Bridging the gap - Establishing a dental-oncology service in a cancer centre.

Dental disease remains the most common non-communicable disease worldwide. It predisposes patients to significant morbidities following bone modifying agents or radiation therapy to the head and neck. Preventative dental regimes effectively reduce the risk of both medication-related osteonecrosis of the jaw (MRONJ) and osteoradionecrosis (ORN) in these patients. Co-ordination of routine dental care as a component of mainstream oncology treatment optimises long term outcomes for oncology patients. This case series offers insights into patient, institutional and social difficulties that challenge the dental-oncology interface. These obstacles and subsequent resolutions experienced whilst establishing a dental-oncology service in a cancer centre highlight the importance of effective multidisciplinary lead care for oncology patients. It reinforces the need for structured, supported dental pathways for these oncology patients.

World Workshop on Oral Medicine VIII: Development of a core outcome set for oral lichen planus: the patient perspective.

OBJECTIVE: This study aimed to explore the lived experience of patients with oral lichen planus (OLP) and investigate what treatment-related outcomes are the most important to them and should be included in a core outcome set (COS) for OLP. STUDY DESIGN: A qualitative study involving focus group work with 10 participants was conducted. Interviews with each focus group were held twice: session 1 explored the lived experience of patients with OLP, and session 2 allowed patients to review a summary of the outcome domains used in the OLP literature to date. The discussions were recorded, transcribed verbatim, and analyzed using framework analysis. RESULTS: In session 1, 4 themes and 8 sub-themes emerged from the data analysis. An additional outcome, 'knowledge of family and friends,' was suggested in session 2. CONCLUSIONS: We have gained valuable insight into the lived experience of patients with OLP via this qualitative study. To our knowledge, this study is the first to explore the patient perspective on what should be measured in clinical trials on OLP, highlighting an important additional suggested outcome. This additional outcome will be voted upon in a consensus process to determine a minimum COS for OLP.

Broken needle: a rare complication of inferior alveolar nerve block - a report of two cases.

Introduction Needle fracture during the delivery of local anaesthesia is a rare complication in modern dentistry. While there has been a decline in its occurrence with the advent of disposable flexible alloys, it still occurs and it is important for all clinicians to know how to deal with this complication. The management of a lost needle in the pterygomandibular space when giving an inferior alveolar nerve block has proven a dilemma in the past. In this paper, we discuss how to minimise the risk and the relevant management of such a scenario while examining two cases of needle fracture while delivering an inferior alveolar nerve block.Discussion There are a number of structures present in the pterygomandibular space of which all clinicians should be cognisant. Should a needle fracture and cannot be removed immediately by the clinician, prompt maxillofacial referral is required for further management.Conclusion While rare, needle fracture can occur while delivering an inferior alveolar nerve block and all clinicians should be aware of how to minimise the risk and how to manage such a complication. If it cannot be removed at the time, a prompt maxillofacial referral should be made.