Irrigation - does it affect post-operative pain?

DESIGN: A randomised control trial involving eighty patients who were blindly allocated into four different groups for different disinfection and irrigation methods on lower permanent molars. The patients were treated by one experienced endodontist across two visits. The four methods of irrigation used were: 1. Conventional irrigation 2. Sonic irrigation activation system 3. Irradiation with a 980 nm diode laser and conventional irrigation 4. Irradiation with a 980 nm diode laser and sonic irrigation activation system Pain levels were then assessed postoperatively at 8 h, 24 h, 48 h and 7 days following access and chemomechanical preparation at the first visit. CASE SELECTION: Eighty patients who visited the Endodontic Department at Biruni University were included in the study. Those who were included were healthy adults, experiencing moderate to severe pain (self-scored from 4 to 10, based on a 0 to 10 pain scale) at the start of treatment and those who were given a dental diagnosis of 'symptomatic apical periodontitis' with a negative cold test in a mandibular molar. DATA ANALYSIS: Qualitative data was analysed using a chi-square test, Fisher's exact chi-square test and Fisher-Freeman-Halton exact test. The Kruskal-Wallis test and Willcoxon test were used to assess inter-group and intra-group parameters. RESULTS: The study found that patients in all groups experienced a statistically significant decrease in pain levels postoperatively. However, different irrigation methods resulted in no statistically significant differences in pain levels. There were also no statistically significant differences based on gender or age. Statistical significance was reached when p < 0.05. CONCLUSIONS: The use of sonic irrigation activation and irradiation with a 980 nm diode laser did not significantly reduce post-operative pain in adult mandibular molars undergoing endodontic treatment when compared to conventional irrigation methods.

Children's hospices: an opportunity to put the mouth back in the body.

Introduction The children and young people who utilise hospice services often have additional oral health care needs and may present with additional challenges in regard to mouth care. Hospice colleagues need support and would benefit from national direction in providing mouth care for this important group.Methods Questionnaires were provided to hospice nursing colleagues, parents and carers to assess current knowledge and confidence around mouth care and diet. An audit was also completed on hospice records to assess the recording of mouth care provision prior to the introduction of Mini Mouth Care Matters. Training was then provided to colleagues in the form of a virtual interactive learning session and a re-audit of hospice records was then completed.Results Almost 30% of colleagues had never received mouth care training and two-thirds of colleagues faced barriers in providing daily mouth care. Overall, 11% of children who accessed hospice services had never visited a dentist and nearly half of the children brushed less than twice a day. The Mini Mouth Care Matters assessment tool resulted in an increase in assessment of the mouth of children using the hospice, along with early identification of problems and improving daily mouth care.Conclusion Mini Mouth Care Matters is transferable to children's hospices and should be extended to all children's hospices nationally.

Role of teledentistry in paediatric dentistry.

Introduction As a result of the COVID-19 pandemic, teledentistry has been used more frequently due to social distancing regulations to minimise the need for face-to-face attendances. Aims Evaluate uses of teledentistry within Newcastle Dental Hospital's Paediatric Dentistry New Patient Service. Establishes potential roles of teledentistry within paediatric dentistry and advantages and disadvantages of this service method. Methods Service evaluation of 653 new patient teledentistry appointments at Newcastle Dental Hospital across a one-month period (13 May- 12 June 2020).Discussion By implementing a telephone consultation as the first point of contact with our team, we were able to reduce the number of face-to-face appointments required by over a third. Teledentistry can be used for numerous applications within paediatric dentistry including initial triage, remote assessment, reinforcement of prevention, implementing initial management and building rapport. Conclusion Teledentistry is an emerging field and has the potential to improve patient journeys, reduce waiting lists and reduce unnecessary face-to-face attendances which is especially important both within and beyond the current COVID-19 pandemic to maximise safety and minimise inconvenience for both parent and child. However, care must be taken to ensure a clinician is confident in their diagnosis prior to discharging or delaying management of a patient.

Do I consider a career in dental academia and if so how do I go about it?

Medicine has around 450 academic foundation roles available every year involving research and teaching, leadership and management, or quality improvement. However, an academic career in dentistry is not as clearly defined immediately post-graduation. The North East General Professional Training scheme is a two-year longitudinal dental foundation training scheme and this year, for the first time, has conducted a pilot programme allowing two trainees the opportunity to complete a research project. The experiences of the two trainees confirm the benefit of dental foundation research posts and support the need for additional positions nationally.