Use of WhatsApp in an oral and maxillofacial surgery department at a major trauma centre and its role during major incidents: our experience.

WhatsApp (Facebook), which is a popular instant messaging "app" that is available on several platforms globally, allows users to share text, images, and video (and much more) over an end-to-end encrypted connection. We have investigated its use among the oral and maxillofacial surgery junior trainees' WhatsApp group at King's College Hospital, a level one trauma centre in London, and reviewed existing studies. On five of the seven days analysed, there were 191 communications. Most (n = 127, 67%) were related to administrative issues and patient care (n = 62, 33%). Only two (1%) related to neither and were classified as "other". No communications were sent to the group over the weekend. WhatsApp is a popular means of communication among junior trainees within our department, and can be used to send concise information to several people at once, often more quickly than by telephone, pager, or email. The technology, however, should be used carefully, and it raises important questions on confidentiality, which have recently been addressed by the medical director of the NHS in the wake of its use as a "cascade mechanism" during major terrorist incidents. We also discuss the potential value of emerging methods of communication that have been specifically designed for use in healthcare.

Paediatric dento-facial infections - a potential tool for identifying children at risk of neglect?

Introduction: Child neglect has a significant impact on children's physical and emotional health and development with lifelong consequences. Dental decay can lead to maxillofacial space infections which can have life-threatening complications and may indicate that a child has suffered dental neglect. Aims and method: In this retrospective audit, we reviewed children below sixteen years who were admitted under oral and maxillofacial surgery for incision and drainage of a dental/facial abscess, under general anaesthesia, between January 2015 and January 2017, to understand if they had experienced dental neglect. We also assessed if they were or had been known to Children's Social Services (SS) before hospital admission. Results: Twenty-seven children were included in the study, eleven children (40%), were known to social services (SS). On average 3.2 teeth were extracted with an average hospital stay of 2.5 days. Discussion: Our data indicate that a significant number of children admitted for maxillofacial space infection are already known to social services. Conclusion: Our recommendation is that all children admitted with dental/maxillofacial space infections, where dental neglect may be present, should be discussed with the local safeguarding team.