Restorative dentistry for the older patient cohort.

The ageing UK population presents a number of challenges to the restorative dentist as a result of complex treatment needs and a significant maintenance burden. This paper discusses how ageing may influence the provision of dental treatment and outlines a variety of conservative, periodontal, endodontic and prosthodontic considerations that are important in the management of the older patient cohort.

Do general dental practitioners leave teeth on 'open drainage'?

OBJECTIVE: There is a need to ascertain the use of evidence-based dentistry in both primary and secondary care in order to tailor education. This study aims to evaluate the use of 'open drainage' as part of endodontic treatment in primary care in South Yorkshire. METHODS: A questionnaire was circulated to 141 randomly selected general dental practitioners in the South Yorkshire area between January 2012 and January 2013. RESULTS: The response rate was 79% (112/141). Five of the returned questionnaires were incomplete and therefore not usable. Seventy-nine percent of respondents were general dental practitioners (GDPs) working in mainly NHS or mixed practices. The year of graduation varied between 1970 and 2011. Forty-one percent (44/107) stated that they had never left a tooth on open drainage. Twenty-nine percent (31/107) stated that they sometimes leave teeth on open drainage. Of those respondents who currently leave teeth on open drainage, most (68%) would leave teeth on open drainage for one to two days or less. CONCLUSIONS: This survey revealed that the practice of leaving teeth on open drainage is still present in general dental practice. Current guidelines do not comment on the use of this treatment modality. There is a need to ascertain further information about practices throughout the United Kingdom in order to provide clear evidence-based guidelines.

An update on resin-bonded bridges.

Since the introduction of the 'Rochette' bridge in the 1970s the resin-bonded bridge has undergone a number of developments to become a commonly used technique for replacement of a missing tooth, especially in a minimally restored dentition. One of the major advantages of the resin-bonded bridge is that it requires less tooth preparation than conventional bridgework, with some authorities advising no preparation at all. Some reports have suggested poor long-term success rates, however, if used in appropriate clinical situations, this treatment modality can be extremely successful. The aim of this paper is to review the literature relating to resin-bonded bridges and suggest recommendations for clinicalpractice concerning the provision of resin-bonded bridges.

The ageing UK population--considerations for the restorative dentist.

The scope of gerodontology and more specifically that of restorative dentistry (which in the UK includes the disciplines of endodontics, periodontics, prosthodontics and operative dentistry) within gerodontology, is expanding. This is true for several reasons. Firstly, the population, in both the UK and most of the western world is generally living longer. Secondly, more elderly patients are retaining their natural teeth longer into old age--thereby necessitating ongoing restorative dentistry input for their maintenance. In addition, many patients' expectations are increasing with regards to restorative dentistry. Natural teeth that were erstwhile considered as automatic candidates for extraction may now be regarded differently, especially if they are considered a 'strategic' tooth within the arch. The aim of this paper is to give a perspective as to how some of the more common restorative dentistry issues that beset the elderly population are addressed in the UK. This paper will focus on operative dentistry and prosthodontic aspects of restorative dentistry for elderly patients.

A comparison of alcohol and drug use among dental undergraduates and a group of non-medical, professional undergraduates.

OBJECTIVE: To compare the alcohol and drug use of dental and law undergraduates. DESIGN: Anonymous self-report questionnaire. SUBJECTS AND METHODS: All dental undergraduates (n = 263) and a randomly selected group of law undergraduates (n = 180) from the same university were questioned on their use of alcohol, tobacco and illicit drugs. RESULTS: Current tobacco use was reported by 7% of dental students and 19% of law students. Alcohol use was reported by 86% of dental students and 88% of law students, with 44% of dental students and 52% of law students estimating they drank above recommended safe limits (14 units for females, 21 units for men). Binge drinking was reported by 71% of dental students and 75% of law students, with weekly binge drinking reported by 27% and 34% of dental and law students respectively. Cannabis experience was reported by 44% of dental students and 52% of law students, with current use reported by 12% and 25% of dental and law students respectively. A small proportion of dental and law students reported using other class A and B drugs including ecstasy, amphetamines and cocaine. CONCLUSIONS: Dental students appear to be indulging in similar levels of alcohol and illicit drug use when compared to students of a different, non-medical faculty. Binge drinking may be more prevalent than previously thought, with potential risks to health, patient safety and professional status.

The knowledge of healthcare professionals regarding elderly persons' oral care.

OBJECTIVE: The aim of this study was to compare the knowledge and views of nursing staff on both acute elderly care and rehabilitation wards regarding elderly persons' oral care with that of carers in nursing homes. SUBJECTS: One hundred nurses working on acute, sub-acute and rehabilitation wards for elderly people (Group 1) and 75 carers in nursing homes (Group 2) were surveyed. DESIGN: A semi-structured questionnaire. RESULTS: Similar percentages of each group of nurses were registered with a dentist (86% and 88% respectively), although more hospital-based nurses were anxious about dental treatment compared with the nursing home group (40% and 28% respectively). More carers in nursing homes gave regular advice about oral care than the hospital-based nurses (54% and 43% respectively). Eighteen per cent of each group thought that edentulous individuals did not require regular oral care. Eighty-five per cent of hospital-based nurses and 95% of nursing home carers incorrectly thought that dentures were 'free' on the NHS. Although trends were observed between the two groups, no comparisons were statistically significant (Chi-square; level p < 0.05). CONCLUSIONS: Deficiencies exist in the knowledge of health care workers both in hospital and in the community setting, although the latter were less knowledgeable but more likely to give advice to older people.