The incidence of esophageal cancer has increased markedly during the past 3 decades, especially due to an increase of the incidence of adenocarcinoma. The prognosis for patients with esophageal cancer is poor, with a 5-year survival rate of 10-25%. The important risk factors for esophageal squamous cell carcinoma are smoking and alcohol intake. Esophageal adenocarcinomas are related to gastro-esophageal reflux disease. The diagnostic procedures are not only focused on obtaining diagnoses, but also on determining how advanced the tumor is. If a patient is fit enough to undergo surgery and no evidence is found that the tumor has spread to adjacent organs or that there are distant metastases, a surgical resection is the primary treatment. In case surgical resection is not an option, palliative treatment is generally needed to reduce the complaints of dysphagia. The improvement or maintenance of the quality of life and symptom-control are important goals of both curative and palliative treatment of esophageal cancer.

A 3-year-old boy was referred to the emergency department of a medical centre because of a local swelling of the tongue. Radiographic imaging concluded that it concerned a complete tooth, which had been overlooked during an earlier visit to the same department. The foreign body was removed easily under general anaesthesia. A foreign body in the lip is a feature frequently seen by family physicians and in emergency departments of medical centres. However, a foreign body in the tongue is, by contrast, less often reported. Physical examination is the key factor in diagnostics. When in doubt, a radiograph should be made.

Displacement of a (part of a) radix or in some cases a part of a tooth into the floor of the mouth can occur during the extraction of a tooth in the mandibula. Possible causes of this are a lingual perforation of the radices or an inappropriate surgical technique. Leaving a fragment in situ in the floor of the mouth can lead to pain, swelling and trismus as a result of infection and/or spontaneous displacement of the fragment. We advise that the tooth or radix be removed as soon as possible. When experience is lacking in the removal of a tooth or radix from the floor of the mouth it is sensible to refer the patient to an oral surgeon. We also advise prescribing antibiotics in order to prevent infection.

In order to find out how dental students feel about their educaton in the application of local anaesthesia, a questionnaire was distributed via e-mail among all dental students in the Netherlands. A total of 397 completed questionnaires were analyzed statistically. At all 3 dental schools in the second year instruction in theoretical aspects of local anaesthesia began. Practical teaching began in the second or third study year. A preclinical training model was used by 15% of the students in Amsterdam, 20% of the students in Nijmegen and 35% of the students in Groningen. When they administered their first injection in a human, a fellow dental student in 91-98% of all cases, 24-74% of the students felt that they were insufficiently prepared. 35-52% of the students said that they would also like to receive instruction in intraligamentary anaesthesia in the dental curriculum. Other changes in the curriculum were also frequently suggested, especially the introduction of preclinical training models (29%, 55% and 56% for Groningen, Nijmegen and Amsterdam respectively).

Twenty-five years ago, the treatment of xerostomia was predominantly symptomatic. At that time, the treatment possibilities were mainly sialogogues, mouthrinses and saliva substitutes. Since then, there have been few changes in the symptomatic treatment of xerostomia. Methods to prevent the development of xerostomia or to reduce its severity were then in their infancy and methods aiming to regenerate a damaged salivary gland did not exist. During the last 2 decades, however, great changes have taken place. New radiation techniques reducing the cumulative dose on salivary glands have been introduced. At the moment techniques are being developed to regenerate the secretory potential of a salivary gland damaged by radiotherapy. In addition, biologicals have recently been introduced which make it possible to intervene in the process of disease associated with Sjögren’s syndrome, by means of which here, too, a degree of regeneration of function can be achieved.