Patients give meaning to changes in health complaints before, during and after the replacement of amalgam restorations.

DESIGN: Qualitative, explorative and reflexive thematic analysis. METHODS: Semi-structured in-depth interviews were carried out with 12 participants who had all taken part in a previous amalgam removal trial. Follow-up; three months and one, three and five years after amalgam restoration removal and replacement. Interviews were carried out by two researchers at a different location from clinical follow-up. Transcripts were analysed by reading through the written material to establish common themes. NVivo9 software was used to assist further organising themes. Themes were then refined and condensed into the presented findings, which included selected quotes. RESULTS: The authors found the following themes to be important to patients in giving meaning to health complaints before, during and after amalgam removal: Something is not working: betrayed by the body. You are out there on your own. Not being sure of the importance of amalgam removal. The relief experienced after amalgam is removed. To accept, to give up, or to continue the search. CONCLUSIONS: For this group of patients, it was important to remove dental amalgam restorations. However, it remains uncertain of how critical this actually was in relation to their experienced changes in health complaints, as they did not feel that they could credit all positive change to the amalgam removal. For some participants it meant this was no longer a source of worry and for others it helped them move towards accepting their health status.

Salt water mouthwash post extraction reduced post operative complications.

DESIGN: Randomised controlled trial. INTERVENTION: Patients aged ≥16 years requiring non-surgical extraction were randomised into three groups. Group A (n = 40) were instructed to gargle six times daily with warm saline and group B (n = 40) twice daily; group C (n = 40) were not instructed to gargle with warm saline and served as controls. All patients received the same oral antibiotics and analgesics, and similar postoperative instructions, except regarding saline rinses. Mouth rinsing was to start 24 hours after the procedure and patients were reviewed at 72 hours. OUTCOME MEASURE: The patients were evaluated 72 h post-operatively for the presence of alveolar osteitis, acute inflamed socket and acute infected socket by an independent observer who was blinded to the treatment group. RESULTS: One hundred and twenty patients were randomised (40 per group). The overall prevalence of alveolar osteitis was 10.0% and that of acute inflamed socket was 25.0%. No cases of acute infected socket were observed.There was a statistically significant difference between the study groups with respect to the development of alveolar osteitis (x(2) = 15.43, df = 2, P = 0.001), but not for acute inflamed socket, with only 2.5% of the saline groups (2 out of 80) developing alveolar osteitis compared with 25% (10 of 40) in the control group. CONCLUSIONS: The instruction to use warm saline mouth rinse is beneficial in the prevention of alveolar osteitis after dental extractions. There is no significant difference in the efficacy of the twice-daily warm saline mouth rinse regimen compared to the six times daily regimen. The twice-daily saline mouth rinse regimen is more convenient, and patient compliance may be better than with the six times daily rinse routine.