Not all temporomandibular disorder patients respond positively to the treatment given. The aim of this retrospective investigation was to study the possible associations between some clinical and psychological factors, recorded at the patient’s first visit, and treatment outcome. Data of 102 patients referred to the department’s clinic was collected. In 51 patients the treatment was unsuccessful (no or only partial relief of pain), in 51 patients, matched for age and gender, the treatment was successful (complete relief of pain complaints). Logistic regression modeling (p = 0.008, explained variance = 15%; sensitivity = 59%; specificity= 57%) showed that an unsuccessful treatment was associated with more preceding treatments and more jaw- disability, a successful treatment with higher scores on the graded chronic pain severity scale. In conclusion, the results of this study suggest that some predictive factors may be helpful in identifying patients who are at risk of being resistant to the usual treatment given.

As is the case with other dental disciplines, pediatric dentistry has moved in the direction of a specialized educational programme. After a cautious start at the end of the last century, the European Academy of Paediatric Dentistry (EAPD) and the Dutch Association of Pediatric Dentistry have now recognized the previously existing programme at the Academic Center for Dentistry Amsterdam (ACTA) and a register for dentists-pedodontologists has been established. Recently, about 30 dentist-pedodontologists have received their certification. They work in private practice, pedodontic secondary dental practice and centers for special dental care as well as in university (hospital) clinics. They willingly assist the general dental practitioner with advice and active treatments.

Although Atraumatic Restorative Treatment (ART) claims to be a patient-friendly method of treatment, little scientific proof of this is available. The aim of this study, therefore, was to acquire a reliable measurement of the degree of discomfort which children experience during dental treatment performed according to the ART approach and during the conventional method. A number of 403 Indonesian schoolchildren were randomly divided into two groups. In each child, one class II restoration was carried out on a deciduous molar either by means of ART or the use of rotary instruments (750 rpm). Discomfort scores were determined both by physiological measurements (heart rate) and behavioral observations (Venham-scale). Venham scores showed a marked difference between the two groups, whereas heart rate scores only differed significantly during deep excavation. A correlation was found between Venham scores and heart rate measurements. Sex, initial anxiety and performing dentist were shown to be confounding variables. In conclusion it can be said that children treated according to the ART approach experience less discomfort than those treated with rotary instruments.

This article is primarily an adapted Dutch translation of an editorial paper in the Journal of the American Dental Association. The editorial paper described a recent mumps epidemic in the United States of America and the possible role of dentists in the early identification of mumps infected individuals. It also described the risk of a pandemic with the avian influenza virus H5N1 and the development of a vaccine against the virus. The second part discusses the risks of an outbreak of mumps or H5N1-influenza in the Netherlands and describes the precautions of the Dutch government for a future influenza pandemic. Is it concluded that dentists in the Netherlands have a limited role in the identification of mumps patients and in an influenza epidemic. However, dentists should obtain actual information on all infectious diseases regularly.

Remineralization of human enamel is an important issue in the prevention of caries. Fluoride has an important influence on the remineralization process. A great deal of research has been done into the role played by the method of application and by the concentration and type of fluoride. In the clinical study of this dissertation the process of remineralization of lesions in human enamel was longitudinally followed in vivo during a period of 3 months. Both the remineralization in the surface softened enamel lesion and the subsurface enamel lesion of human enamel were studied. In addition, attention was devoted especially to the influence of fluoride on this remineralization. The results indicated that the use of a 1,500 ppm fluoridated NaF toothpaste was more effective on the remineralization process than the use of a 50 pmm NaF mouthrinse. Important is the fluoride gradient in the enamel lesion, and in particular the fact that fluoride reaches the lesion front. This most likely accounts for the remineralization efficiency.

Kahler’s disease, multiple myeloma, is a malignant condition of unbridled multiplication of plasma cells in bone marrow. Clinical features are anaemia, pain in the affected bones, spontaneous bone fractures and increased infection susceptibility. In the final stage of the disease severe renal failure can occur. With the present chemotherapy a good response is seen in 50-70% of patients, but complete response occurs only in a minority of patients. Radiotherapy is often used in addition to chemotherapy. Bisphosphonates are used to inhibit osteolysis and to prevent complications associated with osteolysis. Recently, an association was found between use of bisphosphonates and jaw osteonecrosis. In order to minimize the risk of complications, it is advocated to be in touch with the patients haematologist before starting an invasive oral treatment.

Ongoing scientific and technical developments, on the one hand, and the general public’s growing appetite for information on health matters on the other, are forcing dental practitioners to provide evidence-based support for clinical practices. With the continuing stream of academic literature, it can be a daunting task to locate relevant and reliable information. The practitioner, with the benefit of basic training in the recognition and evaluation of high quality evidence-based literature on dentistry, can acquire such information by means of the internet, which is of value for the practice.