Caries is a dynamic process which can develop either progressively or regressively under the all-determining influence of oral health behaviour. Management of caries therefore involves first of all: diagnostics, monitoring and preventive care and treatment which result in good oral health behaviour. The oral care provider should recognize all phases of progression of the caries process, and should be able to differentiate the symptoms which indicate an active or inactive process. A well maintained patient dossier is necessary to monitor this process over time. Following this procedure, the oral care provider is in a position to guide the patient with relevant information in order to achieve the final objective, good oral health.

In a patient with hypoaesthesia of the central region of the mandible, no oral cause could be found which could explain his complaint. Further examination by a neurologist and a specialist in internal medicine revealed the numb chin syndrome. The syndrome was caused by meningeal localisation of a high-grade B-cell lymphoma stade IV. After intensive chemotherapy and radiotherapy of the skull, the complaints disappeared.

The aim of this research project was to learn more about work-related health risks among dental assistants in Flanders, Belgium. Forty-seven dental assistants completed an extensive questionnaire concerning ionized radiation, protection against infection and exposure to chemicals such as mercury, disinfectants and acrylates. Collective and personal means of protection, musculoskeletal disorders and work-related stress were also evaluated. Pain in the lower back, neck pain and shoulder pain were reported by, respectively, 15%, 17% and 22% of the respondents. Eczema resulting from skin irritation or contact-allergy was reported by 13%. Twentythree percent of the assistants did not consistently make use of a radiation badge; 80% wore a mouth mask and 33% wore protective glasses; and 82% was vaccinated against hepatitis B. Almost 10% reported verbal or physical aggression by patients. The mean stress score was 3.95 on a scale from 0 to 10. The results may contribute to the formulation of a number of recommendations for the improvement of the health of dental assistants.

The purpose of this study was to determine how often patients have died after treatment by an oral surgeon in the Netherlands. A review of the literature showed that this kind of complication has rarely been described in international literature. Subsequently, a small questionnaire was sent to 274 Dutch oral surgeons; 140 questionnaires were returned (51% response). The oral surgeons participating in the survey had had, on average, 21 years of work experience and 4.3% were women. Forty percent of the respondents confirmed that they had experienced the death of a patient after oral surgery. Most (18 patients) died after a dental extraction. The most important causes of death were post-operative spreading of an infection (15 patients), failing to survive oncology treatment (9 patients) and as the third cause of death, heart and/or lung failure was named (6 patients).

Dentists are with increasing frequency confronted with patients who are being treated with bisphosphonates for certain bone diseases, hypercalcaemia, and bone metastases of solid malignancies. A side effect of the use of bisphosphonates is osteonecrosis of the jaw. Bisphosphonate-induced osteonecrosis of the jaw occurs mainly after treatment with intravenous bisphosphonates and to a much lesser extent after oral administration of bisphosphonates. The question remains whether oral implants can be safely placed in patients using bisphosphonates. A survey of the literature shows that the risk of osteonecrosis of the jaw and loss of oral implants is not increased when the implants are placed within 3 years after starting treatment with oral bisphosphonates. After this period there is the possibility of a slightly increased risk of complications. The possibility of complications is higher in patients receiving the intravenous bisphosphonates, and, therefore, elective surgical treatments is not advocated.

A few decades ago, relatively little was known concerning the pre-eruptive spatial development of permanent molars. The material that formed the basis for this study consisted of 114 dry human mandibles of young children and adolescents. Measurements were made on radiographs of the bony crypts in which the tooth germs had existed ante mortem and the pattern of spatial development was studied macroscopically and histologically. The findings revealed a consistent developmental pattern, in which the means of expansion of the crypts of the second and third molars, prior to crown-calcification, displayed strong similarities. The displacements as they were indicated by the measurements on the radiographs were confirmed by the macro- and micro-morphological study of the bone surfaces. The mesio-distal relationship of adjacent crypts appeared to be influenced by morphological characteristics of the mandible early on in their development. New insights have not been achieved subsequently, up to the present day, because little follow-up research into the spatial development of the bony crypts has been undertaken.