Staff members and residents of nursing homes and old peoples homes were interviewed about the facilities and provision of oral health care. Clinical examinations were performed to obtain data about the oral health status of the institutionalised elderly. Results show that in most cases the oral health care facilities were insufficient to give care to persons with natural teeth. Of the edentulous elderly 43% reported that the retention of the lower denture was insufficient.

The achievement of absolute anchorage in orthodontics overcoming the reaction forces and moments has been problematic for a long time. This was caused on the one hand by the limitations of the devices available and on the other hand by the dependence on patient cooperation. The introduction of bone anchorage systems changed the traditional way of thinking on orthodontic anchorage. Whereas the application of anchor systems, such as palatal implants and onplants, has specific indications, bone screws with or without plates seem to have the potential of being used on a routine basis. However, appropriate data for more complete understanding of the biological and biomechanical background of this concept of orthodontic anchorage are still lacking. Furthermore, studies on the effectiveness of these systems when compared to the traditional orthodontic anchorage and based on large groups of patients are not available.Well-designed prospective clinical trials substantiating the evidence-based use of these devices are needed.

Originally, dentists were particularly technical and curative practitioners. Nowadays, patient care is brought into focus, directed at maintaining oral health permanently by prevention and necessary curative treatments as a contribution to general health and wellbeing. The changing picture of practising does not develop as a matter-of-course since many factors have an effect on dental practice. Effecting factors are: content concerning developments, technological advancements, legislation, government policies, organizational aspects, and typical characteristics of dental practitioners. The changing picture of practising dentistry is connected with uncertainty, proves to be hard to control, and some adjustments occur around practising.

Dental records are more than a small part of the bookkeeping. In most dental practises, keeping records is the task of a dental assistant. In civil court, the dentist is in most countries liable for the mistakes of his employees. In disciplinary court however there may be doubt whether the dentist is responsible for the mistakes of his assistant. Contrary to their American colleagues, Dutch dental assistants and dental hygienists cannot be summoned before a disciplinary court. As these para-medics perform more and more dental treatment, independently or after delegation, they should be assigned there own disciplinary responsibility.

A 55-years-old man visited his family doctor because of a one-day existing, not painful, right-sided swelling of the cheek. It appeared to be a subcutaneous emphysema, caused at an attempt to remove mandibular third molar roots, using a water- and air-cooled air rotor. Rare potential sequelae resulting from subcutaneous emphysema are venous air embolism, airway obstruction because of neck swelling, pneumomediastinum, and mediastinitis. Using aircooled instruments in surgical orofacial treatments should be avoided because of the possible iatrogenic life-threatening complications.

An 88-year-old diabetic women was hospitalized because of a pheripheral vascular disorder. During her hospitalization she developed a right-sided facial swelling which was not limited by anatomical structures in this area. Ultrasound and computertomographic scanning supported the clinical diagnosis acute sialoadenitis of the parotid gland. The swelling resolved shortly after starting antibiotic therapy.

Special dental care is dental care for patients who are difficult to treat in a general dental practice because of difficult circumstances. In the Netherlands, special dental care is arranged by law and has to fulfil some conditions. Special dental care is provided in special dental care clinics, mostly situated in hospitals. Patients are treated by a multidisciplinary team. In this article, websites of some special care clinics are described.