Working at the interface: lessons from a joined-up approach between oral medicine and paediatric dentistry.

Oral mucosal and other head and neck conditions in children have a variety of presentations. The joint oral medicine and paediatric (JOMP) dental clinic is a specialised unit within a London teaching hospital, developed to manage a wide range of oral conditions with an absolute commitment to a child-centred care approach. The authors present eight cases from the JOMP clinic experience at Guy's and St Thomas' NHS Foundation trust, over a nine-year period. Each case is unique in its presentation, diagnosis and bespoke management, tailored to the nuance of each individual patient and their unique position. The eight clinical cases demonstrate the success of the JOMP team in achieving good patient outcomes, in terms of providing accurate diagnoses for their oral conditions and for appropriately tailored management/ treatment. The cases also serve to raise awareness of some of the more unusual oral conditions affecting paediatric patients among our professional colleagues.

Natal and neonatal teeth: a review and case series.

Natal and neonatal teeth are a relatively rare but well-documented phenomenon, with the majority being prematurely erupted teeth of the normal primary dentition. Related complications include feeding issues, traumatic lingual ulceration and risk of aspiration. We present three clinical cases referred to the Paediatric Dentistry Department at Guy's and St Thomas' NHS Foundation Trust and their management. Treatment choice is based on individual assessment of each patient and options include monitoring, smoothing of the teeth or extraction. General dental practitioners should be able to diagnose natal and neonatal teeth and provide initial management in primary care, with referral to secondary care services in more complex cases or those which are likely to require extraction.

Evaluation of pediatric dentistry guidelines using the AGREE instrument.

PURPOSE: Guidelines are used to inform clinical practice and improve the quality of health care. Poorly developed guidelines may emphasize the incorrect intervention. The purpose of this paper was to evaluate the quality of pediatric dentistry guidelines using the AGREE instrument. METHODS: A search was carried out to identify pediatric dentistry guidelines up to November 2007. Three independent assessors evaluated the guidelines using the AGREE tool. RESULTS: Fifty-seven guidelines produced by 11 organisations were evaluated. Most guidelines assessed were of poor quality, as determined by the AGREE instrument. CONCLUSIONS: Consideration should be given to using the AGREE instrument in the development of new guidelines and review of existing guidelines.

Chronic mucocutaneous candidiasis: a rare diagnosis in paediatric dentistry.

Chronic mucocutaneous candidiasis is a rare disorder that is characterised by chronic or recurrent superficial candida infection of skin, nails, and mucous membranes. We describe such a case in a young boy who failed to respond to conventional therapy. It highlights the important role of the dental team in assessment, treatment, and onwards referral.

Conservative management of juvenile spongiotic gingivitis: a series of ten cases.

Introduction This case series highlights the condition juvenile spongiotic gingivitis; how to recognise it, where it lies in a list of differential diagnoses and why conservative management is the authors' recommended treatment.Case series The authors present ten cases that were successfully managed conservatively on the Joint Oral Medicine Paediatric Dentistry Clinic at Guy's and St Thomas' NHS Foundation Trust over a six-year period. Follow-ups reached up to 5 years and 11 months to date, with no adverse outcomes observed in any of the cases.Conclusion The pathogenesis of this benign condition and its ideal management is not well understood. Recurrence can occur after surgical treatment and the condition is likely to spontaneously resolve or regress with age. Therefore, particularly in asymptomatic cases, conservative management is recommended.