Approximately one third of the Dutch population has an objective need for orthodontic treatment. Yet, patients mostly seek treatment because of aesthetic reasons. Recent social developments and the increased attention for aesthetics ask for ways to objectively measure treatment need. This is not only important because of the risks of orthodontic treatment, but also because of financial reasons. In this article indices to verify treatment need, i.e. the Index for Orthodontic Treatment Need (IOTN), de Dental Aesthetic Index (DAI) en de Index of Complexity, Outcome and Need (ICON), are discussed. All three indices seem to lead to a reduction of treatment need, especially in borderline cases. They can serve as neutral instruments to discuss treatment need with patients and as instruments to allocate financial resources for orthodontic care.

Thirteen patients with resorption of the alveolar process in the upper or lower jaw were treated with augmentation using autogenous bone from the mandibular body. The objective and subjective results were retrospectively assessed. The morbidity of the donorsite was considered mild. 3 Patients experienced temporary sensory disturbance of the inferior alveolar nerve. In 1 patient spontaneous sequestration of a part of the transplant occured. In all patients the bonevolume at time of implantation was sufficient to insert the planned amount of implants. In total 46 implants were inserted. One implant was lost during follow-up and replaced. From this study it is concluded that the mandibular body can be considered as a good donor site for autogenous bone for pre-implant reconstruction of the alveolar process.

The practice guidelines Treatment of tobacco dependence are drawn up by collaboration of all medical and paramedical professional associations and aim at assisting patients who would like to quit smoking. The dental team has a barrier-free opportunity to discuss smoking habits. The relation between smoking and oral health is quite obvious. Dental practitioners should ask about smoking habits regularly and smokers should be advised at least once a year to stop smoking. More intensive strategies for treatment of tobacco addiction in dental settings will be developed in the near future.

An adequate perception is essential for a dentist because details are often just or just not visible. A proper use of light in the oral cavity (mouth of the patient), around the mouth and in the rest of the oral surgery, together with the use of light colours ought to make possible an optimal perception and colour matching. This can also prevent tiring adaptation of the eyes to too strong varying levels of light. Principles of a proper use of light and colours are described.

In a 43-year old female with neuralgia of the second and third branch of the trigeminal nerve, the diagnosis was made on the basis of clinical findings. After the patient was treated with 2 x 200 mg of carbamazepine, all initial symptoms resolved, which confirmed the diagnosis. To distinguish between idiopathic and secondary trigeminal neuralgia, magnetic resonance imaging was scheduled. This investigation showed an acoustic neuroma in the cerebellopontine angle. Without magnetic resonance imaging this benign tumour would be diagnosed in a much later stage and the patient would have suffered unnecessary co-morbidity. Due to the relatively high incidence of secondary trigeminal neuralgia, routine magnetic resonance imaging in patients with a trigeminal neuralgia is justifiable.