The proportion of dental hygienists in oral health care for children is not consistent with the potential of the profession. Developments in cariology point in a direction that fits the profile of the dental hygienist. Stimulation of a re-allocation of jobs in paediatric dentistry in relation to dental hygienists is therefore desirable. Moreover, tackling the causes of oral diseases should be an objective to a greater degree than has been the case in the past. For caries treatment this would mean giving priority to a plaque-related treatment. That amounts to: a non-invasive approach to non-cavitated caries lesions in permanent and temporary dentition and a non-restorative approach to cavitated caries lesions in temporary dentition.

Lyme disease, or Lyme borreliosis, is the most prevalent vector-borne illness in the United States of America and Europe. In the Netherlands, the disease is endemic with an estimated yearly incidence of 133 cases per 100.000 inhabitants. Lyme disease is caused by spirochetes of Borrelia burgdorferi sensu lato and transmitted by Ixodes ticks. Diagnosing the different manifestations of Lyme disease is based on a history of possible exposure to ticks, the appearance of specific clinical symptoms, exclusion of other causes of the symptoms, whether or not combined with serological or other diagnostics tests. Antibiotics are effective in all Lyme disease manifestations and, generally, patients have a good prognosis.

A 12-year-old boy was referred to the Department of Oral and Maxillofacial Surgery of a university clinic, one week after initial treatment related to a dental trauma due to a fall on a swimming pool slide. The treatment by the dentist on duty consisted of repositioning and splinting the maxillary central incisors. However, a radiograph of the affected teeth showed some unrecognizable objects around the left incisor. The nature and localization of the objects were not clear. Therefore, a cone beam computer tomography was produced. This image revealed that the objects were located in the left central incisor’s socket and that this tooth was not repositioned correctly. A retreatment was carried out consisting of removing the objects and repositioning and splinting the left central incisor. Cone beam computer tomography may be of great value in determining the nature and extent of a dental trauma as well as in evaluating the treatment provided.

The present-day terminology and definitions of tooth wear are not unambiguous. For diagnosing tooth wear, however, it is essential that they are unambiguous. In this article a proposal is presented for a tooth wear evaluation system with simplified definitions. This system consists of a number of modules and can be used for various aspects of the diagnostic procedure. It can be used for the quantification of tooth wear, both for periodic screening and for the monitoring of tooth wear in individual patients. The scoring of occlusal/incisal tooth wear as well as of nonocclusal/non-incisal tooth wear is  possible. The evaluative system is also suitable for determining which type of tooth wear, such as attrition, abrasion and erosion, is most likely to have caused any observed loss of hard tooth tissue.

Hardly any data are available on the clinical consequences of untreated severe caries, because there is no method to quantify the prevalence of oral conditions resulting from untreated caries. In the Philippines, an index was developed which records for (the location of) each tooth whether caries has reached the dental pulp, whether ulceration is present in the surrounding soft tissues due to sharp edges of fragments of a tooth lost due to caries, or whether a fistula or abscess is present. By adding the index to the existing Decayed Missing Filled Tooth index, insight is provided on the extent and the consequences of untreated caries and research may be carried out on its possible impact on the general health and wellbeing of national populations.

In the case of growing children with a deviation in the size or position of the upper jaw orthopaedic devices are often used to direct the growth at the level of the sutures. In the PhD thesis ‘The postnatal development of the human maxillary sutural surfaces’, published in 1985, the orientation and macroscopic morphology of the sutural surfaces of the maxilla in children’s skulls were described. The existence of premaxillomaxillary and pterygomaxillary sutures could not be demonstrated. It was observed that the maxillary sutural surfaces were mainly sagittally oriented. Some sutural surfaces became increasingly rough with age, while the majority of the surfaces remained smooth. It was concluded that advice concerning the determination of the direction of orthopaedic forces in relation to the orientation of the sutures needed revision. Subsequent systematic reviews have reported that so far little is known about the long-term stability of orthopaedic effects in orthodontics.