bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can a concise, benchmarked patient survey help to stimulate improvements in perceived quality of care?
Authors: Busby Mike , Burke FJ Trevor , Matthews Roger , Cyrta Jakub , Mullins Anne 
Published: August 2017

Second phase patient survey audit results were reviewed for 41 practices. Five of the six practices with the lowest first phase results achieved significantly improved results in the second phase. The average increase in a patient perception index between phase 1 and phase 2 for these 6 practices was 6 points. The average increase was only 1 point for the other 39 practices. The five practices recording significantly improved patient perceptions all reported that significant practice development had been taking place between the phase 1 and phase 2 audits. For 3 of these 5 practices their first phase audit result had been a significant inspiration for the practice development. It seems that this patient survey instrument may be inspiring significant development when practices score notably below the benchmark. Clinical Relevance: Patient surveys may be of value.
Prosthetic rehabilitation of the gagging patient using acrylic training plates
Authors: Ali Rahat , Altaie Asmaa , Morrow Leean 
Published: August 2017

Patients with a hyper-responsive gag reflex pose dentists with a challenging problem. The gag reflex of some patients may be so severe that patients (and operating clinician) may favour extraction of any painful, infected teeth as opposed to more lengthy and complicated procedures such as root canal therapy. However, consistently adopting this approach may render the gagging patient completely edentulous. Such patients may then present to the dental surgeon requesting tooth replacement with some form of denture. This in itself can be a challenging task given the difficulties one may experience whilst taking impressions in this cohort of patients. This article will discuss the prosthetic management of the maxillary arch in edentulous patients with a severe gag reflex. There will be particular emphasis on the aetiology and physiology of the gag reflex, impression-taking techniques to allow the construction of an acrylic training plate (as an interim measure), principles of training plate design and construction of the definitive removable denture. Clinical Relevance: Removable training plates can be used as an interim measure to desensitize edentulous gagging patients before providing them with a definitive removable denture.
The use of the operating microscope in general dental practice part 2: if you can see it, you can treat it!
Authors: Bonsor Stephen J 
Published: August 2017

The use of magnification by dental clinicians when carrying out examinations and treatments is becoming more commonplace. The best instrument for this purpose is the operating microscope which has been shown to enhance quality, longevity and outcome of clinical work as well as facilitating better ergonomics for both the dentist and dental nurse. This paper, the second of two, explores the potential uses for the operating microscope in general dental as well as specialist practice (such as endodontics) and discusses how the interested clinician can use such equipment in a practical manner. Clinical Relevance: The operating microscope enhances the dental surgeon's vision so improving treatment outcomes not only in specialist fields, such as endodontics, but also in many of the disciplines which general dental practice encompasses.
Amelogenesis imperfecta with coronal resorption: report of three cases
Authors: Bhatia Shannu K , Hunter M Lindsay , Ashley Paul F 
Published: August 2017

Intracoronal resorption of the permanent dentition in cases of amelogenesis imperfecta (AI) is a rare finding which poses an added complication to the already complex management of this condition. This paper presents three cases of AI associated with delayed eruption of permanent teeth in which asymptomatic intracoronal resorption occurred. CPD/Clinical Relevance: This paper highlights the fact that teeth affected with amelogenesis imperfecta may undergo asymptomatic intracoronal resorption which is only identifiable radiographically.
Management of opacities in children and adolescents
Authors: Wallace Ann , Deery Chris 
Published: August 2017

Enamel opacities can appear as white, cream, yellow or brown patches. They can result from developmental or acquired conditions. The diagnosis, severity of the opacity and patient's desire for treatment guide the clinician when choosing the correct management option. Microabrasion is indicated for surface opacities, whereas bleaching can treat opacities deep within the tooth. When these techniques have failed to achieve the desired result, camouflaging the opacity with composite resin may be useful. Novel techniques, such as infiltrating or sealing the opacity, can alter enamel's refractive index, offering further treatment choices. CPD/Clinical Relevance: There are many conservative treatments available which can improve the appearance of enamel opacities.
Conservative management of macrodontia in the mixed dentition stage – a case report
Authors: Harker Ann R , Walley Sian , Albadri Sondos 
Published: August 2017

Macrodontia is a rare dental abnormality, which can cause cosmetic concerns. Various management techniques for this condition have been documented in the literature. This case describes the initial management of macrodontia in the mixed dentition stage with the use of a minimally invasive approach to treatment. CPD/Clinical Relevance: The importance of early referral of dental abnormities is highlighted. Short- and long-term treatment options for macrodontia are described, including the impact such anomalies can have on the developing dentition.
Oral healthcare implications of mass migration
Authors: Murphy Jasmine , Scully Crispian 
Published: August 2017

Population movements, whether voluntary or forced, are an integral part of an increasingly globalized society and, while the health needs of migrant populations cannot be generalized, some migrants can have worse oral health outcomes compared with their host-country counterparts, with their first dental contact typically being for emergency care. Failure to provide immediately necessary treatment may be unlawful under the Human Rights Act 1998. CPD/Clinical Relevance: NHS dental services need to evolve and address the challenges inherent in caring for vulnerable migrants. Education and appropriate training needs to be developed for the dental profession in order to enable new ways of promoting inter-sectoral care and community engagement.
Emergencies in orthodontics part 1: management of general orthodontic problems as well as common problems with fixed appliances
Authors: Dowsing Paul , Murray Alison , Sandler Jonathan 
Published: August 2017

Fixed appliance treatment is a popular treatment modality with a burgeoning increase in the numbers of children and adults realizing the benefits that can be gained. Appliance breakage is an unavoidable nuisance which is at best inconvenient, and at worst may result in significant pain or discomfort for the patient. General dental practitioners (GDPs) should have the practical knowledge of how to provide timely and appropriate orthodontic ‘emergency treatment’. This will significantly reduce the sometimes considerable inconvenience and discomfort for both the patient and his/her parents, and the inevitable frustration for the clinician providing ongoing care. This first paper will deal with general orthodontic problems that commonly present, as well as some issues specific to fixed appliances. The second paper will deal with the other orthodontic appliances that may be encountered by GDPs in their daily practice. Clinical Relevance: Appropriate handling of an orthodontic ‘emergency’ by the general practitioner will, on many occasions, provide immediate relief of pain and distress for the patient. This will in turn allow treatment to continue moving in the right direction, thus allowing more efficient and effective use of valuable resources.
Emergencies in orthodontics part 2: management of removable appliances, functional appliances and other adjuncts to orthodontic treatment
Authors: Dowsing Paul , Murray Alison , Sandler Jonathan 
Published: August 2017

In the second of two papers, management of orthodontic emergencies involving appliances other than fixed appliances will be detailed. Problems relating to removable appliances, as well as other orthodontic adjuncts, will be discussed. Unfortunately, orthodontic appliance breakage does occur, despite the clinicians giving clear and concise instructions to the patients and their parents at fitting. If general dental practitioners have a practical knowledge of how to diagnose problems and to provide appropriate advice or timely ‘emergency’ treatment, this will significantly reduce the inconvenience for all parties concerned. It should also ensure that treatment progresses in the most efficient and comfortable manner for their patients. In specific situations the early, accurate identification of the problem and instigation of its appropriate management can avoid more serious consequences. Clinical Relevance: Appropriate handling of an orthodontic ‘emergency’ by the dentist can, on many occasions, provide immediate relief to the patient. This will, in turn, allow treatment to continue in the right direction, thus allowing more efficient and effective use of valuable resources.
Keep an eye out for the bifid uvula: a case report
Authors: Alroyayamina Seyed , McKnight Mary 
Published: August 2017

The incidence of submucous cleft palate is between 1:1250–1:6000. It is important for this relatively silent deformity to be identified early and referred appropriately as a delay in diagnosis may affect the patient's quality of speech in the long term. This paper presents a case of submucous cleft palate which was diagnosed late (age 14). Nevertheless, by the appropriate intervention of the multidisciplinary cleft team, the patient was treated successfully. Clinical Relevance: Dentists and doctors need to be aware of the signs and symptoms associated with submucous cleft palate so that they can refer the patient to an appropriate specialist centre for further investigation and treatment. Moreover, patients with this condition are shown to have a higher incidence of dental abnormalities, such as hypodontia and peg-shaped laterals.
Seventeen years of using flowable resin restoratives – a dental practitioner's personal clinical review
Authors: Firla Markus Th 
Published: August 2017

Seen through the author's eyes on the basis of his practising dentistry for almost three decades, light-activated flowable resin restoratives (FRCs) or, in common clinical dental terminology, flowable composites have gradually gained major importance in restorative dentistry. Inputs to this ongoing trend are coming from continuous improvements in material properties and the favourable handling characteristics experienced with this particular group of restoratives. Intended to be used in direct adhesive filling procedures, the number and variety of recent generations of flowable composites for lining, restoration of all cavity classes (I–V), core build-ups and, more recently, ‘bulk-fill-restorations’, however, necessitates a profound clinical understanding of the selective use of flowable composites to ensure clinical success and guarantee long-term high quality results. Clinical Relevance: Today's flowable composites allow for reliable restoration of all kinds of defects. However, both the handling characteristics and the material properties of FRCs must be fully understood before taking advantage of their potentially excellent clinical performance.
Essentials of medical history-taking in dental patients
Authors: Greenwood Mark 
Published: August 2017

The starting point in the assessment and management of any patient is dependent on good history-taking. The main parts of the history-taking process well known to practitioners are the presenting complaint, the history of the presenting complaint and the current and past medical history. This paper concentrates on those aspects of the process that are particularly important to dental practitioners. Clinical Relevance: The cornerstone of safe and effective patient management lies with the history. This paper describes various aspects of history-taking and highlights important areas.
Rehabilitation of oncology patients with hard palate defects part 1: the surgical planning phase
Authors: Ali Rahat , Altaie Asmaa , Nattress Brian 
Published: August 2017

This article is the first in a series of three papers that will discuss the conventional non-implant retained prosthodontic rehabilitation of oncology patients with surgically acquired hard palate defects. In this first paper, the dental challenges posed by the oncology patients will briefly be discussed. The interface between the specialist restorative dentist and the maxillofacial surgeon when planning the conventional dental rehabilitation of an oncology patient with a hard palate defect will be discussed in detail. Clinical Relevance: To highlight the importance of the restorative dentistry/surgical interface when planning a treatment for a patient requiring a maxillectomy and conventional obturation.
A clinical guide to needle desensitization for the paediatric patient
Authors: Taylor Greig D , Campbell Caroline 
Published: August 2017

Needle phobia is a common problem encountered by dental practitioners and it can pose a challenge, especially in the paediatric patient. Needle desensitization can be used for patients who have needle fear or phobia and help them overcome this by repeated, non-threatening and controlled contacts. This paper will describe an accepted technique of needle desensitization and work through the steps required to achieve a successful outcome of local anaesthesia being delivered in a calm, safe and controlled manner. Clinical Relevance: Needle desensitization is an effective technique which can be used to enable a needle phobic patient to receive a dental injection.
Minimally invasive long-term management of direct restorations: the ‘5 rs’
Authors: Green David , Mackenzie Louis , Banerjee Avijit 
Published: August 2017

The assessment and operative long-term management of direct restorations is a complex and controversial subject in conservative dentistry. Employing a minimally invasive (MI) approach helps preserve natural tooth structure and maintain endodontic health for as long as possible during the restorative cycle. This paper discusses how minimally invasive techniques may be applied practically to reviewing, resealing, refurbishing, repairing or replacing deteriorating/failed direct coronal restorations (the ‘5 Rs’) and provides an update of contemporary MI clinical procedures. CPD/Clinical Relevance: The assessment and long-term clinical management of deteriorating/failing direct restorations is a major component of the general dental practice workload and NHS UK budget expenditure for operative dentistry.
Rehabilitation of oncology patients with hard palate defects part 2: principles of obturator design
Authors: Ali Rahat , Altaie Asmaa , Nattress Brian 
Published: August 2017

The first part of this series on the conventional rehabilitation of oncology patients with hard palate defects discussed the dental challenges posed by oncology patients and the surgical/restorative planning interface for conventional dental rehabilitation. This article will describe Aramany's classification of hard palate defects, Brown's classification of palatal defects and focus on the basic principles of obturator design which need to be appreciated when prosthetically rehabilitating a patient with a hard palate defect. CPD/Clinical Relevance: A good understanding of basic removable prosthodontic theory relating to denture design, dental materials science and head and neck anatomy is a prerequisite when designing an obturator for a patient.
The truth about sugar
Authors: Yeung C Albert , Goodfellow Ashley , Flanagan Louise 
Published: August 2017

Sugars are used by the industry to enhance the attractiveness of foods and drinks. These added sugars, or ‘free sugars’, are not easily identified in food or drink labels. Certain manufactured foods and drinks with ‘safe’ names, such as dried fruit and fruit juice, still contain free sugars and can be confusing. Guidance states that daily consumption of free sugars should be less than 10% of total energy intake (no more than 5% in the UK). However, it is found that both tooth decay and obesity are associated with consumption of free sugars in large quantities and at inappropriate times. CPD/Clinical Relevance: When giving dietary advice to dental patients, it should be emphasized that free sugars hidden in certain foods and drinks are directly linked to tooth decay and obesity.
Worn down by toothwear? aetiology, diagnosis and management revisited
Authors: Yule Pamela L , Barclay Stewart C 
Published: August 2017

The incidence of toothwear in the population is increasing, as is the number of referrals regarding this problem to secondary care dental hospital consultants and specialists. This paper outlines current theories in aetiology, diagnosis and management of localized and generalized toothwear, as well as describing clinical tips for assessing such patients. CPD/Clinical Relevance: Clinicians will gain a better understanding of how to address the problem of toothwear and what can be achieved in primary care and secondary care settings.
Odontogenic cysts – an overview
Authors: Nayyer Namita V , Macluskey Michaelina , Keys William 
Published: August 2017

This article aims to discuss the clinical features, radiological assessment, histopathology and management of a variety of odontogenic cysts. It also highlights the reclassification of odontogenic keratocysts to keratocystic odontogenic tumours. Clinical Relevance: Dentists should be aware of the multiple odontogenic cysts that can present in the oral cavity and be able to formulate appropriate management plans.
Pain part 4: odontogenic pain
Authors: Thayer Tom 
Published: August 2017

Pain is one of the major reasons that lead patients to seek dental care. For the majority of patients, the pain is of odontogenic origin, as a consequence of dental disease. The timely diagnosis and management of dental pain is an essential component of dental care, and this article reminds readers of the common presenting symptoms of simple dental pain, diagnoses and pragmatic management. Clinical Relevance: Pain of odontogenic origin is common, and distressing. However, the pathology is consistent, as are the symptoms, and an understanding of this underpins the careful history-taking that will lead the clinician to the diagnosis.
Pain part 5a: chronic (neuropathic) orofacial pain
Authors: Renton Tara , Kahwaja Nadine 
Published: August 2017

Neuropathic pain is a significant social and economic burden. Back pain, joint pain and headaches affect over 30% of the population. Chronic orofacial pain is a common condition and is difficult to diagnose and manage. This two-part paper aims to provide an overview of novel understanding of neuropathic pain, and furnish clinical teams with an update on the less common and less well-recognized chronic orofacial conditions. Headaches and temporomandibular disorders are the most common conditions and are covered in separate papers (6 and 10). Trigeminal neuralgia, burning mouth, and trigeminal autonomic cephalgias are also covered in separate papers (7, 8 and 9). The remaining conditions: post-traumatic neuropathy (nerve injury); and persistent idiopathic facial pain and atypical odontalgia are discussed in this and the following paper. Clinical Relevance: Neuropathic pain, though rare, is a consequence of dental treatment. Nerve injury in relation to M3M surgery, dental implants, endodontics and local anaesthesia result in 70% of affected patients experiencing chronic neuropathic pain.
Minimizing digital data loss
Authors: Chande Milan 
Published: August 2017

Clinical photography has now reached all areas of dentistry, with camera equipment and photography skills being present in many practices. Whilst taking good photographs is just one part of improving record-keeping, the other part, which is arguably the more important aspect, is to store securely this vast amount of data that is created. This article intends to explore the options available to practices to store the data securely and recommends the easiest and most effective ways available today. CPD/Clinical Relevance: With clinical photographs becoming ever more important in the field of dentistry, correct storage and use of camera equipment is important.
Modern endodontic principles part 3: preparation
Authors: Darcey James , Taylor Carly , Roudsari Reza Vahid , Jawad Sarra , Hunter Mark 
Published: August 2017

The purpose of instrumentation is to facilitate irrigation and allow controlled obturation. This article will revisit methods of instrumentation of the root canal system with consideration given to length determination, apical preparation and the concept of patency filing. It will discuss hand instrumentation and rotary preparation looking at emerging technology such as reciprocating systems and the self-adjusting file. CPD/Clinical Relevance: Mechanical preparation of the root canal system is of fundamental importance in achieving success, creating a more easily managed environment from a biological perspective.
Dental materials: what goes where? class V restorations
Authors: Burke F J Trevor 
Published: August 2017

A large number of Class V restorations are placed per annum to restore cervical lesions. This paper evaluates the pathogenesis of these lesions, with particular reference to the role of occlusal factors, and reviews the literature in order to provide advice on the material(s) which are most likely to produce optimal longevity of a Class V restoration. CPD/Clinical Relevance: Resin-modified glass ionomer materials appear to provide optimal survival for a Class V restoration, but a (flowable) composite might produce a better aesthetic result.
Evidence-based dentistry in everyday practice
Authors: Gudray Kiran , Walmsley Anthony Damien 
Published: August 2017

This article informs readers of a method of implementing evidence-based dentistry in practice. Following these steps, practitioners should be able to use this skill in an efficient manner. The importance of evidence-based dentistry and its relevance to situations encountered in everyday practice is also highlighted. CPD/Clinical Relevance: This article highlights a series of steps to be followed by practitioners to ensure that treatment provided is supported by the most recent, good quality evidence.
Antimicrobial resistance and antibiotic prescribing in dental practice
Authors: Palmer Nikolaus O A 
Published: August 2017

The purpose of this paper is to review the principles of antibiotic prescribing in light of the increasing worldwide problem of antimicrobial resistance and the evidence of inappropriate use of antibiotics in dentistry. Guidance on the management of dental infections and antibiotic prophylaxis based on a review of the scientific evidence will be given to ensure good patient care.CPD/Clinical Relevance: To discuss the relevance of legislation around antimicrobial prescribing and antimicrobial stewardship for dentists.