Routine Dental Treatment Research Articles

Classical trigeminal neuralgia is associated with gephyrin and sodium voltage-gated channel alpha subunit 8

Trigeminal neuralgia is highly debilitating, and its etiology is still undefined. The goal of this work was to define associations between well-characterized trigeminal neuralgia cases and common genetic variants in the population. two hundred and fifty-seven individuals diagnosed with classical trigeminal neuralgia were compared to 865 individuals without classical trigeminal neuralgia and with an assessment for lower or higher pain threshold based on the amount of anesthetic required for routine dental treatment. Genotypes of 24 variants marking genes in the VGSC (voltage-gated sodium channels) or GABA (gamma-aminobutyric acid) pathways were obtained using TaqMan chemistry end end-point analysis. Chi-square was used for all comparisons with an alpha of 0.002. An association between classical trigeminal neuralgia and individuals requiring less or more anesthetic for routine dental treatments showed associations with SCN8A rs1601012 and GPHN rs723432 (p = 0.0009 and p = 0.0002, respectively). In conclusion, classical trigeminal neuralgia is associated with SCN8A and GPHN and markers rs1601012 rs723432 may be useful to determine individual risks for the condition.

Hidrojen Peroksit/Kolloidal Gümüş’ün Staphylococcus aureus Üzerindeki Etkisi: Pilot Çalışma

Objective: To determine the distribution of Staphylococcus aureus (S. aureus) aerosols in the immediate environment of dental operators during routine dental treatment and to investigate the reduction in S. aureus colonization using 0.5% hydrogen peroxide/colloidal silver disinfectant were aimed.
 Materials and Methods: The study was divided into two groups. Sterile distilled water was used in Group A (n = 90 Petri plates). Sterile distilled water with hydrogen peroxide/colloidal silver was used in Group B (n = 90 Petri plates). The plates were set up seperately in two directions on the head phantom corresponding to the 6 and 9 o’clock positions. Three petri plates were placed side by side up to 50 cm, 100 cm and 200 cm distances, and the experimental design were proceeded by contaminating with S. aureus (ATCC 29213). Mann Whitney U test was used for comparing to independent samples.
 Results: When compared to Group A, S. aureus grown colonies on agar plates in Group B was significantly decreased in directions corresponding to the 6 and 9 o’clock positions to 50 cm, 100 cm, and 200 cm distances (p = 0.00).
 Conclusion: H2O2/Colloidal-Ag can safely be used as a supportive precaution against S. aureus.

The role of primary dental care practitioners in the long-term management of patients treated for head and neck cancer

Patients treated for head and neck cancer may be susceptible to a higher incidence of dental disease due to long-term sequelae of treatment for head and neck cancer. Most patients with head and neck cancer are discharged from a hospital environment and responsibility for long-term dental care is transferred back from the restorative dentistry team to the dentist and dental care professionals in primary care. Treatment of these patients should be undertaken in a supportive environment, taking into account the physical and psychological repercussions of previous treatment. With the exception of some surgical procedures, routine dental care is not contraindicated in patients after head and neck cancer treatment and it is expected that the dentist and dental care professionals will be responsible for long-term routine dental treatment. Primary dental care practitioners should be aware of the process to refer patients back to the head and neck cancer multidisciplinary team if they note a suspicious change during their routine clinical examinations. Referral to a restorative dentistry consultant for planning and carrying out complex items of care may sometimes be necessary, but patients should always remain under the long-term care of their primary dental care practitioner.

Strategies for managing dental care for refugee patients.

To outline key factors that contribute to oral health issues of refugees and asylum seekers and provide management strategies for dental providers to teach desensitization and fear reduction for this special population. We researched published literature in the PubMed database and incorporated lessons gained from treating refugee and asylee patients at a Vulnerable Populations Clinic (VPC) at an urban academic dental school. Refugees and asylees are at high risk for oral conditions due to a tendency to not seek routine dental treatment, psychological stressors, and various systemic factors. Oral healthproviders can teach patients desensitization and fear reduction by working to gain patients' trust by having effective communication and prioritizing comfort in the dental operatory. Providers should also utilize translation, psychological, and/or multicultural support services during their management of care. By having a stronger understanding of the key causes of oral health issues among refugees and asylees in the United States, dental providers can better approach managing care for this vulnerable patient population. The concepts of teaching desensitization and fear reduction utilized for this special population can be applied to managing care for the wider special needs patient community.

Minimal Intervention Dentistry (MID) mainstream or unconventional option? Study exploring the impact of COVID-19 on paediatric dentists’ views and practices of MID for managing carious primary teeth in children across the United Kingdom and European Union

PurposeTo explore the techniques used to manage carious primary teeth during the COVID-19 pandemic by paediatric dentists and dentists with a special interest in paediatric dentistry (DwSI) who are members of the British Society of Paediatric Dentistry (BSPD) and the European Academy of Paediatric Dentistry (EAPD), and their views on the use of minimal intervention dentistry (MID) in children prior to, during and post the COVID era.MethodsA total of 212 paediatric dentists and DwSI completed an online questionnaire. Six MID techniques were explored: fissure sealants, resin infiltration, Hall Technique (HT), 38% silver diamine fluoride (SDF), atraumatic restorative treatment (ART), stepwise removal and selective caries removal.ResultsThe majority were specialists (26%) followed by clinical academics (23.1%) working mainly in university teaching hospitals (46.2%). Routine dental treatment for children with carious primary teeth was provided by the majority (92.5%) during the pandemic. HT (96%) and 38% SDF (65.7%) were the most commonly used techniques among the BSPD members whereas conventional restoration of non-selective caries removal and pulp therapy remained the most widely used technique among the EAPD members (66.2%). Most of the MID techniques were used as a treatment option (48.1%) rather than a choice (43.4%), with most of these choices having been affected by the patient’s behaviour (82.5%). More than one thirds (39.2%) of the participants were reluctant to adopt MID after the pandemic. Several barriers such as lack of teaching and confidence as well as perceived lack of evidence were identified.ConclusionA range of MID techniques is practiced broadly by a sample of paediatric dentists and DwSI across the United Kingdom (U.K) and European Union (E.U). The majority of clinicians are willing to continue using these techniques going forward after COVID restrictions are lifted. The pandemic served as an opportunity for many dentists to become familiar with various MID practices, such as SDF, which has been already established some time ago.

Airway management, intensive care requirement, and corticosteroid use in cervicofacial infection. A Maxillofacial Trainee Research Collaborative (MTReC) study

Cervicofacial infection (CFI) is a frequently encountered presentation to Oral and Maxillofacial Departments (OMFS). The United Kingdom has recently seen cessation of all routine community dental treatment due to the Coronavirus (COVID-19) pandemic and consequently an initial modification of treatment received in secondary care. Subsequent airway difficulties and the need for level 2 High Dependency Unit (HDU) or level 3 Intensive Care Unit (ICU) is a concern to surgeons and anaesthetists alike. The availability of skilled staff and appropriate facilities can be variable. It is imperative to understand the resource implications of CFI with respect to airway management and critical care utilisation. Adequate provision is fundamental for optimal care. A national, multicentre, trainee-led audit was carried out across 17 hospitals in the UK from May to September 2017. Information recorded included demographic features, presentation, airway management, medical and surgical treatment, and steroid administration. One thousand and two presentations (1002) were recorded. Forty-five percent were female, with a mean (range) age of 37.5 years (0–94). Regarding surgical airway management, 63.4% had a standard intubation (oral 42%, nasal 21.4%). Awake fibreoptic intubation (AFOI) was performed in 28% and surgical airway required in 0.9%. Impending airway compromise at the time of presentation was 1.7%. Following surgical incision and drainage, 96.1% of patients returned to a general ward, 2.7% to Level 3, and 1.1% to Level 2 care. The return to theatre was 2.8%, and 0.7% required reintubation. There was an association between corticosteroid administration and duration of intubation. Those who received steroids were more likely to remain intubated postoperatively (p = 0.006), require a higher level of postoperative care (p < 0.001), and require a return to theatre (p = 0.019). Postoperatively, patients who received steroids were less likely to be extubated at the close of the procedure. Intubated patients who received multiple steroid doses postoperatively were extubated with less frequency those that received a single dose. To our knowledge, this dataset is the largest ever recorded for CFI. Our results showed a high requirement for advanced airway management in this cohort. The requirement for surgical airway was low, but the significance of this situation should not be underestimated. The relatively frequent need for care at levels 2 or 3 within this cohort also placed a significant demand on already overburdened resources. Knowledge of care requirements for these patients will inform resource planning.

Distraction With Virtual Reality Goggles in Paediatric Dental Treatment: A Randomised Controlled Trial

AimThe aim of this study was to examine whether screening content through virtual reality (VR) goggles can diminish pain perception during local anaesthesia administered using the inferior alveolar nerve block technique and rubber dam placement in routine paediatric dental treatment. Materials and methodsThis is a crossover study of healthy 4- to 12-year-old children who were scheduled to receive local anaesthesia administered using the inferior alveolar nerve block technique and rubber dam placement in 2 visits. The participants were randomly assigned to undergo 1 treatment performed with Oculus GO VR goggles and the other treatment without. Pain was evaluated using the Wong-Baker FACES Pain Rating Scale and the Modified Behavioral Pain Scale (MBPS). ResultsThe study group included 29 children with a mean age of 8.29 years (SD, 1.96). Whilst administering local anaesthesia, no significant difference was observed in the Wong-Baker FACES Pain Rating Scale and in MBPS movements between visits with and without the VR goggles. However, significantly lower pain perception was observed in the other parameters of MBPS when using the VR goggles: Face (P = .007) and Cry (P = .046). During placement of a rubber dam, significantly less pain was reported by the patients (P = .005) and observed by the assessor (Face [P = .005], Cry [P = .029], and Movement [P = 0.028]) when the VR goggles were used. ConclusionsVR can decrease pain perception during rubber dam placement in children, but it has limited benefit during administration of local anaesthesia.

Articaine: dental practitioner use, basis of perception and evidence-based dentistry—a cross-sectional study

BackgroundLimited data exist on dental practitioner use and perceptions of articaine. This study is a cross-sectional survey of dental practitioners from January, 2021 to ascertain the extent of their use of the dental local anaesthetic, articaine, the basis of their perceptions about articaine and whether current practices are in line with recent evidence regarding articaine safety and efficacy.MethodAn anonymous survey was designed using the SAP Qualtrics Core XM software platform and a survey link was disseminated from December 2020 to January 2021 via social media. The survey was designed as a five minute, anonymous, online questionnaire including a plain language information sheet, request for participant consent and 14 questions. Data were entered onto a Microsoft™ Excel spreadsheet and analysed qualitatively, isolating the answers into recurrent themes.ResultsSixty percent of the surveyed dental practitioner used articaine as their preferred dental anaesthetic. Twenty-three percent of the dental practitioner surveyed used articaine for all of their dental procedures including inferior alveolar nerve blocks, while 40% of respondents used articaine for all their dental procedures except inferior alveolar nerve blocks. The predominant basis of dental practitioner uses and perception of articaine were their countries dental guidelines.ConclusionDespite the latest findings that articaine is as safe and more efficacious as lidocaine for all routine dental treatment, 40% of survey respondents avoided articaine use for inferior alveolar blocks. Our study recognises a discrepancy between reported clinical practice and current research evidence. Further research and clarifications are needed to achieve ubiquitous practice of evidence-based dentistry.

Evaluation of Association of Oral Bacterial Profile with HBV and HCV Infection and T Lymphocyte Level in HIV-Positive Patients.

Background This study was aimed to determine the oral bacterial profile of HIV-positive patients and their correlation with T lymphocyte and CD4 count and hepatitis B and C incidence. Methods In this study, 73 patients who were diagnosed HIV-positive and were referred to Shiraz HIV research center for routine dental treatment were enrolled. Demographic data including sex, ethnicity, CD4+ T cell, and T lymphocyte counts were collected from their medical records. Supragingival dental plaque and samples from the dorsal of the tongue were collected by sterile swabs. These samples were transferred to the microbiology laboratory of Jahrom University of Medical Sciences. After primary biochemical test of cultured samples, assessment of bacterial biofilms was done by DNA extraction. Real-time PCR with specific primer of each bacterial species was done, and assessment of the results of real time PCR led to determination of the species of the evaluated bacteria. The correlation of bacterial prevalence with hepatitis B and C was evaluated by chi-square test. Furthermore, Mann–Whitney test was used to evaluate the association of bacterial species prevalence with CD4 and T lymphocyte level. Results The prevalence of none of the detected bacteria had statistically significant relationship with hepatitis C, except for Peptostreptococcaceae (p value = 0.016) in the tongue plaque and Leptotrichia (p value = 0.022) in dental plaque. None of the evaluated bacteria showed any significant association with CD4 and T lymphocytes level, except for Kingella (p value = 0.025, 0.019, respectively), and also no significant correlation was reported with CD4, except for Gemella (p value = 0.021) and Campylobacter gracilis (p value = 0.029). Conclusions The diversity of the detected bacteria was more in dental plaque, while their density was more noticeable in the tongue plaque. No significant correlation was found between the prevalence of most of the detected bacteria and CD4 level and T lymphocyte level and incidence of hepatitis B and C.

Active oxygen oral rinse: chairside treatments against coronavirus infections

In 2020, many patients were infected with the coronavirus disease 2019 (COVID-19) worldwide. The identification of coronavirus in saliva have suggested the oral cavity as a potential reservoir for COVID-19 transmission, particularly in dental clinics. Chairside oral rinses have been widely used as a standard measure before routine dental treatment for many years. Recently, the use of chairside oral rinse has been recalled as a pre-procedural infection control measure by several health authorities, especially during the COVID-19 pandemic. Although there is still no clinical evidence, oral rinses containing active oxygen agents (e.g. BlueM formula) have been recommended to reduce the viral load in aerosols and drops during oral procedures. This paper aimed to provide an overview of the current guidelines and recommendations on the use of active oxygen oral rinse as chairside treatment against the COVID-19 pandemic in dentistry.

Assessment of Skin and Mucosa at the Equine Oral Commissures to Assess Pathology from Bit Wear: The Oral Commissure Assessment Protocol (OCA) for Analysis and Categorisation of Oral Commissures.

Simple SummaryThe goal was to implement a protocol to categorize and record pathological findings at the lip commissures. First, the precise anatomical location was defined; second, pigmentation was classified as natural or potentially pathological; and third, pathological lesions were characterized. Associations between the horse’s history and the observed findings were sought. A convenience sample of 206 horses presented for routine dental prophylaxis were sedated; the mouth was held open with a gag, and photographs were taken of the oral commissures and adjacent areas of the lips. The horses were divided in two groups: horses that had never been bitted and horses currently or previously bitted. The owners completed a questionnaire describing the horse’s name, identification number, breed, age, sex, colour, training level, and discipline. The photographs were analysed in a systematic manner, and a score chart was developed to standardize the reporting of lesions. Potentially pathological pigment changes occurred more frequently in horses with a higher level of training (p = 0.04) and light-coloured horses (p = 0.0004), but were not associated with current bit use or the discipline that the horse participated in (p = 0.20). Scars were more frequent in horses competing at a higher level. Only two horses had contusions/erosions, five had ulcers and none showed bleeding; these numbers were too low for statistical analysis.This study addresses the presence and location of natural pigmentation, potentially pathological changes in pigment, interruptions of the natural lining (scars), roughness, and erosions/contusion (bruising) in and around the corners of the lips of 206 horses presented to a veterinarian for routine preventative dental treatment. After sedation, photographs were taken and later evaluated for the presence of lesions. During the photographic analysis, the Oral Commissure Assessment (OCA) protocol was developed to map precisely the areas of skin and mucosa around the corners of the lips, and the presence of lesions was recorded for each area. Potentially pathological pigment changes occurred more frequently in horses with a higher level of training (p = 0.04) and in light-coloured horses (p = 0.0004), but there was no association with the current use of a bit or the discipline that the horse participated in (p = 0.20). Scars occurred more frequently in horses competing at a higher level. Only two horses had contusions or erosions, five had ulcers, and none showed bleeding; these numbers were too low for statistical analysis. Using the OCA protocol provides a detailed method for categorizing and recording lesions in and around the corners of the lips, including natural vs. potential and/or definite pathological character.

Knowledge and attitudes of dental practitioners regarding the use of behaviour management techniques for paediatric dental patients.

Understanding children's behaviour and development is crucial in managing and treating paediatric dental patients. Dental practitioners are expected to be aware of the behaviour management techniques which will facilitate routine dental treatment of the child dental patient.

Interest in dentistry in early months of the COVID-19 global pandemic: A Google Trends approach.

BackgroundIn early the COVID‐19 pandemic, routine dental treatments have been delayed due to the risk of disease transmission. This delay may lead public to search for information on the Internet for a solution.ObjectivesThis study aims to evaluate the public interest in dentistry in the early months of the COVID‐19 global pandemic in the selected countries.MethodsThe daily numbers of new COVID‐19 cases were recorded for China, South Korea, Italy, Germany, Russia, Ukraine and Turkey. For these countries, Internet search interest of the keyword ‘dentistry’, ‘coronavirus’, ‘COVID‐19’, ‘SARS‐CoV‐2’ and ‘pandemic’ in the early months of the COVID‐19 pandemic was evaluated by using Google Trends data.ResultsIn most countries included the public Internet search interest in ‘dentistry+coronavirus+COVID‐19+SARS‐CoV‐2+pandemic’ peaked prior to the peak of new COVID‐19 cases. While a statistically significant positive correlation was observed between the number of new cases and Google Trends data in China, South Korea, Italy and Germany, a statistically significant negative correlation was observed in Turkey.ConclusionThe peak public interest in dentistry has been prior to the peak of COVID‐19 new cases in most countries. The use of Internet data can provide useful information about pandemics and many other diseases.

Wide Cost Variations Observed in Antibiotics and Analgesics Prescribed for Dental Care in India: A Price and Affordability Analysis.

IntroductionWith high prevalence rates across the population, dental pain is the most common symptom that drives a patient to visit the dentist. Dentists prescribe analgesics and antibiotic prophylaxis apart from routine dental treatments. The increasing costs of medications are a major factor that adds to the financial burden of patients seeking oral care.MethodsA list of antibiotics and analgesics recommended by the American Dental Association for dental pain, swelling, and post-procedural pain management was analyzed for the cost variation and cost ratio. The affordability was calculated by the World Health Organization/Health Action International (WHO-HAI) methodology. The most expensive and the least expensive brands of all drug regimens were compared.ResultsWide cost variations were observed between the different brands of antibiotics and analgesics. The highest cost variation was found in ampicillin 500 mg injection (13579.2%). In the affordability analysis; when the most expensive brands were analyzed, the lowest-paid unskilled worker had to lose 2.1 days of wages to afford the drug regimen. The price range was widest for injection ampicillin 500 mg (Rs. 4.24-580.0) and lowest for tablet ibuprofen 400 mg (Rs. 0.7-1.6). ConclusionDental surgeons need to be well aware of the pharmacoeconomics behind medications that directly decides the affordability of treatments. Careful selection of drugs by the dentists considering their quality, availability, and costs is of pivotal importance. Prescribing generic medications and increasing the availability of drugs in public health sectors can help provide cost-effective dental care for all.

Mandible bone density in adolescents with cerebral palsy using antiepileptic drugs

Objective: The aim of this study was to assess the bone density of the mandible in adolescents with cerebral palsy(CP) treated with antiepileptic drugs using one beam computed tomography (CBCT). Methods: The study wascarried out with 18 adolescents aged 12–18 years, undergoing routine dental treatment at the dental clinic ofAPCD-São Caetano do Sul. CBCT scans were of divided into two groups: G1 adolescents with CP using antiepilepticdrugs and G2 normoactive adolescents. A single dentomaxillofacial radiologist assessed and evaluated the imagesusing Dental Slice software and Image J. Fisher’s exact tests as well as paired and unpaired Student’s t-testswere performed. Results: Groups differed significantly with regard in the values of density (p &lt; 0.001), withG1 presenting lower values compare to G2. G1 showed significantly lower density means on the right side, leftside, and right/left sides of the mandible edge than G2 (p &lt; 0.001). Conclusion: CP patients using antiepilepticdrugs show evidence of bone mineral density loss of the mandible. KEYWORDSAntiepileptic drugs; Bone mineral density; Cone beam computed tomography; Mandibular indices; Osteoporosis.

Evaluation of therapeutic effect and health economics of general anesthesia and routine outpatient dental treatment in children with severe early child caries.

To evaluate the efficacy and health economics of the comprehensive therapy for the children with severe early child caries (S-ECC) under dental general anesthesia (DGA) and conventional outpatient treatment to provide references for dentists and parents in the choice of clinical treatment. A retrospective cohort study was conducted on S-ECC children aged 36-71 months and who received dental treatment under general anesthesia or routine outpatient situation. The filled tooth survival rate, treatment cost, and cost-filled tooth survival time of the two groups were compared, and the curative effect and health economics was evaluated. The filled tooth survival rate of the DGA group was higher than that of the routine outpatient group (P<0.05). The average direct medical cost per filled tooth was significantly higher in the DGA group than in the routine outpatient group (P<0.05). The direct medical cost-filled tooth survival time ratio in the DGA group was higher than that in the routine outpatient group (P<0.05), but no significant difference was observed in the total medical cost-filled tooth survival time ratio (P>0.05). Compared with the conventional outpatient treatment group, the treatment outcomes of S-ECC under general anesthesia were better, and the costs were higher. However, no significant difference was observed in the total medical cost-filled tooth survival time between these two groups, and the conventional outpatient treatment did not have evident economic advantages.

Pediatric Dentists' Service Provisions in South-East Europe during the First Wave of COVID-19 Epidemic: Lessons Learned about Preventive Measures and Personal Protective Equipment Use.

Introduction: Having in mind the importance of providing continuous pediatric dental services during the COVID-19 pandemic and the fact that children have similar viral loads to adults, the potential to spread the virus to others, and with variable clinical presentation of COVID-19 infection, this study aimed to analyze the impact of COVID-19 outbreak on pediatric dentistry service provision, risks, and preventive measures before and during dental treatment. Method: Structured and closed epidemiological cross-sectional survey involved seven Southeastern European countries. The questionnaire was developed using the modified Delphi method, pretested, and tested in North Italy during April 2020. The sample consisted of licensed dental professionals reached via national dental chambers and social media using the best strategies according to the national setting. Results: A total of 3227 dentists participated in the survey, and we included 643 specialists in this study—among them, 164 were pediatric dentists. Most pediatric dentists worked in the public sector (61.0%) and provided emergency (64.6%) and routine dental treatment (18.3%) during the outbreak. One-third of pediatric dentists were COVID-19 tested, statistically significantly more than other specialties, and 3.0% tested COVID-19 positive. In addition, significantly more pediatric dentists (13.4%) reported the presence of at least one symptom related to COVID-19 compared to other specialists (6.1%). None of the pediatric dentists reported PPE shortage. However, 26.2% of all specialists stated that they lacked clear step by step professional guidance in a national language. Similarly, in both groups, around 10% of specialists attended education on coronavirus. Conclusions: Considering that most pediatric dentists provided dental treatment during lockdown in their countries in public health centers and that they will continue to work during pandemic, our results suggest that pediatric dentists might be at higher risk of COVID-19 infection. Further research should focus on finding better ways to promote and adapt preventive, protective measures and PPE in the pediatric dental setting to be behaviorally acceptable. Moreover, additional efforts should be invested in dental education regarding COVID-19 in the mother tongue.

P080 An embedded pathway to mandibular advancement splint (MAS) construction in a tertiary hospital reduces barriers to care for low-income individuals

Abstract Introduction The aim of this study was to report the outcomes of patients referred within and to a tertiary hospital dental unit for subsidised construction of a MAS over a 5-year period. Methods Medical records of patients referred from 2015–2020 were examined for reason for referral, details of diagnosis, pathway to diagnosis, treatment, compliance, clinician-reported and lab-based outcomes and follow-up reviews. Results One hundred patients referred from: The Hospital Sleep Unit 40, other Tertiary Hospitals 27, Private Sleep Clinics 13, Medical GPs 10. 76 patients were confirmed health care card holders. 30 patients did not proceed for reasons of cost or poor oral health. 59 patients were newly fitted with a MAS (27F,32M), 17 severe, 21 moderate, 17 mild OSA, mean age 52.9(+13.9) years, BMI 30.2(+6.3) kg/m2, ESS 11.4(+5.3). 22 of 36 patients with serial ESS scores had excessive daytime sleepiness upon initial presentation. 15/22(68%)(p&amp;lt;0.005) of patients had resolution of their excessive daytime sleepiness following MAS wear. 8/15(53%) of patients had a subsequent AHI &amp;lt;50%. 33 patients (56%) continued MAS wear, mean follow-up time 13.8(±14.6) months with an average of 5.8(+3.0) visits. 6 were lost to follow up, 20 patients (33%) ceased MAS wear with 10(50%) of these stopping because routine dental treatment affected the device fit or discomfort later developed. Conclusion Subsidised expert construction of MAS embedded in a tertiary hospital is a well-utilised and effective service which reduces barriers for patients. The referrals to this service appear to be appropriate, with most patients proceeding to MAS construction.

Emergency dental care triage during the COVID-19 pandemic.

Introduction Due to the COVID-19 pandemic, from 23 March 2020, routine dental treatment was stopped by the Chief Dental Officer, with the emphasis towards urgent dental care only.Aim To evaluate the activities of the emergency service at a secondary care Urgent Dental Care (UDC) hub during the COVID-19 pandemic.Materials and methods The total number of patients seen from 30 March to 20 June 2020 was recorded. The effectiveness of telephone triage and the appropriateness of patients invited for a clinical assessment were evaluated over a two-week period.Results The number of calls into the UDC hub were highest during the first few weeks, with up to 249 per day. The most commonly provided emergency treatments included extractions and pulp extirpations.Discussion As other UDC hubs opened, the number of calls reduced, with patients being directed to a UDC nearer to where they lived.Conclusions The dental profession had to make some significant changes in the way they worked due to the risk of COVID-19 transmission and due to the effects of the lockdown. This review highlights the effectiveness of telephone triage as well as its drawbacks.

Oral Health Education Combined with Routine Dental Treatment Reduces hsCRP

A multitude of studies investigated the beneficial effects of periodontitis therapy on general health. In contrast, the present trial aimed to investigate the effect of an oral health education program combined with routine dental treatment on serum biomarkers of systemic health in a community of low-socioeconomic background with general dental treatment needs. Eligible participants (plaque index >50%, bleeding on probing >30%, active carious lesion) were randomised to a group that received dental treatment combined with an oral health education program (OHE+GDT) or a group that received general dental treatment only (GDT). Participants in both groups received routine dental treatment. In addition, participants in the OHE+GDT group received 180 min of health education and a full-mouth debridement. Serum levels of high-sensitivity C-reactive protein (hsCRP), lipid profiles, and HbA1c were measured at baseline and after 12 months. 295 participants (mean age, 45.4 ± 11 years) were analysed. Periodontal health significantly improved in both groups. However, no intergroup differences were detected (P=0.92 Generalised Estimating Equation (GEE)). A significant reduction of hsCRP levels at the follow-up assessment was observed in the OHE+GDT group, which was significantly different from the GDT group (P =0.01). Multivariate modelling indicated that baseline hsCRP levels, baseline body mass index, and higher consumption of vegetables (P = 0.021) predicted a reduction in hsCRP levels. This study demonstrated that oral health education combined with routine dental treatment was associated with a significant reduction in hsCRP levels and hence suggests a beneficial effect on general health.