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.

Perception of simulation training in emergencies for dental sedation practitioners.

BACKGROUND: Simulation education is an important part of health care education and training. There is growing evidence to support the usefulness of simulation, especially in training for infrequently occurring situations, such as medical emergencies seen by dental practitioners. There are, however, few data on the longer term effects of simulation, including usefulness, relevance, emotional effect and ability to affect changes to daily practice. METHODS: Dentists and dental nurses who had undergone simulation training in medical emergencies for dental sedation practitioners undertook a semi-structured interview about their perception of the simulation experience. They explored recollection of the experience and its emotional weight, perception of usefulness and relevance, specific learning outcomes and changes to practice prompted by the simulation session. RESULTS: Participants reported finding the simulation sessions worthwhile, realistic, challenging and almost universally emotionally positive. In situ simulation training was particularly well received, both in terms of realism, as well as identifying system flaws in emergency drugs and equipment. Participants reported gaining both increased clinical knowledge and human factors skills, which were reflected in subsequent changes to their practice. There are few data on the longer term effects of simulation DISCUSSION: Our results support the usefulness and applicability of simulation education to training in medical emergencies for dental sedation practitioners. In particular, specific benefits reported from in situ sessions and in human factors concepts will prompt us to review the structure of our teaching to maximise the benefit to participants.

Multiple sclerosis and oral care.

Multiple sclerosis is a complex neurological condition affecting sensory and motor nerve transmission. Its progression and symptoms are unpredictable and vary from person to person as well as over time. Common early symptoms include visual disturbances, facial pain or trigeminal neuralgia and paraesthesia or numbness of feet, legs, hands and arms. These, plus symptoms of spasticity, spasms, tremor, fatigue, depression and progressive disability, impact on the individual's ability to maintain oral health, cope with dental treatment and access dental services. Also, many of the medications used in the symptomatic management of the condition have the potential to cause dry mouth and associated oral disease. There is no cure for multiple sclerosis, and treatment focuses on prevention of disability and maintenance of quality of life. Increasingly a multi-disciplinary team approach is used where the individual, if appropriate his/her carer, and the specialist nurse are key figures. The dental team plays an essential role in ensuring that oral health impacts positively on general health.