The withdrawal of a license to trade can result in problems with the availability of drugs. The reasons for withdrawal can be of an economic nature, but the balance between effectiveness and side effects of a drug can also, after a period of time, prove disappointing and the drug can, as a result, be withdrawn from sale. A scarcity of basic materials, too, can play a role in availability, as can the inability of the manufacturer to meet the standards of the relevant authority.

A 30-year-old woman appeared at the gnathology department of a centre for special dentistry complaining of migraine attacks which were preceded each time by severe odontalgic pain. Furthermore, she suffered from an autoimmune disease as well as from tension headaches. The oral health care provider in charge suspected that the episodes of odontalgic pain, which lasted for several hours or even several days, were caused by bruxism. Treatment of the bruxism resulted in reduced pain as well as reduced severity of the migraine attacks.

During the past decade, cosmetic facial treatments have become a standard element of the work of both dentists and oral and maxillofacial surgeons. A shift has taken place from invasive surgical treatments in the direction of minimally invasive treatments. One of the most frequently carried out minimally invasive treatments is the treatment with botulinum neurotoxin type A. Since botulism was first described in the 18th century, this neurotoxin has undergone a slow development to botox which is now manufactured. Botox attaches itself to the nerve endings and is subsequently taken up in the vesicles which contain acetylcholine. Botox blocks, there, the protein which is responsible for the production of acetylcholine. Botox reduces wrinkles in the skin at the muscles of facial expression and is therefore employed in areas with dynamic wrinkles. Appropriate areas include frown lines in the glabella, lines in the forehead, lateral periorbital lines, hyperactivity in the muscles of the upper lip, hypertrophy of the musculus masseter.

With a CO2 laser superficial lesions of the oral mucosa can be removed by evaporation. During CO2 laser evaporation there is minimal damage to the surrounding tissue, resulting in minimal scarring after healing. Therefore the CO2 laser seems to be a modality which is appropriate for the treatment of leukoplakia of the oral mucosa. In 1985, the effect of CO2 laser light on mucosa and the healing after CO2 laser evaporation was studied. In addition, clinical research was carried out concerning the effectiveness of CO2 laser evaporation in the treatment of 103 cases of leukoplakia of the oral mucosa. The cure-rate was 91% and no malignant degenerations were seen in the treated area. The group was expanded (282) and evaluated again, with a cure-rate of 90%. In 1% of the cases, malignant degenerations were seen. CO2 laser evaporation seems the modality of choice for the treatment of leukoplakia of the oral mucosa.

In 1986 the thesis entitled ‘Choosing for dental hygienists’ was published in the Netherlands. It provided the scientific basis for the further development of the profession of dental hygienists in the Netherlands. Since then, the profession has developed very strongly. In the intervening years, qualified dental hygienists have come to be considered capable of taking over simple restorative treatments from dentists. As a result, treatment, especially in children, can largely be carried out by one person. Nevertheless, recent developments, such as the sharp increase in the number of new dental students, suggest that the re-allocation of responsibilities is proceeding slowly. This suggests that policy makers have not yet unambiguously opted for dental hygienists and prevention.