The TMD management dilemma.

As temporomandibular disorders (TMDs) become ever more prevalent in both primary and secondary care settings, successful management is increasingly challenging in both sectors. The authors aim to explore the dilemma of TMD management as the patient journeys through from primary to secondary care and offer educational tools to support practitioners in managing this complex patient cohort, as well as outlining alternative solutions for the delivery of TMD management strategies.

The use of liquid formulation pentoxifylline and vitamin E in both established and as a prophylaxis for dental extractions "at risk" of osteoradionecrosis.

BACKGROUND: Osteoradionecrosis (ORN) of the jaws remains one of the most debilitating complications of radiotherapy (RT) in patients with head and neck cancer (HNC). Liquid pentoxifylline and vitamin E (PVe) presents an alternative formulation to tablets for patients with dysphagia or enteric feeding. OBJECTIVE: This study aimed to assess the clinical outcomes of using a liquid formulation of PVe for both established ORN and as a prophylaxis to avoid its occurrence after dental extractions. A secondary objective was to determine patient-reported side effects in relation to the liquid formulation of PVe. STUDY DESIGN: The clinical records of 111 patients with HNC who were prescribed liquid PVe were reviewed retrospectively (66 with established ORN and 45 as prophylaxis before an invasive dental procedure). RESULTS: In established ORN, 44% healed, and 41% were stable. In the prophylaxis group, 96% of surgical sites healed completely, with 4% (n = 2) developing ORN. Most patients (89%) were able to tolerate liquid PVe. Of the 11% (n = 12) who could not tolerate this regime, the most commonly reported side effect was gastric irritation (n = 5/12), whereas no more than 1 patient reported dizziness, malaise, and bleeding. CONCLUSIONS: This retrospective review suggests that liquid PVe is efficacious for both established ORN and as a prophylaxis. Side effects reported were similar to those recognized for the tablet formulation.

Survival rates of dental implants in patients with head and neck pathologies: 12-year single-operator study.

OBJECTIVE: To evaluate the survival rates of dental implants placed in patients with head and neck pathologies treated with resective surgery with or without free flap reconstruction, radiotherapy alone, and/or chemotherapy. STUDY DESIGN: In this study, we retrospectively analyzed the survival of intraoral dental implants placed by the same surgeon over a 12-year period from 2007 to 2019. These implants were followed up clinically and radiographically for a period of 36 months postoperatively and throughout the restorative phase. RESULTS: A total of 190 patients with a total of 739 dental implants, comprising both intraoral and zygomatic implants, were included in this study. Overall, the dental implant survival rate was 95%, with a similar rate for dental implants placed in irradiated and nonirradiated bone (90% vs 93%). A lower implant survival rate was noted in implants placed in transplanted bone (79%). In cases of implant failure (n = 17), 35% (n = 6) of protheses survived and remained functional. CONCLUSIONS: Our findings support the placement of dental implants in patients with benign and malignant pathologies of the head and neck to improve their quality of life. However, we highlight the need for careful surgical planning and placement by experienced clinicians.

COVID-19 and Postgraduate Dental Training-A commentary.

In this commentary, we discuss the short-term and long-term implications of COVID-19 on postgraduate dental training in the UK, specifically Dental Core Training (DCT) and Specialty Training. Although this commentary focuses on the authors' experiences within Guy's and St Thomas' NHS Foundation Trust (GSTT) in London, we hope that our viewpoint will resonate with dental postgraduate trainees across Europe and may guide further discussion in this area. We also reflect on adaptations that may be required if there are any future disruptions to dental postgraduate training in the UK.

Psychosocial effects of the COVID-19 pandemic on staff in a dental teaching hospital.

Introduction As COVID-19 rapidly developed across the UK, health services were forced to make radical changes. Within the dental department, all elective procedures were cancelled and staff members were redeployed to support other services within the trust. Studies have demonstrated increased prevalence of psychiatric disorders among healthcare workers during virus pandemics.Aims To assess the psychosocial implications of COVID-19 on members of the dental team working within a large dental teaching hospital.Methodology A survey comprising a series of questions (closed and open) and a Generalised Anxiety Disorder assessment (GAD-7) was distributed to members of the dental team between 1-3 April 2020.Results A total of 120 surveys were completed; 53.3% of respondents displayed symptoms of generalised anxiety. The highest average GAD-7 score was noted among dental nurses. The most common concern was the impact of COVID-19 on friends and family followed by personal health and nature of the disease.Conclusion(s) High anxiety levels and significant psychosocial implications were noted among dental staff during this virus pandemic. Our findings add to a growing body of data on the psychosocial impact of virus outbreaks on healthcare workers and highlight the importance of wellbeing initiatives for healthcare workers to be placed at the forefront of future pandemic crisis planning.