bluuebunny/crossref_metadata_2025_split huggingface dataset:
How neurolinguistic psychotherapy (NLPt) could help to improve psychological wellbeing within the dental profession
Authors: Taylor Joanna 
Published: August 2017

This article is an exploration of some of the causes of stress within the dental profession and a discussion on how some of the models and philosophies of NLPt could help improve the levels of psychological wellbeing within the profession. Some of the fundamental concepts of NLPt are explored, with particular reference to their application in regard to stress. It is concluded that NLPt could provide a robust methodology for reducing psychological distress within the profession, by helping dentists to understand the concept of unuseful constructs, to improve behavioural choice and to discover the possibility of a more resourceful way of being. CPD/Clinical Relevance: Dentists under stress do not perform well; judgement is impaired, motivation is reduced and poor decisions can be made which impact directly on patient care.
Pain part 9: trigeminal autonomic cephalalgias
Authors: Abu Bakar Norazah , Matharu Manjit , Renton Tara 
Published: August 2017

The trigeminal autonomic cephalalgias are a group of rare, highly disabling, primary headache syndromes distinctly characterized by the unilaterality of their attacks and presence of cranial autonomic symptoms. Although pain is often localized to the peri-orbital and temporal regions, it is not uncommon for pain to radiate to tooth-bearing areas and mimic toothache or jaw pain. Hence, dental practitioners should be aware of these syndromes to enable appropriate referral and avoid unnecessary, and often irreversible, dental treatments. Many dentists will not have heard of these conditions but must remain vigilant, and ensure that they are not confused with trigeminal neuralgia, so that their patients are appropriately advised and referred. CPD/Clinical Relevance: The dental practitioners may be the first line of healthcare providers consulted by these patients in the hope of obtaining pain relief. Lack of familiarity with an uncommon condition may lead to poor patient management.
The prosthetic management of an infra-occluded first permanent molar: case report
Authors: Sehra Beshandeep , Johnson Joanna 
Published: August 2017

This report describes the prosthetic management of a 15-year-old patient with an infra-occluded first permanent molar due to primary failure of eruption (secondary retention). An indirect composite onlay restoration was used to stimulate the periodontal fibres, improve function and restore occlusal stability. This paper describes the clinical technique involved. CPD/Clinical Relevance: Early detection, diagnosis and management of infra-occluded permanent molar teeth is important to avoid occlusal complications, in addition to improving function and stimulating the periodontal fibres.
Non-pulmonary tuberculosis – a case report: importance and pitfalls of diagnosis
Authors: Pepper Hannah , Davies Rebecca , Hughes Ceri , Thomas Steve , Pring Miranda , Hetzel Martin 
Published: August 2017

A case of tuberculosis presenting as a neck lump is highlighted. Tuberculosis is on the increase. There are national and international strategies to improve the management of tuberculosis in the United Kingdom, and raising clinical awareness of tuberculosis is an important part of that strategy. Neck lumps can present in the dental setting and the differential diagnosis should include tuberculosis, with referral to an appropriate multidisciplinary team. Special tests to aid diagnosis are helpful but not completely discriminating. Tuberculosis is a notifiable disease and it must be treated by a designated specialist medical team. CPD/Clinical Relevance: Tuberculosis is a differential diagnosis for a persistent neck lump and clinicians should understand the problems of diagnosis and the importance of appropriate referral for treatment in the national and international strategy to reduce this disease.
Managing the unstable mandibular complete denture – tooth placement and the polished surface
Authors: Clarke Peter , Leven A Johanna , Youngson Callum C 
Published: August 2017

Constructing satisfactory conventional mandibular complete dentures is often challenging in comparison to the upper counterpart partially due to differences in the anatomy of the denture-bearing area. This problem is exaggerated in the atrophic mandible, where supporting structures are frequently ill-defined and suboptimal in quality. Implant-retained prostheses offer well recognized benefits but are not always a feasible options, so conventional methods must be relied upon. The importance of impression quality and registration has been reviewed previously. This article aims to discuss the influence of tooth placement, the polished surfaces and the neutral zone on the success of lower dentures. CPD/Clinical Relevance: This article highlights the importance that polished surface contouring and tooth prescription can have on the outcome of lower dentures. Techniques for assessing and recording the neutral zone are explained, along with alternative occlusal schemes.
Could video glasses contribute to behaviour management in the 21st century?
Authors: Casaus Abdullah , Patel Biraj , Brown Laura , Coomaraswamy Kristian 
Published: August 2017

Dental fear in the paediatric population can be a significant barrier to providing optimal dental care. Pharmacological management techniques utilized to manage anxiety, such as conscious sedation and general anaesthesia, are expensive and require specialized equipment with additional staff training. With recent advances in technology, video glasses are an economic and novel distraction technique that may aid in improving behaviour management and facilitate dental treatment. CPD/Clinical Relevance: Nervous children may find difficulty in accessing care owing to their inability to co-operate and accept dental treatment. This paper describes an innovative technique that may aid the clinician in overcoming this barrier.
Sore or swollen lips part 3: diagnosis and treatment
Authors: Malamos Dimitrios , Scully Crispian 
Published: August 2017

This series of three papers reviews the causes, diagnosis and differential diagnosis, and outlines the management of sore and/or swollen lips. CPD/Clinical Relevance: Sore and/or swollen lips are not uncommon, often have a local cause but may reflect a systemic disease. The previous 2 papers in the series discussed their causes. This paper reviews their diagnosis and treatment.
The paradoxes of phantom bite syndrome or occlusal dysaesthesia (‘dysesthesia’)
Authors: Kelleher Martin G , Rasaratnam Lakshmi , Djemal Serpil 
Published: August 2017

Phantom bite syndrome was first described by Marbach over 40 years ago as a mono-symptomatic hypochondriacal psychosis. He used the term to describe a prolonged syndrome in which patients report that their ‘bite is wrong’ or that ‘their dental occlusion is abnormal’ with this causing them great difficulties. This strong belief about ‘their bite’ being the source of their problems leads to them demanding, and subsequently getting, various types of dentistry carried out by multiple dentists and ‘specialists’. Sadly, even after exhaustive, painstaking, careful treatment, none of the dental treatments manages to solve their perceived ‘bite problems’. This is because they suffer from a psychiatric illness involving a delusion into which they continue to lack insight, in spite of the failures of often sophisticated dental treatments. 1 ,2 ,3 In summary, dental practitioners, or other specialists, who suspect that they might be dealing with such a problem should refer these patients early on for specialist management by an appropriate specialist within the secondary care settings, preferably before they get trapped into the time-consuming quagmire of their management. A ‘Phantom Bite Questionnaire’, which is available to download free, might help. CPD/Clinical Relevance: This article aims to provide professionals in various fields with guidelines on detecting, diagnosing and managing patients with Phantom Bite Syndrome (PBS). This is desirable in order to prevent extensive, or unnecessarily destructive, or unstable dental treatment being undertaken on such patients in a vain attempt to solve their problems with ‘dentistry’ when, in fact, these are really due to underlying mental health issues. WARNING Phantom bite patients are often highly resistant to being referred to psychiatrists as they lack insight into their behaviour. They often complain if even a gentle suggestion is made of a possible referral to a psychiatrist. They remain resolutely convinced that if they could only get someone competent enough to get their ‘bite right’ then all their problems would be solved.
Surgical emphysema: a rare complication of a simple surgical dental extraction without the use of an air-driven rotor
Authors: Gowans Keegan , Patel Muneer , Lewis Khari 
Published: August 2017

Surgical emphysema is a rare complication of dental extractions, often associated with the use of high-speed air rotors. This report describes a case of extensive surgical emphysema following a simple surgical extraction of a LL6 under local anaesthetic. There was no use of air-driven handpieces during the procedure. The patient developed extensive surgical emphysema bi-laterally in both cervical neck and facial planes. After prophylactic antibiotics with careful monitoring in a secondary care setting, the patient made a full unremarkable recovery. CPD/Clinical Relevance: Simple extraction of teeth is a procedure carried out daily by most general dental practitioners. However, the risk of surgical emphysema without the use of high-speed air rotors or instruments using pressurized air/water is not well known or documented.
The immune system: basis of so much health and disease: 2. innate immunity
Authors: Scully Crispian , Georgakopoulou Eleni A , Hassona Yazan 
Published: August 2017

The immune system is the body's primary defence mechanism against infections, and disturbances in the system can cause disease if the system fails in defence functions (in immunocompromised people), or if the activity is detrimental to the host (as in auto-immune and auto-inflammatory states). A healthy immune system is also essential to normal health of dental and oral tissues. This series presents the basics for the understanding of the immune system, this article covering innate immunity. Clinical Relevance: Modern dental clinicians need a basic understanding of the immune system as it underlies health and disease.
Dental unit water lines and their disinfection and management: a review
Authors: Pankhurst Caroline L , Scully Crispian , Samaranayake Lakshman 
Published: August 2017

The perceived threat to public health from dental unit water line (DUWL) contamination comes from opportunistic and respiratory pathogens such as Legionella spp, Nontuberculous Mycobacteria (NTM) and pseudomonads. These organisms can grow and multiply in the DUWL biofilm to reach infective concentrations, with the potential for inhalation leading to respiratory infections or direct contamination of surgical wounds. In this paper we discuss current legislation and practical methods for delivering water within the DUWL that meets the standards for safety. CPD/Clinical Relevance: Understanding the clinical relevance and methods for decontaminating DUWL is essential to create a safe working environment in dentistry.
Complications of an ageing dentition part 1: occlusal trauma and cracked teeth
Authors: Murchie Bryan Daniel 
Published: August 2017

A growing problem in dentistry is complications associated with failing amalgam restorations that have been in place for many years. At present, there is a wide variety of treatment options available in the clinician's armamentarium when this situation arises, however, without the correct diagnosis, the prognosis for the tooth may quickly diminish, despite the clinician's best efforts. A confusing array of symptoms and failures may confound even the most experienced dentist, which will inevitably lead to invasive and time consuming approaches in a desperate attempt to rectify the initial problem. This paper, the first part of a three-part series, discusses the possible aetiological factors responsible for restoration failure, including occlusal issues and cracks within the tooth structure. The second part of the series will focus on restorative options and root-treated teeth. The third, and final, part of the series will provide an overview of the previous papers and conclude with a case report. CPD/Clinical Relevance: Failure of amalgam restorations is a commonly encountered clinical problem in general practice and no one case presents in the same way. A competent diagnosis regarding the occlusion and tooth structure, followed with implementation of the most appropriate, minimally invasive treatment option, requires an adequate knowledge of current literature.
The immune system: basis of so much health and disease: 3. adaptive immunity
Authors: Scully Crispian , Georgakopoulou Eleni A , Hassona Yazan 
Published: August 2017

The immune system is the body's primary defence mechanism against infections, and disturbances in the system can cause disease if the system fails in defence functions (in immunocompromised people), or if the activity is detrimental to the host (as in auto-immune and auto-inflammatory states). A healthy immune system is also essential to normal health of dental and oral tissues. This series presents the basics for the understanding of the immune system; this article covers adaptive immunity. Clinical Relevance: Dental clinicians need a basic understanding of the immune system as it underlies health and disease.
Dietary advice – getting the message across
Authors: Raindi Devan , Thornley Peter 
Published: August 2017

Providing dietary advice to our patients forms the cornerstone of prevention for many dental diseases. However, simply prescribing information is unlikely to bring about long-term behavioural change. This article explores the theory of health behaviour as well as ways in which we can ‘get the message across’. CPD/Clinical Relevance: Prescriptive approaches to behaviour changes can be considered inconsistent and ineffective. This article explores more patient-centred methods of inducing behaviour change with regard to dietary advice in the general dental practice setting.
Complications of an ageing dentition part 2: restorative management options
Authors: Murchie Bryan Daniel 
Published: August 2017

This is the second-part of this three-part series. The first paper discussed the occlusal and cracked tooth aetiological factors which may be responsible for restoration failure. This paper will outline the restorative options for cracked and root canal-treated teeth. It will also briefly give an overview of some of the potential endodontic complications commonly associated with failed restorations. The third, and final, part of the series will provide an overview of the previous papers and conclude with a case report. CPD/Clinical Relevance: Failure of amalgam restorations is a commonly encountered clinical problem in general practice and no one case presents in the same way. Therefore, a competent endodontic diagnosis and implementation of the most appropriate, minimally invasive restorative option requires an adequate knowledge of the current literature.
Alcohol and the dental team: relevance, risk, role and responsibility
Authors: Shepherd Simon , Ogden Graham 
Published: August 2017

An enquiry about alcohol use, whenever a patient presents for dental treatment, is now firmly established within the taking of a social history. Dental professionals are well placed to provide relevant alcohol advice. Indeed, it is now embedded within the training of undergraduates as required by the General Dental Council (GDC) in Preparing for Practice. 1 Practitioners therefore need to be aware of recent changes in alcohol guidelines commissioned by the UK Chief Medical Officers. This paper explores alcohol-related harm, screening tools to facilitate an enquiry, and our roles and responsibilities for providing alcohol advice accepting the limited time available within the dental appointment. CPD/Clinical Relevance: Alcohol has both local and systemic effects. Understanding these effects, the recently updated guidelines and available screening tools are important steps towards supporting dental professionals in the provision of alcohol-related advice.
Orthodontic and periodontal multidisciplinary care
Authors: Pye Gurpreet , Pye Andrew 
Published: August 2017

Patients who are at risk of, or have a history of, periodontal disease requesting orthodontic treatment require careful multidisciplinary management in order to achieve optimal orthodontic and periodontal outcomes. An understanding of the periodontal tissues and the disease processes that can affect the periodontium is required by the orthodontist to ensure that patients are managed appropriately. CPD/Clinical Relevance: This paper discusses the multidisciplinary management of periodontal patients who require orthodontic treatment and methods for ensuring optimal outcomes.
Fusions and orthodontic treatment
Authors: Seehra Jadbinder , Coutts Fran 
Published: August 2017

The term double tooth is used to describe fused teeth, gemination, twinning and concrescence. Fused teeth can be the cause of a local malocclusion manifesting as crowding or spacing. The aetiology of dental fusion is unclear, with both genetic and environmental factors suggested. Treatment options for fused teeth include: accept and align, reduction in size, extraction and surgical hemi-section. Successful management of these cases may involve a multidisciplinary approach. The following is a description of a clinical case in which a fusion of the LL1 and LL2 presented in association with a complex malocclusion. The aetiology and management of fused teeth is discussed.
Multidisciplinary care – how should we manage the complex orthodontic-paediatric dentistry case? part 2
Authors: Parvizi Farnaz , John Rebecca , House Kate , Atack Nikki 
Published: August 2017

This second article aims to outline the role of combined paediatric dentistry-orthodontic planning in the management of complex cases of the developing dentition. Case studies have been used to highlight those patients who would most benefit from such a combined approach. Clinical Relevance: This paper highlights the more uncommon yet challenging cases which may present in the mixed dentition, requiring a joint paediatric and orthodontic approach.
Longitudinal involvement of the psychologist in services for people born with a cleft lip and/or palate: CLP series part 3
Authors: Hammond Vanessa 
Published: August 2017

This paper provides an overview of the longitudinal role of psychologists within the multidisciplinary team (MDT) working with people born with a cleft lip and/or palate and their families. The role of the psychologist is described using a lifespan model, outlining the psychological issues and giving examples of different service models. The role of psychology with special groups of patients, within the MDT and across the broader service network, is also described. Clinical Relevance: Understanding psychological issues pertinent for people born with a cleft lip and/or palate and their families. Also, understanding the role of the psychologist as part of the multidisciplinary team working with people born with a cleft lip and/or palate and their families.
Digit sucking – what to do
Authors: Clover Matthew , Hobson Ross 
Published: August 2017

Dentists are often questioned by anxious parents about the effects of digit sucking and the possible ways of stopping their child's habit. This article discusses the aetiology, prevalence and effects of digit sucking, various means of stopping the habit and the problems that may occur if digit sucking persists into the permanent dentition. Clinical Relevance: Digit-sucking habits can have a detrimental effect on the development of the occlusion. Various methods are discussed to help children to stop.
A dentigerous cyst containing an ectopic canine at the infra-orbital rim: a case report
Authors: Dobbyn Lorna , Benington Philip , Devlin Mark 
Published: August 2017

This case report demonstrates the spontaneous eruption of a maxillary canine from the infra-orbital margin after marsupialization of a dentigerous cyst. Clinical Relevance: Dental practitioners should be aware of the presentation of dentigerous cysts, their possible effect on the position of associated teeth, and the indications for urgent referral of such cases. The need to examine radiographs carefully for ectopic teeth in unexpected positions should also be appreciated.
Severe bimaxillary dento-alveolar proclination with hyperdivergent jaw bases treated with temporary anchorage devices: a case report
Authors: Gandedkar Narayan H , Revankar Ameet V 
Published: August 2017

The article describes the orthodontic treatment of a 19-year-old female with severe bimaxillary dento-alveolar proclination and severely hyperdivergent jaw bases. Clinical and cephalometric analyses denoted it to be a critical anchorage case. Accordingly, with the aim of providing absolute anchorage, temporary anchorage devices (TADs) were placed in all four quadrants in the inter-radicular area of the second premolar and first molar, following extraction of all first premolars. Facial aesthetics improved considerably, fullness of the upper and lower lip reduced and incompetency of the lips was eliminated. The application of TADs not only reduced the antero-posterior discrepancy, but also addressed the vertical problem. Clinical Relevance: The treatment of critical anchorage, hyperdivergent cases with conventional orthodontics has always remained a challenge, with a greater chance of an unsatisfactory treatment outcome. The use of TADs has changed the scenario with the concept of absolute anchorage coming closer to reality.
The orthognathic management of cleft lip and palate skeletal discrepancy: CLP series part 9
Authors: Knox Jeremy , Extence Helen , Hammond Vanessa , Hunt Jenny , Sugar Adrian 
Published: August 2017

A patient with a repaired cleft of lip and/or palate (CLP) may develop dentofacial disproportion, classically a Class III skeletal and inter-arch relationship, due to an underlying maxillary hypoplasia. The definitive correction of the dental and facial aesthetic and functional problems associated with this anomaly requires a multidisciplinary input involving orthodontists, surgeons, speech therapists and psychologists. A successful outcome is dependent on a close working relationship between these disciplines and a planned care pathway that is adapted to patient needs. This paper outlines such a care pathway. Clinical Relevance: This paper offers the clinician an understanding of a multidisciplinary approach to the orthognathic management of a patient with cleft lip and palate.
Restorative management of the cleft patient: CLP series part 10
Authors: Ali Rahat , Nixon Peter J , Chan Martin F W-Y 
Published: August 2017

This article describes the role of the restorative dentist in the multidisciplinary management of cleft lip and palate patients. The various clinical presentations and restorative challenges are outlined. The restorative treatment of cleft patients requires the use of a wide range of different clinical skills and techniques to achieve oral rehabilitation. The various treatment modalities are described and range from minimally invasive adhesive techniques to conventional fixed and removable prosthodontics, obturators and the use of dental implants. The eventual restorative outcomes are related to the initial severity of the defect and the degree of success of the previous surgical and orthodontic interventions. Clinical Relevance: This article will be of interest to clinicians, technicians, dental care professionals and other members of the team who are involved in the oral rehabilitation of cleft patients.