Patient education is an important part of the care provided in a dental practice. Explanations concerning dental treatments is in the majority of practices exclusively the responsibility of the dentist. Information about oral hygiene and prevention is generally provided by oral hygienists and prevention assistants. It is striking that agreements are made concerning the form and content of patient education, the division of responsibilities and the use of teaching aids in only 39% of practices. It is possible that this has to do with the relatively few hours that oral hygienists and/or prevention assistants are active each week in the practice, and the judgement of the dentists that sufficient time has to be devoted to discussing a proposed treatment with the patient.

In order to investigate which initiatives are being taken in The Netherlands to anticipate a change in oral health care demands as a result of ageing, 9 experts in the field of oral health care for the elderly were interviewed. The experts were selected because of their varied expertise and involvement in geriatric dentistry. Those interviewed were unanimous in the opinion that the demand for oral health care among the elderly will increase in the years to come. National initiatives to improve oral health care for the elderly appear to be limited. This situation can be changed by getting professional homecare more involved in oral health care for the elderly, and by regular dental checkups, stimulated by more actively operating general dental practitioners. For those in homes for the elderly and nursing homes, there appears to be no national policy with regard to oral health care. Several initiatives have been undertaken to improve dental health care, but those differ from institution to institution. According to the interviewed experts, financing, government prioritization, and health care laws are major bottlenecks on the road to the improvement of oral health care for the elderly.

Professionalism is considered as a core competency for dentists. As a result of changes in the healthcare sector, it is becoming increasingly important for dentists to be more transparent to the community in their delivery of care. The ability ‘to provide justification’ thus becomes an important skill. To train dentists to become professionals who can account for their actions, we developed an educational programme in Groningen which trains students in the following professional skills:1. make explicit; 2. concretize; 3. analyze; 4. diagnose; 5. generalize; and 6. formulate learning points and experiment with them. This educational programme is given, under the supervision of a coach (generally a practicing dentist), during the entire curriculum, in small groups. Professionalism is integrated with other course programmes (work placement, working in the clinic), because professionalism is a competency which is only expressed by practicing other competencies. The professionalism of the student is also assessed.

Since the introduction of the bachelor-master structure five years ago at the Amsterdam Dental School, the evaluation and assessment of professional behaviour has been an examination subject in the bachelor programme. Professional behaviour is understood to be the student’s observable behaviour in the educational setting, as distinguished from someone’s inner beliefs or convictions. The core of this element in the curriculum is the feedback which the student regularly receives from several teachers concerning their behavior, given what is expected from a medical professional. The programme’s requirement is that a third year student demonstrably has sufficient satisfactory evaluations to earn the necessary study credits.

Working professionally and professional behaviour are important issues in the practice of a medical profession. The Radboud University Nijmegen Medical Centre’s Dental School recognizes their importance. The aims of the education in professionalism are that a student’s professional behaviour can be seen to be improving during the study, that the student can reflect on his professional behaviour and that the student, working in a dental team, is able to deal with other people’s responses to his professional behaviour. During the entire study, a ‘Developmental plan of professional behaviour’ is recorded digitally. This developmental plan is discussed and if necessary aspects requiring improvement are indicated.

A female patient (age 26) visited the orthodontist for correction of the reduced exposure of the upper incisors during laughing. She also reported crowding of the lower incisors and an association between lisping and her open bite. The diagnosis in this case: a Class III malocclusion case with incisor crowding and an open bite. Because her main complaint was reduced upper incisor exposure while talking and laughing, which would not be corrected with orthodontic appliances only, the position of the maxilla was corrected during orthodontic treatment by means of vertical intra-oral maxillary distraction. An acceptable and relatively stable result was achieved.

The conclusion of a recent systematic review of the literature on the relation between nutrition, physical activity and cancer is that more than 30% of all cases of cancer can be prevented by improving nutrition and increasing physical activity. In the Netherlands, 1 out of 100 men and 1 out of 160 women develop oropharyngeal cancer. The major risk factors are smoking tobacco and excessive alcohol consumption. According to the systematic review of the literature, a substantial consumption of vegetables and fruit can reduce the risk of this type of cancer.