Although not scientifically proven, dental foci are believed to result in severe local or systemic disease. Eradicating dental foci in order to prevent possible interference with a medical treatment may be important in specific patient groups. To gain insight in the number of dental focus examinations, the medical evidence, the number of potential foci determined, as well as the treatment eradicating the focus, all dental focus examinations in 16 Dutch hospitals were registered during 3 months. A total number of 470 examinations were performed. Scheduled heart(valve)surgery and radiotherapy of the head and neck were the main reasons for a dental focus examination. Dental foci were found and treated in more than 50% of the patients examined. There was a significant difference between dentate and edentulous patients in the percentage of patients diagnosed and treated for a dental focus. More than 80% of dentate and less than 20% of edentulous patients were treated.

As a result of the recognized need for dentists with a special expertise in the field of managing and treating patients who are difficult to treat especially because they are fearful, a post-graduate programme was established, in 2001, in ‘dealing with fear of dentists.’ This 3-year programme of study makes it possible for dentists, both working within and outside of departments of special dental care, to develop knowledge and experience in this field. The intention behind this initiative is to contribute to the quality of care provided to patients who avoid treatment out of fear. A brief summary of the programme’s target group and academic goals, as well as its organization and contents are provided.

What are the dental stimuli and situations that are experienced as more or less fear provoking by anxious dental patients? To investigate this question, 81 highly anxious patients, who were referred to a centre of special dental care were presented with a list of 76 potentially fear provoking objects and situations. The results showed that invasive dental procedures are considered as most terrifying by anxious patients, and that stimuli related to the dental office (dental chair), the dental team (dentist) and their equipment (protecting clothes) are considered as least fear provoking. Root canal treatments were rated as most fear provoking. The results emphasize the importance of assessing the whole range of potentially terrifying stimuli for each anxious patient. Only in this way an approach focused on the extinction of patients’ dental fear can be successful.

A 15-year-old autistic boy of subnormal intelligence appeared at the office of his dental practitioner complaining about pain in the third quadrant. Investigation revealed that the second molar could be intruded easily. No other irregularities, such as caries or periodontal disease were apparent. Due to the severe pain it was decided that the tooth should be extracted. Extraction of the tooth induced massive bleeding. Hemostasis was achieved by repositioning the molar in its alveolus, according to the principle of putting a cork in a bottle. Radiographic investigation showed the presence of an intraosseous arteriovenous malformation. These malformations are potentially life-threatening lesions. Treatment of choice is a combination of transarterial embolization and surgical removal of the malformation.

Routine dental radiographic examination in a 16-year-old girl revealed the presence of 3 well-defined radiolucent cystlike structures in the mandible. After clinical and radiological examination, a multiple traumatic bone cyst was diagnosed. Surgical exploration confirmed the diagnosis. Curettage of the lesions was performed. Fifteen months later, a panoramic radiograph showed almost complete ossification.

The Digital Academic Repositories (DARE) programme is a joint initiative of all Dutch universities and some scientific organizations to store all results of scientific research digitally, and provide access to them by means of a network. Within the various institutions, this happens in a similar way with each institution being responsible for and administering its own records. This material can subsequently be made accessible in various ways and in various forms; traditionally via journals or books; online by the homepages of universities and electronic journals but now also by a single internet address: the DAREnet. In this issue an overview about the build up and operation of this network is presented.