The furuncle is a staphylococcal infection of a single hair follicle which can occur on the skin in the maxillofacial region. Untreated, this infection can lead to life-threatening situations. This article discusses the etiology, clinical findings, possible complications as well as a series of differential diagnoses. In addition, several therapeutic and preventive strategies are described.

Eruption guidance appliances are recommended for early orthodontic treatment or prevention of malocclusions. The treatment effect of eruption guidance appliances and functional appliances is similar. In addition to dentoalveolar and skeletal effects, eruption guidance appliances would also have myofunctional effects for treating open mouth behaviour and swallowing problems. However, there is no solid evidence for the myofunctional effect claimed. The position of erution guidance appliances in the orthodontic treatment arsenal is limited: early treatment of Angle Class II malocclusion in 2 phases has no advantage over a 1 phase treatment. When eruption guidance is needed, preference is given to an individually produced appliance.

Evidence-based dentistry is the science which carries out research which provides the most reliable form of evidence for clinical disciplines. Only several robust randomised controlled trials can generate evidence. A survey of available publications of the Oral Health Group (part of the Cochrane Institute) proves that there is at this moment only limited robust evidence for dentistry. In the near future little evidence will emerge from Dutch sources (Dutch trial register). Due to inferior design and practice randomised controlled trials often lack quality. Biases, like selection-bias, information-bias and confounding-bias, must be taken into consideration while reading reports. Prejudices, bad tendencies, errors, external influences and stubbornness all occur often in research practice. Many years of research, involving many test cases, a great deal of money and personnel have, up to the present time, produced little evidence. Just a few ‘random subjects’ in dentistry and assertions concerning the use of fluoride can be considered evidence-based-proof.

The traditional ‘trial and error’ methods for skin colour recording are not satisfactory. In 1982 a dissertation was published, titled ‘Skin colour and facial prosthetics, a colorimetric study’. The dissertation was concerned with a clinical study of skin colour recording objectively in a random sample of 100 people, using subtraction colorimetry. Subsequently, facial prostheses were fabricated for a group of patients with a facial defect who had to undergo radiotherapy. From the results of the study the 3 following conclusions were drawn. Skin colour recording for producing a facial prosthesis need to be carried as close to the facial defect as possible. Alterations of skin colour are determined by light scattering in the skin as well as skin pigments. In patients with facial defects who have to undergo adjuvant radiotherapy, skin colour alterations are present until on average 13-14 weeks after completion of the radiotherapy and from that time point the skin colour remains rather stable. After publication of the dissertation, other research results demonstrated that light scattering in the skin, a sign of skin translucency, may be determined with a fiberoptic scattering meter (volume reflectometer). Using the fiberoptic scattering meter, a colour formula can be made, which by calculation shows the amount of pigments and scattering objects needed to produce the correct translucency and colour of a facial prosthesis. Currently, a small beam reflectometer is used for this purpose.

A 71-year-old man is discussed in whom the oral and maxillofacial surgeon observed, by chance, a radiopacity on the panoramic radiograph that was highly suggestive of a calcification at the bifurcation of the internal and external carotid artery. While, on the basis of international literature, various treatments are advanced with respect to the importance of vascular investigation and possible surgical removal of significant calcification, at present the view in the Netherlands is that the family doctor has the responsibility to assess whether such patient should be referred for further evaluation by the neurologist or vascular surgeon. The same applies to the possible indication for prescription of antitrombotics.

A 58-year-old woman was referred by her dentist to a maxillofacial surgeon because of a rapidly increasing facial swelling. The swelling developed after sodium hypochlorite irrigation during the endodontic treatment of tooth 25. A mechanical heart valve, a heart rhythm disorder, and antithrombotic therapy were complicating medical conditions. Treatment consisted of 12 mg dexamethason administered once intravenously, augmentin administered thrice daily intravenously, and oral analgetics. Damage following sodium hypochlorite irrigation during endodontic treatment is a rare disorder which is associated with a severe reaction in the surrounding tissue. Damage can be permanent.

Nowadays for a variety of reasons personal information is collected which may interfere with an individual’s privacy. To enhance the careful management of personal information and to make it possible for an individual to monitor that management, in The Netherlands a specific law was enacted. Health care providers who have to process many medical records when treating patients also have to follow this law. The organization responsible for implementing this law and for ensuring that it is properly carried out is the College for the Protection of Personal Information. At the website of this organization, myprivacy.nl, valuable information is available on the implications of this law for the maintenance of patients’ health care records.