Smoking may cause periodontal diseases and raises the chance of getting oral cancer. The Dutch Guideline for the Treatment of Tobacco Addiction recommends that dental professionals explicitly advise all patients who smoke to stop smoking. In 12 dental practices a study was made of how the guidelines could be implemented. The strategy consisted of a patient protocol for minimal, one-time cessation advice or for more intensive supervision, a patient leaflet, centralized training for the dental team, and repeated monitoring with feedback on the patients’ experience of the behaviour that they have been advised to follow. Before the training and again 3 months after, professionals (n = 38) and an a-select sample of smoking patients (n = 197) completed questionnaires. A majority of patients was receptive to cessation advice of a dentist (95%) or counseling (68%). After 3 months it appeared that patient behaviour as reported by patients with respect to all points of the patient protocol had significantly improved.

Physical exertion, such as practicing sports, may have an influence on the secretion and composition of saliva. As a result of intensive physical exertion, the saliva immunoglobulin concentration decreases and the concentration of protein – the output of protein (mg/min), however, remains constant – and the viscosity of the saliva increase, while the watery secretion decreases. Moreover, saliva testosterone levels decrease and salivary cortisol levels increase. The saliva Na+, K+, Ca2+ and PO43- concentrations increase slightly or remain unchanged. After a single physical exertion, the alterations are reversible and the values return to baseline within a few hours. In the case of long lasting intensive physical exertions, for instance lasting several months, particularly the decrease in the concentration of the most prevalent immunoglobulins in saliva (s-IgA) seems to have a more permanent character. This has a detrimental effect on the immunological defence, which may reduce oral as well as upper respiratory tract health. Complaints about this are not uncommon among serious athletes who are active at a high competitive level. Among these athletes, the combination of changes in the composition and secretion of saliva, together with intense mouth-breathing and an adjusted diet and drinking habits carry a higher risk of developing caries and erosion. However, in case of decent oral health selfcare, the detrimental effects on oral health can be prevented.

The first part of this article is an edited Dutch summary of the paper ‘Oral-health-related benefits of orthodontic treatment’ by Donald J. Burden in the special issue ‘Orthodontics: quality of care, quality of life’ in Seminars in Orthodontics (June 2007). Burden carried out a systematic review of the literature on some, historically claimed, beneficial influences of orthodontic treatment, such as reduced susceptibility to dental caries, periodontal disease, temporomandibular dysfunction, and traumatic injury. Based on the results of this review, Burden concludes that the oral health benefits of orthodontic intervention have not been demonstrated. The second part is a critical and balanced commentary on the content of the paper and on Burden’s conclusions.

Oral implantology is a fast growing and dynamic specialization. An increasing number of dental professionals are carrying out oral implant treatments. Recommendations for oral implant treatments are needed to improve and manage treatment quality. In this article recommendations are proposed for 4 oral implant and superstructure indications in patients without complicating factors. The 4 oral implant indications are a mandibular complete overdenture, a maxillary complete overdenture, a single crown in the maxillary aesthetic region, and crowns and fixed partial dentures in the non-aesthetic region. The recommendations are also related to diagnostics and aftercare.

A 39-year old Antillean woman was referred by her family doctor to an oral and maxillofacial surgeon because of an unusual and painful ulcer in the buccal region of the first left mandibular molar. Earlier that day, she was diagnosed as hiv-positive. The ulcer was diagnosed as an atypical necrotising ulcerating periodontitis. Antibiotics were subscribed and after removal of the first left mandibular molar, the ulcer healed. After several weeks, the patient was referred by her internist because of another ulcer at the lateral border of the tongue. This ulcer was diagnosed as an eosinophilic ulcer and was healing slowly. Both ulcer types are seen rarely and are strongly related to immunodeficiency diseases.

Locating the desired evidenced-based literature via the internet is usually time-consuming and not particularly straight-forward. Websites offering evidence-based information should be accessible, efficient and user friendly. Many of these websites, however, only make their own content available, making it necessary to change websites in order to get a complete picture of the required information. The so-called website of ‘Turning Research Into Practice’ is a positive exception. This website makes it possible to search the whole range of evidence-based publications on a certain subject with 1 search action, is straight-forward and practical to use, and the presentation is exceptionally good.