The first part of this article is an edited Dutch summary of an editorial paper which appeared in The Journal of the American Dental Association. In this editorial paper, the author pleads for a substantial increase in training in the biological sciences and internal medicine for dental students. He also devotes attention to potential problems associated with the introduction of such training. In the second part, in a commentary on the content of this editorial, the situation in The Netherlands is discussed. The conclusion is drawn that in The Netherlands, too, in the dental curriculum, an expansion of such training would be desirable.

In 1972 the results of a study of the long term effect of dental care for youths in the Netherlands, a programme which was then still called ‘school dental care’, were published. In the study a comparison was made between military recruits from municipalities with school dental care and those from municipalities without it. Results were measured most importantly in two areas, ‘dental health’ and ‘habits of dental care’, variables in which a number of dental and behavioural characteristics were combined. Between the groups of recruits only marginal differences were found. This result was unexpected because previous research had indicated that in the case of primary school students there was much less untreated caries if school dental care was available in a municipality. Subsequent research revealed that the level of care of caries lesions in the teeth of children who were registered with an institution for dental care for youths, was generally higher than that of children who were treated by a general health practitioner. The level of care was especially high among children who were treated by specialists in child dental care. The fact that most institutions for dental care for youths make use of treatment protocols seems to be an important reason for this result. The fact that most of the children who participated in a dental care for youths programme differed in socio-economic status from those who received care from a general dental practitioner meant that the extra caries-preventive effect of dental care for youths could not easily be established.

In the early 1970s dental composites came to be extremely important. The interesting possibilities that these materials offered was the reason to conduct a doctoral degree research project. During the period when the project was carried out, composites were already used in restorative dentistry extensively. At that time, mainly two-paste en UV-setting composites and a few visible light curing composites were available. However, the mechanical properties, the polymerization mode, the polymerization shrinkage and the composite wear were aspects of particular attention. During the past 25 years, research and material development have contributed to a significant improvement of these aspects. As a result of sophisticated filler technologies, occlusal wear of composites has achieved the level of good resistance, while the degree of shrinkage during hardening has been significantly reduced. However, shrinkage stress is still a matter of concern and remains an important subject of research, particularly with focus on the resin matrix. Low shrinking monomers and expanding monomers are being developed. If these materials can be introduced in dentisty, the shrinkage stress may be further reduced.

An 18-year-old boy was referred because of diminished chewing capacity. In addition he had aesthetic concerns about his appearance. From the age of 4, he had been known to suffer from cherubism, a rare hereditary, self-limiting fibrous dysplasia characterised by painless enlargement of the jaws. The characteristic ‘angel-like eyes-to-heaven’ appearance was only minimally visible because the maxilla was hardly affected. Radiographs showed well-defined multilocular radiolucencies and with age, thick sclerotic borders were visible. These intracortical sources caused compression of the dentition, which resulted in malocclusive and abnormal dentition. In the mandible only the teeth 35, 36 and 46 were present. To restore the dentition, orthodontic treatment and instalment of endosseous implants were planned. In advance, the mandible was explored, and the granulomas were removed and replaced by autologous bone transplants. After orthodontic treatment 5 Brånemark implants were successfully installed to support an overdenture.

Fanconi anemia is a recessively inherited disease, characterized by various anomalies, bone marrow failure, and a predisposition to acute myeloid leukaemia and squamous cell carcinoma. The disease is caused by mutations in one of the 13 currently known Fanconi anemia genes involved in the repair of DNA breaks. Squamous cell carcinomas arise chiefly in the oral cavity, but also in the anogenital region, mostly at relatively young age. Managing the carcinomas is difficult since the patients have are extremely sensitive to treatments such as radiation and chemoradiation using cisplatin. Therefore, early diagnosis and early surgical intervention are the best approaches. Human papillomavirus may play a role in the etiology of the oral squamous cell carcinomas, but current research results are inconsistent. Human papillomavirus vaccination and non-invasive screening for premalignant lesions, combined with frequent clinical examinations and early surgical treatment should improve the prevention and prognosis of these tumors in Fanconi anemia patients.