Professionalism, then and now.

For centuries only three professions were recognised as such: medicine, law and theology. Now that the word 'professional' is applied to all occupations it can be difficult to understand the meaning of professionalism within dentistry and healthcare. We simply cannot treat dentistry as a commodity or business when it is a highly specialised personal service. Now more than ever, dentistry is a team game and all dental professionals must maintain the values and codes that distinguish what we do from most other vocations.

Dental technicians: regulation and quality assurance.

For many years, dental technicians were largely self-regulated and left to work without any undue interference from, or legislation by, outside authorities. This situation has changed somewhat dramatically in recent years, primarily as a result of a) mandatory General Dental Council (GDC) registration of UK-based dental technicians and b) the requirement to comply with certain EC directives governing the provision of dental appliances. There seems to be some confusion, however, about these various changes and the ensuing ramifications for dental practitioners. The purpose of this paper is firstly to clarify the various regulatory issues currently surrounding technician registration and the provision of laboratory work ('Made in Britain' or otherwise) and secondly to explore the various internationally-recognised quality assurance standards that can be applied to the production of such work in order to assist dentists in gauging quality-related claims made by dental laboratories, both in the UK and overseas.

Retrospective survival analysis of 3-unit fixed-fixed and 2-unit cantilevered fixed partial dentures.

To evaluate the cumulative survival (CS) rates of fixed partial dentures (FPDs) retained by full-veneer retainers, and those of resin-bonded FPDs provided by graduating dental students for the replacement of a single missing tooth. In 168 patients, 61 3-unit fixed-fixed FPDs and 25 2-unit cantilevered FPDs retained by full-veneer retainers, and 77 3-unit fixed-fixed resin-bonded FPDs and 47 2-unit cantilevered resin-bonded FPDs, were examined for their retention and integrity. The periodontal health, endodontic status and coronal tissues of all abutment teeth were also evaluated. The survival rates of these various designs were analysed with the Kaplan-Meier method. The mean age of all FPDs was 31 months. At 48 months after their insertion, 3-unit FPDs retained by full-veneer retainers had a CS rate of 82%, followed by 2-unit resin-bonded FPDs at 81%, 2-unit FPDs retained by full-veneer retainers at 77%, and 3-unit resin-bonded FPDs at 63%. No significant difference was found between the four designs (P>0.05). Up to both 48 and 60 months, the most common causes of failure were endodontic for FPDs retained by full-veneer retainers, and dislodgement for resin-bonded FPDs. The 3-unit fixed-fixed FPDs retained by full-veneer retainers had the most favourable prognosis after 48 months for replacing a single missing tooth, but the difference between designs was not statistically significant.

Prevalence of impacted teeth and associated pathologies--a radiographic study of the Hong Kong Chinese population.

OBJECTIVES: To investigate the prevalence and pattern of impacted teeth and associated pathologies in the Hong Kong Chinese population. SETTING: The Reception and Primary Care Clinic, Prince Philip Dental Hospital, Hong Kong. DESIGN: Retrospective study. SUBJECTS AND METHODS: The records of 7486 patients were examined to determine whether the chief complaints were related to impacted teeth and associated pathologies, which were investigated using panoramic radiographs. RESULTS: A total of 2115 (28.3%) patients presented with at least one impacted tooth. Among the 3853 impacted teeth, mandibular third molars were the most common (82.5%), followed by maxillary third molars (15.6%), and maxillary canines (0.8%). Approximately 8% of mandibular second molars associated with impacted third molars had periodontal bone loss of more than 5 mm on their distal surfaces. Caries were also found on the same surfaces in approximately 7% of the second molars. Approximately 30% of patients with dental impaction had symptoms, and 75% had complaints limited to one side of the mouth. CONCLUSIONS: The prevalence of impacted teeth was high, and there was a predilection for impacted third molars in the mandible. More than 50% of maxillary third molars had erupted, creating potential trauma of the pericoronal tissues of the partially erupted mandibular third molars. Caries and periodontal diseases were commonly seen in relation to the impacted third molars, whereas cystic pathology and root resorption were rarely observed.

Dental bodies corporate and their approach to customer care.

For many years the 27 bodies corporate registered with the General Dental Council were of little interest to most people in the UK dental profession, serving only as an anachronistic reminder of a bygone period. How times change. Although they still have only a small share of the dental market - with 4% of all dentists in the UK in early 1999 - they have expanded rapidly from a small base and are expected to continue to do so in the future. The reasons behind this growth are numerous and include such factors as: deregulation of the profession allowing dentists to advertise thus facilitating company branding; a general move away from NHS dentistry; a growing consumerism amongst the general public; precedents set by pharmacists and opticians; and, last but not least, the belief of venture capitalists amongst others that investment in dentistry will yield attractive returns.