UK Dental Medicines Advisory Service - questions asked by dentists: part 3 - prescribing of anxiolytic medications in dental practice.

The UK Dental Medicines Advisory Service (UKDMAS) provides advice to dentists and other dental healthcare professionals concerning the use of medicines and medical devices in dentistry. The commonly asked questions posed to the UKDMAS concerning the prescribing, administering or dispensing of oral anxiolytic medicines in dental practice are discussed with answers supplemented by relevant information from clinicians. These include: types of oral anxiolytics available, prescribing guidelines, appropriate dosing regimens, indications and contraindications to prescribing and drug interactions.

Dental treatment before haematopoietic stem cell transplantation - a service evaluation.

Introduction National guidance by the Royal College of Surgeons (England) recommends a dental assessment and necessary treatment before haematopoietic stem cell transplantation (HSCT). Within the special care dentistry department in Liverpool University Dental Hospital, patients are assessed before transplant; however, the efficiency and efficacy of the service was unknown and therefore a service evaluation was indicated.Aim To evaluate the current referral process and dental care provided before patients receive HSCT.Method Dental case notes were reviewed retrospectively for all patients who attended before allogeneic or autologous HSCT in the year 2016.Results There appeared to be a positive engagement of both the medical team and patients with regards to referral for a pre-HSCT dental assessment. In addition, it was evident that this patient cohort did require dental treatment before HSCT with diagnoses of caries, periradicular infections and periodontal disease being made.Conclusion Pre-HSCT dental assessment and treatment continues to be an important aspect of the medical pathway for this patient cohort. Developments to the care pathway and improvements in communication with the medical teams will help ensure the best-quality care is provided to the patients at the correct time. Future prospective studies are required to establish the overall benefit to patients of dental treatment before HSCT.

Managing the Medically Complex Patient: Risk Assessment and Information Gathering.

Primary care dentists are providing dental care for an increasingly medically complex cohort of patients. The ability to understand medical histories, how and when to get further information, and then to be able to risk assess the information is paramount to providing safe and effective dental care. The success of modern medicine combined with a population who are retaining their teeth and choosing to have ever more complex dentistry, means that primary care dentists are facing challenges not seen previously. This article seeks to inform the reader of the importance of risk assessment and how to gather information pertinent to delivering safe dental treatment to a cohort of medically complex patients.

A survey of general dental practitioners in the North West of England concerning the dental care of patients following head and neck radiotherapy.

AIMS: The aim of this survey was to investigate the views of general dental practitioners (GDPs) on their perceived roles and the barriers regarding dental care of patients following head and neck radio-therapy. METHODS: From a total of 1163 GDPs on the Mersey Postgraduate Dental Deanery mailing list, 369 were selected at random. Questionnaires were sent out in February 2010 followed by reminders a month later. A study-specific questionnaire was piloted prior to the survey. RESULTS: One hundred and ninety-eight of the potential 336 respondents returned valid questionnaires, a response rate of 59%. They did not respond to all questions. Of those who responded, 99/188 (53%) were either 'not at all' or 'little' happy about managing these patients and 118/183 (64%) and 100/173 (58%), respectively, perceived that complex management and the new General Dental Services (nGDS) contract introduced in 2006 were 'quite a bit' or 'very much' barriers to treatment. The majority of the respondents felt that they were 'quite a bit' or 'very much' happy to carry out routine fillings (177/195; 90%), periodontal treatment (166/195; 85%), removable dentures (161/195; 83%), crown and bridge work (123/192; 64%), and root canal therapy (114/195; 58%) but only 53/191 (28%) to perform dental extractions. Over half of the respondents felt that they had 'quite a bit' or a 'main role' in managing radiotherapy caries, xerostomia, detecting recurrence and offering smoking-cessation advice. CONCLUSION: The majority of the GDPs who responded had been involved in the management of patients who had undergone radio-therapy to the head and neck. A substantial number perceived barriers to care, such as the complexity of the treatment and the nGDS contract. These findings need further investigation. Continuing professional development would be helpful to improve GDPs' confidence in dealing with this group of patients.

Computerised dental implant rehabilitation planning and execution following mandibular resection: a case report.

This paper discusses the merits of Computer Tomography (CT) based dental implant planning in the rehabilitation of patients following oral cancer This case report describes the process of prosthetic work-up, computerised implant planning, surgical treatment and successful prosthetic oral rehabilitation of a patient following segmental mandibulectomy and post-operative radiotherapy for intra-osseous squamous cell carcinoma (SCC).

The significance of alcohol misuse in the dental patient.

UNLABELLED: This paper presents a general overview of the consequences of alcohol use and misuse in dental patients. Current guidelines for sensible drinking, screening tools for alcohol use and medical problems associated with alcohol misuse are highlighted. The dental management and oral sequaelae of alcohol misuse and dependency are also discussed. CLINICAL RELEVANCE: Patients who misuse alcohol will seek dental care. This paper discusses the identification of this group of patients and the implications for their management.