A case report: retigabine induced oral mucosal dyspigmentation of the hard palate.

BACKGROUND: Dyspigmentation of the oral mucosa has a multitude of aetiological causes. Retigabine, a new antiepileptic drug, has the potential side effect of inducing a blue/purple pigmentation of the oral mucosa in addition to the skin, lips, nails and retina of the eyes. This article presents a unique case of dyspigmentation present in the oral mucosa of the hard palate which has previously been unreported in the dental literature. CASE PRESENTATION: A 70 year old white male presented to a secondary care oral surgery department with an unusual asymptomatic pigmented lesion present in the hard palate of the oral cavity. The pigmentation was remarkable for its distinct blue/purple colouration which was associated with a similar discolouration of the nail beds of the hands. This is believed to be a side effect of the anti-epileptic medication retigabine. CONCLUSION: The dental profession and wider healthcare community should be made fully aware of the potential side effect of oral dyspigmentation associated with the novel anti-epileptic medication retigabine. Enhanced knowledge of the causative role of retigabine in dyspigementation of the oral mucosa will allow the practitioner to make an appropriate diagnosis. As far the authors are aware this is reaction is unreported in the dental literature and should be disseminated to the wider oral health professional's community.

Inappropriate behaviours in a dental training environment: pilot of a UK-wide questionnaire.

Incivility and inappropriate behaviour in the workplace are topics of growing interest due to their impact on patient care and safety. Several surveys and campaigns have emerged highlighting the existence of a problem. However, the true scale is difficult to ascertain. The aim of this study is to determine the existence of inappropriate behaviours within the UK dental training environment.An anonymous pilot questionnaire was distributed across multiple platforms reaching out to dental professionals within training environments, inviting responses between July 2022 and October 2022. A total of 215 responses were received. The vast majority (73.2%) felt that inappropriate behaviour is a problem within UK dental training. Senior colleagues were identified as perpetrators in 88% of responses. Most respondents (66%) reported feeling uncomfortable raising the issue, and when raised, 30% felt unsupported. Only 9% felt confident that action was taken after the issue was reported. Belittling was experienced and witnessed most commonly.The feedback received reveals the existence of inappropriate behaviours within dental training environments. Qualitative feedback indicates that if left unaddressed, the impact of such behaviour may persist long-term. Further research is required to address this issue, improve dental training conditions and job satisfaction.

Reducing the harmful effects of alcohol misuse: the ethics of sobriety testing in criminal justice.

Alcohol use and abuse play a major role in both crime and negative health outcomes in Scotland. This paper provides a description and ethical and legal analyses of a novel remote alcohol monitoring scheme for offenders which seeks to reduce alcohol-related harm to both the criminal and the public. It emerges that the prospective benefits of this scheme to health and public order vastly outweigh any potential harms.

Coronectomy for infraoccluded lower first permanent molars: a report of two cases.

Two cases of infraoccluded lower first permanent molars were treated at Glasgow Dental Hospital and School with a joint orthodontic and surgical approach. Coronectomy, a technique usually reserved for deeply impacted lower third molars, was carried out in both cases; these are discussed.

Dentofacial injuries and domestic abuse.

DATA SOURCES: Ovid, Medline, EMBASE, PsycINFO, CINAHL, LILACS, CENTRAL, bibliographies of identified RCTs, Current Controlled Trials, domestic violence organisations, handsearching of a number of articles. STUDY SELECTION: This is an update of a review reported in 2004. Randomised controlled trials in any language that included adults (persons >16 years of age) presenting with facial or dental injuries to dental or healthcare settings. Eligible interventions were: referral to support services or screening for domestic violence. Eligible outcomes were: frequency of physical assault by self-report, severity of injury by self-report and proportion of victims of domestic violence detected by self-report. DATA EXTRACTION AND SYNTHESIS: Two reviewers screened potential reports and would have data extracted had suitable RCTs been included. RESULTS: No RCTs met the inclusion criteria. CONCLUSIONS: There is also no evidence from RCTs to suggest that screening for domestic violence in adults with dental or facial injury in any health setting is beneficial or harmful.

Assessing the impact of FFP3 masks to oxygen saturation and pulse rate in the Oral Surgery department at the Glasgow Dental Hospital during the COVID-19 pandemic: an observational study.

Aim: The impact on physiological parameters and well-being from potential respiratory distress caused by FFP3 masks, particularly during extensive clinical sessions, has been widely speculated during the COVID-19 pandemic. This study aims to investigate the effect of FFP3 mask wear on clinicians' pulse rate and oxygen saturation. Material & Methods: Clinical staff within the Oral Surgery department recorded their oxygen saturation (SpO2) and pulse rate prior to donning an FFP3 mask, prior to doffing FFP3 mask and after doffing FFP3 mask using a finger pulse oximeter for a two-week period in May-June 2020. The duration of wear, the session (AM/PM), the brand of mask and the presence of previous COVID-19 symptoms were also recorded. Results: Twenty-eight data sets were collected from twelve participants (1M:11F). Of the FFP3 masks worn, nineteen (67.86%) were ARCOTM, eight (28.57%) were 3MTM masks and one (3.57%) was 3M+TM. At baseline, the mean SpO2 was 98.39% and the mean pulse rate was 72.11. Prior to mask removal, the mean SpO2 was 97.82% and the mean pulse rate was 70.04. At the end of the session, the mean SpO2 was 98.14% and the mean pulse rate was 69.54. The mean duration of wear was 150.34 min. Data sets were collected evenly across AM (14) and PM (14) sessions. Five participants (17.86%) reported previous COVID-19 symptoms. Conclusion: The data demonstrated a mean reduction of 0.25% in oxygen saturation and 3.56% in pulse rate, following the use of an FFP3 mask. These changes in physiological parameters are not clinically significant and sessional use appears to be safe.

Management of patients at risk of adrenal crisis in the dental setting: a review of current practice in UK dental teaching hospitals.

Introduction Patients with impaired corticosteroid response due to Addison's disease or systemic glucocorticoid use are at risk of adrenal crisis when undergoing dental treatment. There is a lack of conclusive evidence to support dental teams in identifying patients at risk and their management to prevent an adrenal crisis.Aim To review the current practice in UK dental teaching hospitals regarding the management of patients at risk of adrenal crisis in the dental setting.Methods An electronic survey focused on patients who may be at risk of adrenal crisis due to systemic glucocorticoid therapy was sent to all 18 UK dental teaching hospitals. Information on the use of a policy or guidance was requested. Responses were evaluated for clinical decision-making, patient risk assessment and steroid cover dosing regimens.Results A 78% response rate was achieved. Only 29% of institutions had a written policy or guidance document. Variation exists in the threshold of steroid dose and duration of treatment in identifying patients at risk of adrenal suppression. Furthermore, the dose regime for steroid cover varied.Conclusion Further evidence on the management of patients at risk of adrenal crisis is required to inform national guidance and reduce variation in patient management.

Evaluation of the information provided by UK dental practice websites regarding complications of dental implants.

Introduction Dental implants are a popular option for replacing missing teeth. When searching for information regarding dental implants, patients may first look to their dental practice website. The aim of this study was to assess the variance of patient information provided regarding implant complications on dental implant practice websites.Materials and methods Inclusion criteria for this study were dental practices within the Greater Glasgow & Clyde health board and practices with an active website. Completeness was assessed using a six-point score based on the British Association of Oral Surgeons 'Information for patients' leaflet and Association of Dental Implantology 'Considering dental implants? - A patient's guide to dental implant treatment' leaflet.Results In total, 90.7% (n = 107) of practices provided accessible implant information on their websites. However, only 37.3% (n = 44) mentioned one or more specified dental implant complications. Pain/discomfort was the most frequently stated complication (n = 41/118); implant failure was only mentioned by 19 practices (16%). The mean number of complications mentioned by the 118 practices offering dental implants was 1.1.Discussion As implant dentistry grows, there may be concerns over patient expectations. To overcome lack of quality assurance on the internet, dentists can provide factual information on their websites. They should be aware of their duty to provide material that is accurate, honest, informative and not potentially misleading.

The scar on the face of Scotland: deprivation and alcohol-related facial injuries in Scotland.

BACKGROUND: : Recent media and political attention have focused on a "rising tide" of youth violence and alcohol-related problems in Scotland. Facial injuries in Scotland are most commonly sustained as a result of interpersonal violence, and young men are a high risk group for facial injuries. Facial injuries are known to be associated with alcohol consumption but the sociodemographic determinants are not fully known. METHODS: : Influences on the incidence of alcohol-related facial injuries were investigated using data on 22,417 patients between 2001 and 2006 from the Scottish Morbidity Records. RESULTS: : Since 2001, the incidence of alcohol-related facial injuries in Scotland has declined, but the nature and scale of the problem remain considerable, with the major burden for such injuries disproportionately affecting young men from socioeconomically deprived areas. CONCLUSIONS: : The role of poverty as the major determinant of alcohol-related facial injuries has thus far not been explicitly acknowledged. Interventions to change behavior alone are unlikely to succeed unless they are supported by measures designed to improve socioeconomic circumstances and to reduce socioeconomic inequalities.

Medics against violence--the development of a new violence prevention intervention for schools.

UNLABELLED: This article outlines the rationale, evidence base and development of a new anti-violence intervention for schools delivered in the school setting by healthcare professionals. It is an example of multi-professional and mutli-disciplinary working and demonstrates how all healthcare professionals can be involved in wider healthcare issues. CLINICAL RELEVANCE: The majority of victims of violence are young men. Most incidents of interpersonal violence involve injury to the head and neck area, including the dentition. The Medics against Violence Schools Project is very relevant to Oral and Maxillofacial Surgeons, Oral Surgeons and General Dental Practitioners all of whom may have to deal with the sequelae of such injuries.

Preliminary research informing policy on remote alcohol monitoring in criminal justice: the Scottish experience.

OBJECTIVES: To explore the views of Scottish offenders on the impact of alcohol on their experience of offending and their lives in general. Furthermore, to explore their views on the concept of remote alcohol monitoring (RAM) as a way to address alcohol misuse upon liberation from prison. METHODS: A convenience sample of 12 serving offenders participated in one of three focus groups. Data were analysed using the principles of thematic analysis. RESULTS: Analysis of the data revealed the significant impact of alcohol on the lives of the participants. Key themes included the amount and frequency of alcohol consumption; the association of alcohol with harm; the association of alcohol with offending; the previous attempts to reduce alcohol consumption and possible reasons for failure; and the views of participants on the utility of RAM in relation to crime prevention. CONCLUSIONS: Participants had significant issues with alcohol misuse prior to incarceration that had impacted on their offending and resulted in both health and social harms. Participants were generally positive but pragmatic about RAM, recognising that technology alone may not be enough to change deeply ingrained and addictive behaviours.

An experimental trial exploring the impact of continuous transdermal alcohol monitoring upon alcohol consumption in a cohort of male students.

OBJECTIVE: To examine the impact of continuous transdermal alcohol monitoring upon alcohol consumption in male students at a Scottish university. METHOD: Using a within-subject mixed-methods design, 60 male university students were randomly allocated into three experimental conditions using AUDIT score stratified sampling. Participants in Conditions A and B were asked not to consume alcohol for a 14-day period, with those in Condition A additionally being required to wear a continuous transdermal alcohol monitoring anklet. Condition C participants wore an anklet and were asked to continue consuming alcohol as normal. Alcohol consumption was measured through alcohol timeline follow-back, and using data collected from the anklets where available. Diaries and focus groups explored participants' experiences of the trial. RESULTS: Alcohol consumption during the 14-day trial decreased significantly for participants in Conditions A and B, but not in C. There was no significant relative difference in units of alcohol consumed between Conditions A and B, but significantly fewer participants in Condition A drank alcohol than in Condition B. Possible reasons for this difference identified from the focus groups and diaries included the anklet acting as a reminder of commitment to the study (and the agreement to sobriety), participants feeling under surveillance, and the use of the anklet as a tool to resist social pressure to consume alcohol. CONCLUSIONS: The study provided experience in using continuous transdermal alcohol monitors in an experimental context, and demonstrated ways in which the technology may be supportive in facilitating sobriety. Results from the study have been used to design a research project using continuous transdermal alcohol monitors with ex-offenders who recognise a link between their alcohol consumption and offending behaviour.

Facial injuries in Scotland 2001-2009: epidemiological and sociodemographic determinants.

To our knowledge, sociodemographic determinants of facial injuries in children have not previously been reported in Scotland. We analysed the pattern, time trends, and key sociodemographic determinants of facial injuries in children and adolescents using Scottish morbidity records for inpatient care (2001-2009) which were retrieved from the Information Services Division of National Health Services (NHS) Scotland. We calculated annual incidences by age, sex, health board, Scottish Index of Multiple Deprivation (SIMD), and mechanism of injury. A Poisson regression analysis model was used to incorporate the variables. A total of 45388 patients aged from birth to 17 years sustained a facial injury (4.7/1000 population over nine years); 60% (27101) of injuries were unintentional, 15% (6726) resulted from motor vehicle accidents, and 9% (4149) resulted from alleged assaults; 5% (2058) were alcohol related. The incidence decreased over time from 5.5/1000 in 2001 to 4.0/1000 in 2009. The rate ratio for boys was 1.94 times greater than for girls (p<0.001), and it varied significantly between health board areas (0.68 in Dumfries and Galloway and 1.76 in Grampian) (p<0.001). There was a significant association between facial injury and increasing deprivation (p<0.001). The incidence of facial injury is highest among boys living in areas of high socioeconomic deprivation so education and resources should be directed towards prevention in these areas.