentistry is difficult in these groups of patients and often leads to management required in secondary care. An awareness of the background pathology is needed when managing these groups of patients. Management of dental pathology in this particular patient often required input from other specialties to ensure a successful outcome. Clinical Relevance: To raise awareness of the dental pathologies patients with mitochondrial disease may experience as they present to the general dental practitioner, and what treatments may be appropriate.
‘hubble-bubble leads to trouble’ – waterpipe smoking and oral health
Authors: Shah Savan B , Chestnutt Ivor G , Lewis Michael AO 
Published: August 2017

Waterpipes are used to smoke tobacco by more than 100 million people worldwide. Use is not restricted to any single racial, ethnic, or cultural group, and dentists are almost certain to encounter waterpipe users amongst their patients. This article describes what the practice involves and seeks to inform members of the dental team of the significantly detrimental impacts of waterpipe smoking on both general and oral health and how ‘hubble-bubble really can lead to trouble’. Advising patients on ceasing waterpipe use is also discussed. Clinical Relevance: This paper explains what smoking a waterpipe involves, the associated misconceptions of safety amongst users and the dangers to health.
Special care dentistry: part 3. dental management of patients with medical conditions causing acquired bleeding disorders
Authors: Nizarali Najla , Rafique Sobia 
Published: August 2017

The second paper in this three part series discussed the dental management of patients with drug-related acquired bleeding disorders. This paper will discuss and outline the dental management of patients with acquired bleeding disorders that can result from medical conditions. Again, these may be associated with vascular defects, platelet defects or coagulation defects. In an age when people are living longer, and medical interventions are continually becoming more advanced, clinicians will need to be aware of systemic disorders and treatments that may cause complications in the dental setting. Clinical Relevance: Being able to recognize which medical conditions, including their management, may cause bleeding problems at an early stage will lead to good patient management, particularly in planning and delivering treatment involving any invasive dental procedures that can cause bleeding. Whilst most patients can be successfully treated in general dental practice, the clinician may need to make a decision on whether or not to refer a patient to specialist services for all dental treatment, or to share care between primary care and specialist services.
Long and short term management of implant-supported mandibular overdentures
Authors: Parmar Sabrina , Karir Naveen , Walmsley Damien , Patel Upen 
Published: August 2017

Common problems with the long term clinical use of implant-supported mandibular overdentures (ISMDs) include fractures of dentures, bars and clips, and reactivation of clips. Many general dental practitioners (GDPs) are reticent to be involved in the maintenance of ISMDs, especially if they have not had any further training or are unfamiliar with implant components and systems. This article highlights the need for the training of GDPs in maintenance and management of ISMDs as an increasing number of edentulous patients are being provided with ISMDs, resulting in an increasing need for the maintenance of the prosthesis in the primary care setting at a possible cost to the patient. Clinical Relevance: Implant-supported overdentures are becoming a common treatment option for edentulous patients, however, they are not without their clinical challenges, many of which can be easily rectified in a primary care environment, such as general practice.
Posts – when it all goes wrong! part 2: post removal techniques
Authors: Rollings Sam , Stevenson Brian , Ricketts David 
Published: August 2017

Many different techniques for the removal of posts have been proposed over the years, including the development of a number of different instruments and systems. This article discusses a number of the more common techniques, systems and their indications. Clinical Relevance: Dentists should be aware of the techniques available for the removal of posts and understand which techniques are appropriate for individual cases.
To retrieve or not to retrieve the coronectomy root – the clinical dilemma
Authors: Patel Vinod , Kwok Jerry , Sproat Chris , McGurk Mark 
Published: August 2017

Abstract: Coronectomy of mandibular third molars is a well established technique that is going through a resurgence as it seems to reduce the risk of inferior dental nerve (IDN) injury. The reservation with the technique arises because of fear that the retained root will become infected and symptomatic over time. General dental practitioners will be responsible for the long-term review and care of these patients and, consequently, it is important that they are aware of the technique and its sequelae. Clinical Relevance: Coronectomy of mandibular third molars to avoid nerve injury is becoming increasingly popular. It is important that general dental practitioners (GDPs) are aware of the immediate and later sequelae of treatment and the implication of the retained root.
The coping-retained bridge: a modified approach to conventional bridge design – review and case report
Authors: Campbell Stuart C , Harper Amy L , Scott Kenneth H 
Published: August 2017

Missing teeth may be restored with conventional bridgework. A modified approach to traditional bridge design may be necessary to restore edentulous spaces in the presence of poorly aligned abutment teeth and abutment teeth of guarded prognosis. The coping bridge is a useful technique in the dentist's armamentarium for patients in whom implant-supported or removable prostheses are inappropriate. This paper examines the use of coping-retained bridges as a modification on traditional design and discusses how these appliances may be applied in general practice. A case report is presented describing the application of this design in general practice. Clinical Relevance: Applying a modified approach to bridge design may allow complicated edentulous spaces to be restored successfully in general practice.
Special care dentistry: part 2. dental management of patients with drug-related acquired bleeding disorders
Authors: Nizarali Najla , Rafique Sobia 
Published: August 2017

The first of this series of three articles discussed the dental management of patients with inherited bleeding disorders. This paper will discuss and outline the dental management of patients with acquired bleeding disorders that can result from drug therapy. These may be associated with vascular defects, platelet defects or coagulation defects. In an age when people are living longer, and medical interventions are continually becoming more advanced, clinicians will need to be aware of systemic disorders and treatments that may cause complications in the dental setting. According to National Statistics, 1 the UK population is projected to increase by 0.7% by 2016. This trend is shared with other European countries which also have ageing populations. The proportion of people aged over 65 is predicted to increase from 16% in 2006 to 22% in 2031. Clinical Relevance: Being able to recognize which drugs may cause bleeding problems at an early stage will lead to good patient management, particularly in planning and delivering treatment following invasive procedures such as dental extractions. Whilst most patients can be successfully treated in general dental practice, the clinician may need to make a decision on whether or not to refer a patient to specialist services for all dental treatment, or to share care between primary care and specialist services for selected procedures.
Overview of paediatric dental sedation: 1. current UK guidelines
Authors: Wilson Katherine E 
Published: August 2017

The use of conscious sedation in paediatric dentistry is very beneficial for the management of anxious children. It is essential that it is provided according to national guidelines in a safe and effective manner. Clinical Relevance: Dentists carrying out conscious sedation in children must be aware of current national guidance and the most appropriate techniques to use.
The long and winding road part 2. the CLP patient's journey, 0–21 years
Authors: Sandler Paul Jonathan , Murray Alison , Orr Robert , Madahar Arun K 
Published: August 2017

Patients with a cleft lip and palate (CLP) deformity require the highest standard of care that the NHS can provide and this requires multidisciplinary care from teams located in regional cleft centres. Care of these cases is from birth to adulthood and requires several phases of intervention, corresponding to the stages of facial and dental development. Management ideally starts pre-natally, following the initial diagnosis, and occasionally pre-surgical appliances are prescribed. The lip is ideally repaired within three months, followed by palate closure between 12 and 18 months. Careful monitoring is required in the first few years and ENT referral, where necessary, will diagnose middle ear infection, which commonly affects CLP patients. Speech therapy is an integral part of the ongoing care. Excellent oral hygiene is essential and preventive dietary advice must be given and regularly reinforced. Orthodontic expansion is often needed at 9 years of age in preparation for a bone graft and, once the permanent dentition erupts, definitive orthodontic treatment will be required. Maxillary forward growth may have been constrained by scarring from previous surgery, so orthognathic correction may be required on growth completion. Final orthodontic alignment and high quality restorative care will allow the patients to have a pleasing aesthetic result. CLP patients and their families will need continuing support from medical and dental consultants, specialist nurses, health visitors, speech and language specialists and, perhaps, psychologists. The first article in this series of two outlined the principles of care for the CLP patient and this second part illustrates this with a case report, documenting one patient's journey from birth to 21 years of age. Clinical Relevance: A successful outcome for CLP patients requires a sound dentition. The general dental practitioner role is vital to establish and maintain excellent oral hygiene, a healthy diet and good routine preventive and restorative care. Understanding the total needs of CLP patients can help the dentist to provide high quality care as part of the multidisciplinary management.
Information for patients undergoing treatment for toothwear with resin composite restorations placed at an increased occlusal vertical dimension
Authors: Burke FJ Trevor 
Published: August 2017

Toothwear is affecting increasing numbers of the population. In the past, treatment of patients whose teeth were affected by toothwear often involved the reduction of these teeth for crowns; a severe form of toothwear. Contemporary management of such cases is by the bonding of resin composite restorations to the worn and wearing surfaces, with these restorations being placed at an increased occlusal vertical dimension. The advantage of the technique is its minimal-or non-intervention nature and its high reported degree of patient satisfaction. There are, however, short-term disadvantages to the technique, such as the potential for lisping, pain from the teeth which will be subject to axial orthodontic tooth movement, and difficulty in chewing on the posterior teeth if these are discluded. It is therefore important, as with any treatment, that the advantages and disadvantages are fully explained to the patient. This paper therefore describes the clinical technique and presents a Patient Information Leaflet that the author has used for over five years. Clinical Relevance: Patients should be advised regarding the disadvantages and advantages of any technique.
International rescue? managing the dental tourist
Authors: Iqbal Junaid , Shah Shilpa , Ashley Martin 
Published: August 2017

The concept of dental tourism can be considered two-fold. On one side it is a term used to describe non-UK residing patients who visit, requesting NHS dental care whilst here in the UK. Alternatively, it also encompasses patients who travel to destinations outside their residing countries to receive care. The latter has become an ever-growing issue in the UK; one that warrants appropriate management and knowledge of current legislation amongst dental professionals. Clinical Relevance: Clarity and guidance on who is eligible for care under the NHS when visiting the UK and who, if anyone, is ultimately responsible when treatment abroad fails.
How many of our patients can really give consent? – a perspective on the relevance of the mental capacity act to dentistry
Authors: Holden Alexander C L , Holden Neil L 
Published: August 2017

The different ways that clinicians perceive adult patients with dental phobia is varied and diverse. From treating the dental phobia as a separate illness to dismissing it as a neurosis, sometimes little consequence is attached to its existence. True dental phobia is classed as a psychological illness and therefore comes under the remit and guidance of the Mental Capacity Act 2005. Failure to assess the impact of dental phobia upon an individual's capacity to consent could lead to allegations of negligence or even assault. Clinical Relevance: This paper highlights the importance of considering the capacity to consent of some of the most vulnerable dental patients and how we can better protect both their rights in the law and their dignity.
NHS pilots in primary care – an insight into the future?
Authors: Sihra Tajinder , D'Cruz Len 
Published: August 2017

This article looks at the background to the current changes in primary care dentistry being piloted in England. It looks at the structure of the different elements being piloted, such as the oral health assessment, interim care appointments and care pathways. It also examines advanced care pathways and how complex care will be provided when clinically feasible and beneficial to the patient. The authors have worked in a Type 1 pilot practice since September 2010. Clinical Relevance: The NHS contract currently being piloted in England delivers care through care pathways and clinical risk assessments with prevention as an important building block for the delivery of services. There are new measures planned for measuring quality outcomes in primary care. This has implications for how services are delivered, who delivers them and how dentists will be remunerated in the future.
Fact or fiction: does a relationship exist between free sugars, dental caries and body weight?
Authors: Carson Susan , Freeman Ruth 
Published: August 2017

This article is about dental caries and body weight. It will provide the reader with an overview of the complexity in the relationship between these and suggest the implications of taking a public health approach when addressing them within a primary dental care setting. Clinical Relevance: To provide dental care professionals with an update on the available evidence surrounding the relationship between free sugar, dental caries and body weight.
Swallowed and inhaled dentures – what's the problem?
Authors: King Elizabeth , Jagger Robert 
Published: August 2017

Loose or fractured dentures may be displaced towards the back of the mouth into the pharynx and become ingested or inhaled. The consequences of denture impaction on a patient's health can be severe, both short-term and long-term. Diagnosis and treatment can be challenging, therefore an understanding of the incidence, risk factors, symptoms and management of risk factors is important to reduce the occurrence of denture impaction in the aero-digestive system. This article includes an overview of the related literature and highlights the importance of managing risks and the importance of good denture design and appropriate maintenance. Clinical Relevance: Dentists need to be aware of risk factors and harmful effects associated with inhaled and swallowed dentures to help minimize the incidence.
The use of the operating microscope in general dental practice part 1: magnification in general
Authors: Bonsor Stephen J 
Published: August 2017

An increasing number of clinicians are using magnification to facilitate their vision when carrying out dental examinations and treatments. The use of an operating microscope in some dental specialties (such as endodontics) is now commonplace and there is also a role for this equipment in branches of general dentistry. This paper, the first of two, reviews the many advantages of using an operating microscope and offers practical advice on how the interested clinician may embark on using such an instrument by discussing the equipment required. The second paper will focus on the potential uses for the operating microscope in general dental as well as specialist practice. Clinical Relevance: The operating microscope enhances the dental surgeon's vision, potentially improving treatment outcomes not only in specialist fields, such as endodontics, but also in many of the disciplines that general dental practice encompasses.
Diabetes mellitus: considerations for the dental practitioner
Authors: Mohamed Kareem , Yates Julian , Roberts Anthony 
Published: August 2017

The prevalence of diabetes is increasing significantly and, therefore, dental practitioners are having to manage diabetic patients on a more regular basis. Alongside the systemic effects on the various tissues and organs of the body, diabetes can adversely affect oral health and all clinicians should be aware of the issues that may arise. Clinical Relevance: Dental practitioners are almost guaranteed to encounter both diagnosed and undiagnosed diabetic patients. It is therefore important that they are aware of the oral signs and symptoms of disease and the reciprocal relationship between oral health and glycaemic control, so that diabetic patients are managed accordingly.
Management of the single discoloured tooth part 1: aetiology, prevention and minimally invasive restorative options
Authors: Barber Andrew J , King Paul A 
Published: August 2017

The single discoloured tooth is commonly encountered in general practice. This is the first of two articles covering the broad range of management options for the single discoloured tooth. This first part outlines the common causes of discoloration and possible methods of prevention. Minimally invasive techniques are covered. Clinical procedures are outlined and clinical cases used to demonstrate outcomes that can be achieved. Clinical Relevance: The single discoloured tooth is a commonly encountered clinical problem in general dental practice. A wide variety of management options exist and any one in particular may be most appropriate given the clinical scenario. It is therefore essential that general dental practitioners are familiar with the range of options that exist, as well as their indications, and consider adopting minimally invasive techniques in the first instance before moving to more invasive therapies.
Management of the single discoloured tooth part 2: restorative options
Authors: Barber Andrew J , King Paul A 
Published: August 2017

This is the second article of a two part series covering the aetiology, prevention and broad range of management options for the single discoloured tooth. The article covers situations where masking and simulation techniques with direct composite are required. Direct composite, indirect composite and ceramic veneers are then considered, as well as full coverage crowns. The option of extraction of the affected tooth and its prosthodontic replacement will also be considered. Clinical cases are used to illustrate various scenarios. Clinical Relevance: The single discoloured tooth is a commonly encountered clinical problem in general dental practice. A wide variety of management options exist and it is recommended that general dental practitioners consider adopting minimally invasive techniques in the first instance before moving on to more invasive therapies.
Interactive treatment planning in toothwear: are we doing it right?
Authors: Eliyas Shiyana , Shah Kewal , Briggs Peter FA 
Published: August 2017

Toothwear is now common, especially in younger patients, with high demand for the restoration of the damaged teeth which is likely to increase further over time. Fixed prosthodontic options range from direct composite resin to conventional tooth preparation and cemented indirect restorations. This paper summarizes the views of a variety of clinicians on a plan delivered to a patient with toothwear in secondary care and explores the possible reasons for the variation in decision-making in the treatment of toothwear.Clinical Relevance: With levels of toothwear increasing, the clinician needs to be aware of the different treatment modalities which are appropriate.
What steroid supplementation is required for a patient with primary adrenal insufficiency undergoing a dental procedure?
Authors: Henderson Simone 
Published: August 2017

Patients with primary adrenal insufficiency (Addison's disease) lack the endogenous steroid hormones cortisol and aldosterone and require daily steroid therapy (usually hydrocortisone and fludrocortisone) to replace them. These patients are unable to adapt physiologically to stress and may need supplemental steroid therapy when having dental procedures, to prevent adrenal crisis. This paper provides guidance on dental procedures for which steroid supplementation may be required in patients with primary adrenal insufficiency and gives advice on doses and timing of supplementation. It does not address the management of patients with secondary adrenal insufficiency caused by long-term use of high doses of steroids. This document is for guidance only. Patients with primary adrenal insufficiency should be assessed individually as steroid requirements will vary. Clinical Relevance: Although patients with primary adrenal insufficiency (Addison's disease) are invariably very well informed about their steroid requirements prior to a dental procedure, dental staff should have an understanding of the steroid supplementation that may be required.
Haemostasis part 2: medications that affect haemostasis
Authors: McCormick Neal J , Moore Undrell J , Meechan John G , Norouzi Mohsen 
Published: August 2017

Post-operative haemorrhage is a recognized complication in dental practice. This may be more prevalent in patients taking anti-thrombotic medications. It is important that the dentist understands the mechanism of action of these drugs and how they may affect management of dental patients. Clinical Relevance: Dental professionals must be aware of those medications affecting haemostasis and how they may impact on management. The emergence of different therapeutic regimens has increased the number of such drugs.
Dysphagia and dentistry
Authors: Curl Charlotte , Boyle Carole 
Published: August 2017

Dysphagia is defined as a ‘difficulty in swallowing’ and is commonly found in the general population, particularly in the elderly. This article gives an overview of the more frequently encountered swallowing disorders and provides advice on how to manage the dysphagic patient in the dental surgery. Clinical Relevance: By identifying patients with dysphagia and being aware of the potential problems that the clinician may experience when treating them, the risk of aspiration, choking and healthcare-acquired upper respiratory tract infections may be reduced.