[Complications due to the waiting period for dental treatment under general anaesthesia]. / Complicaties door wachttijd voor behandeling onder algehele anesthesie.

The capacity for dental treatment under general anaesthesia is limited. Clearly, the demand for treatment exceeds the supply. A written questionnaire completed by all 403 patients who were treated in 2003 in a centre for special dentistry under general anaesthesia, or their parents or carers, revealed that the median time between referral and the first consultation was 8 weeks. The median time between the first consultation and treatment was also 8 weeks. The waiting period for children was longer than that for adults, with that for 4- and 5-year-olds the longest of all. During the waiting period, 43% of the patients developed complications, such as oral pain and problems with eating and sleeping. Children developed complications more often than adults. With every week of waiting, the likelihood of children developing complications increased by 6.7%.

Participatory continuing dental education.

The significance of continuing education for the development of a professional person is indisputable. There is evidence that participatory continuing education is the most effective form for this activity to take in relation to dentists and clinical practice. Working Group 15, appointed by the FDI Commission, specifically studied this form of continuing education by use of a questionnaire to 26 representative national dental associations. The majority of countries surveyed have at least some education of this sort although it forms only a small proportion overall. Little evaluation seems to take place to measure the subsequent value to the practitioners attending. The results of the information gathered are discussed and recommendations are made.

Long-term results of surgical intervention on the temporomandibular joint.

Between 1973-1987, 40 patients (51 joints) underwent 71 surgical procedures on the temporomandibular joint (TMJ). Indications for surgery included painful TM dysfunction, not alleviated by conservative treatment of at least 12 months' duration, or complete anterior disk dislocation not responding to conservative treatment for three to six months. The incidence of surgical treatment in the period 1983-1987 was 4.1% in a group of 679 patients. The mean follow-up is 5.8 years (range 1-15 years). At the follow-up examination (37/51) 72.5% of the treated joints appeared to have an excellent or good result; however, 14/51 joints had one or more reoperations (= 14/40 patients: 35%). The first surgical procedure on the TMJ resulted in an excellent or good result in 29/51 (57%) joints: 6/14 (= 42.9%) high condylectomies; 5/8 (= 62.5%) high condylectomies with a plication procedure; 15/24 (= 62.5%) plication procedure only; 2/2 silastic implants. After one or more reoperations, these figures improved to 10/14 (71%) high condylectomies, 7/8 (87.5%) high condylectomies with a plication procedure, 17/24 (70.8%) plication procedures. Radiographic changes, including flattening of the condyle, lack of condylar contour, erosion, sclerosis, subcondral cysts, and osteophytes were seen in all (16/16) patients in which a high condylectomy was performed. Out of 22 joints in which only a disk repositioning and plication procedure was performed, only 4/22 showed radiographic changes. The radiographic status was not correlated to the clinical picture at the time of the follow-up examination.