In the Netherlands mamma carcinoma is diagnosed in about 12.000 women each year. The prognosis has improved due to screening, local control and adjuvant therapy. This induced a mortality reduction of 20% during the last decennium. If mamma carcinoma has been diagnosed, local surgical treatment of the breast will take place. This may be carried out by breast conserving therapy or by breast amputation. For axillary staging a sentinel node procedure is performed. In case of axillary metastasis, an axillary lymph node dissection is needed. Systemic therapy may be needed as well. This can be chemotherapy, immunotherapy, hormonal therapy or a combination. Recent developments in molecular techniques will provide individualized systemic treatment in the near future.

In a 3-year-old child, acute dental abscesses in combination with clinical and radiographic impressions of a number of deciduous teeth indicated regional odontodysplasia as probable diagnosis. Histological examination of the removed deciduous teeth confirmed the diagnosis. Early determination of this regional developmental anomaly in the odontogenesis is of great importance for optimal guidance of the dental care of a patient with regional odontodysplasia.

A 21-year-old woman was referred by the dental practitioner to an oral surgeon concerning a hard elastic swelling of the left cheek in combination with local paresthesia. Histopathologic and radiographic examination revealed an osteosarcoma in the left segment of the maxilla. Subsequently, the patient was referred to a medical centre for head and neck oncology. The treatment consisted of 3 courses neoadjuvant chemotherapy, followed by radical surgical resection of the tumor, and 3 courses adjuvant chemotherapy. One year after treatment, there was no sign of local tumor recurrence or metastases. An osteosarcoma is a malignant tumor of bone forming cells. About 10% of osteosarcomas are appearing in the head and neck region, primarily in the mandible and the maxilla. The treatment of choice is adequate surgical removal. Treatment with (neo)adjuvant chemotherapy seems to have additional benefit, but this needs further research.

In this contribution, the results are presented of a study of the degree of satisfaction among parents of children with a cleft lip and/or palate with care provided for their children. A questionnaire with declarative statements and a number of open questions relevant to treatment received was sent to the 213 members of the workgroup Cleft Lip and/or Palate of the society of the motor-handicapped and their parents. In addition, parents were asked to give a grade for the team who treated their child. The results (response n = 101) indicate that, with respect to a number of aspects, there are differences in satisfaction concerning the care which was provided among the 5 treatment-teams with the most responses. The average grade given by parents for the care provided by Dutch cleft lip and/or palate teams was 7.4. Parents would like to be better informed and treated in a friendlier way.

The obstructive sleep apnea syndrome (OSAS) is characterized by repetitive upper airway obstructions during sleep. This sleep-related breathing disorder is associated with excessive daytime sleepiness and increased cardiovascular risk. Recently, the national multidisciplinary guidelines for the diagnosis and treatment of OSAS in adults have been thoroughly revised. In the guidelines an important place has been created for mandibular repositioning appliances. With these devices, which resemble activators, a widening of the upper airways is produced during sleep by advancing the mandible. According to the guidelines therapy with repositioning appliances should be considered a first-line treatment for patients with mild to moderate OSAS.

Non-steroidal anti-inflammatory drugs are often used analgetics in dentistrybecause of their analgetic and anti-inflammatory effects. Oral health care providers should know their interactions and side-effects meticulously. The automatic prescription of another analgetic just to avoid the side-affects is not always an option, since then the specific properties of NSAID’s are missed. A correct patient information, specific medical controls, a combination with other medication or other measures may provide for a safe use of NSAID’s. In case of healthy patients younger than 70 years of age and a medication time less than two weeks seldom specific measures are indicated.