Newcastle Dental Hospital

The effective management of tooth wear is one of the biggest challenges faced in modern dentistry. Tooth wear can significantly impact oral health-related quality of life, yet there is no existing condition-specific patient-reported outcome measure (PROM) available to accurately capture and comprehensively measure this impact. This study aims to qualitatively explore patient perspectives of tooth wear to generate items for a condition-specific PROM. Adults referred to Newcastle Dental Hospital for management of diagnosed tooth wear were invited to participate in a semi-structured qualitative interview. Participants were purposively selected from a range of ages, genders, with varied tooth wear aetiology and severity, and at different stages of treatment. Recruitment continued until purposive sampling requirements had been met, and data saturation was reached. Thematic analysis was undertaken independently by two researchers, prior to discussion to reach agreement on the identified themes. Seventeen participants with a range of tooth wear aetiologies, severity and at different stages of treatment were interviewed. Thematic analysis produced three broad themes including psychosocial impact of tooth wear, effect on function and knowledge and understanding of tooth wear. This study demonstrates the broad impacts that tooth wear can have on patients’ oral health-related quality of life, and has generated a wealth of items to inform generation of a condition-specific PROM. Understanding how tooth wear can impact on oral health-quality of life from a patients perspective is a critical first step in generation of a condition-specific patient-reported outcome measure.

ABSTRACT Background In 1971, the World Health Organisation concluded the term Adenomatoid Odontogenic Tumour (AOT). This tumour accounts for approximately 2%–7% of all odontogenic tumours. AOTs commonly present in the younger demographic with a 2:1 female predisposition. The maxilla is more commonly affected. AOTs are categorised into follicular, extrafollicular and peripheral variants, respectively. Patients are usually asymptomatic with evidence of expansion of the cortical bone. AOTs are slow‐growing and well‐encapsulated with enucleation and curettage being the treatment modality accepted amongst the literature. Methods A 15‐year‐old female was referred to the oral surgery department at Edinburgh Dental Institute with a 6–7‐month history of an asymptomatic swelling adjacent to tooth 22. On clinical assessment, there was a firm labial swelling adjacent to tooth 22. Radiographic assessment highlighted the presence of a unilocular radiolucency with a corticated margin distal to the root surface of tooth 22 with expansion, thinning and perforation of the buccal cortical bone. Diagnosis suggested a benign odontogenic lesion: an odontogenic keratocyst, lateral periodontal cyst or lateral radicular cyst. Results Management involved enucleation for histopathological assessment. This confirmed an intraosseous AOT with complete excision. Clinical and radiographic review highlighted complete mucosal healing with evidence of bony infiltration and no recurrence. Conclusion This case highlighted the effective management of an intraosseous AOT with enucleation and curettage.

BackgroundSmoking is a key contributor to health inequalities, particularly impacting oral health. Periodontal (gum) health is significantly affected by smoking. With their extensive reach, regular and frequent patient contact, and potential teachable moments, dental teams are well placed to support patients to stop smoking. This is currently mainly provided through Very Brief Advice (VBA) interventions and so there is scope to enhance the cessation support offered. A large definitive trial is needed to confirm whether this would lead to improved smoking quit rates, improved oral health, and be good value for money.MethodsThe ENHANCE-D trial is a multi-centre, pragmatic, definitive, 3-arm, parallel group, individually randomised controlled superiority trial, including an internal pilot, conducted in NHS dental settings. In total, 1215 patients who are current regular smokers will be randomly allocated using a 1:2:2 ratio to the following: (i) VBA; (ii) the offer of a standard course of Nicotine Replacement Therapy (NRT); (iii) or the offer of an e-cigarette starter kit. A subgroup of patients with periodontitis (gum disease) will have additional oral examinations and samples collected. The primary outcome is biochemically verified smoking abstinence at 6 months. A key secondary outcome is the percentage of periodontal sites with probing pocket depths (PPDs) ≥ 5 mm at 6 months in the periodontitis subgroup. Participants will be blinded to the purpose of the trial and not be aware of the treatment packages. Periodontal health outcomes will be recorded by trained and aligned assessors, blinded to intervention arm. Participant recruitment started in July 2022 with an internal pilot progressing to the main trial in May 2023. A qualitative process evaluation will explore participants’ experiences of receiving the study interventions, alongside the views of dental teams, NHS commissioners, service managers, and policymakers. An economic evaluation will include a cost-effectiveness analysis and a cost–benefit analysis.DiscussionThis will be the largest contemporary randomised trial of smoking cessation interventions in dental settings and one of the first to evaluate enhanced interventions. E-cigarettes were included as an intervention due to growing evidence of their effectiveness. They will be compared to VBA and NRT, and oral health outcomes assessed. The multi-centre, pragmatic design of this trial supports the external validity and potential for impacting clinical practice.Trial registrationISRCTN 13158982. Registered on 10 May 2022. https://www.isrctn.com/ISRCTNISRCTN13158982Supplementary InformationThe online version contains supplementary material available at 10.1186/s13063-025-08954-z.

The kynurenine (KYN) pathway is the major catabolic pathway for tryptophan in humans, producing several metabolites that influence health. In clinical settings, KYN levels serve as a valuable biomarker for diagnosis and prognosis of inflammatory and neurological diseases. Nevertheless, KYN detection relies on mass spectrometry analysis, which requires specialised knowledge and expertise with high operational costs. The bacterial biosensor presents as a promising tool for rapid and cost-effective targeted substance detection due to its ease of genetic modifications. Therefore, this study aimed to develop an engineered bacterial biosensor by integrating a genetic module in a plasmid designed for KYN detection harboured in an Escherichia coli chassis. The KYN biosensing component in the genetic module encodes a KYN pathway regulator (KynR) from Pseudomonas aeruginosa, driven by the PBAD arabinose-inducible promoter. Upon expression, KynR would bind to the exogenous KYN and the bacterial responding kyn promoter to express the downstream green fluorescent protein gene to emit a fluorescence signal. However, despite successful induction by arabinose and the presence of KYN, biosensors with different gene orientation and genetic components failed to produce a significant fluorescence signal. These findings suggest that the sensitivity of P. aeruginosa KynR is insufficient to detect physiological level of KYN. Further exploration of alternative biological sensing components is warranted.

This article underscores the need for comprehensive interpretation of dental panoramic tomograms (DPTs), emphasising the significance of dental anatomy and broader head and neck structures. While general dental practitioners (GDPs) commonly use DPTs for diagnosing dental pathology, there is a tendency to focus solely on the dentition, overlooking information related to head and neck anatomy. The potential medico-legal consequences associated with incomplete reporting make a thorough assessment imperative. The article introduces 'the Heath-MacLeod technique' for reporting, outlining a systematic approach to ensure all aspects are considered. This stresses the importance of a holistic approach to DPT interpretation using a 'radiological sieve', improving patient care and reducing the risk of misdiagnoses and legal consequences.This article is for GDPs on the wealth of anatomy of the maxillofacial region as seen on a DPT and discusses technical errors and examples of pathology. This in turn will provide a foundation of knowledge, allowing for a robust reporting technique, ensuring no clinical information is missed. This not a comprehensive analysis of pathology seen on a DPT but introduces concepts which will allow safe reporting. The reader should be able to analyse the key anatomy seen on a DPT, its presence or absence and how this applies to the holistic management of the patient.

Social accountability relates to the obligation of a health professional school to align education, research, and services with community health priorities. Limited research has examined the role of social accountability in dental education and its potential for addressing oral health inequalities. The aim of this narrative review is to describe current research of relevance to social accountability in dental education and identify gaps in the literature. A systematic search of the electronic databases PubMed, Medline, Embase, Web of Science, and Scopus, using the terms "social accountability", "social responsibility", and "dental education" was undertaken. Articles included in the review were those published between January 1995 and May 2024 which were related to dental professional education and deemed relevant to social accountability. Four themes of relevance to social accountability were identified in the literature (curriculum design and delivery, attitudes, social responsiveness, and cultural competence). This review highlights challenges in measuring the community impact of socially accountable approaches in dental education. There is a need for more longitudinal research to assess the long-term impacts of social accountability in dental education. There are also potential implications for policy and research to influence the working environment of dental graduates to enable and support the workforce to apply and embed social accountability in the practice of dentistry.

This narrative review considers the common clinical dilemma of choosing from non-surgical root canal re-treatment (NSRCreT), surgical root canal re-treatment or dental extraction. While orthograde root canal treatment is generally successful, cases with unresolved symptoms or persistent infection prompt the need for orthograde root canal re-treatment or surgical intervention. The latter involves microsurgery, reserved for suitable cases. Deciding on the appropriate treatment requires a holistic understanding of the patient, the existing dentition and specific tooth factors. This article discusses insights into decision-making, fostering optimal endodontic care and successful treatment outcomes. CPD/Clinical Relevance: Knowledge of current recommendations regarding non-surgical root canal re-treatment, extraction or referral for apical surgery is useful knowledge.

This study was carried out in New York City over a period of twelve months for each child. 1207 children from 977 families, with clinically diagnosed ECC, were recruited. Inclusion criteria included children that had at least one filled or decayed primary tooth surface and were aged between 2 years to 6 years. Exclusion criteria included children that may have conditions that would have prevented the provision of oral hygiene habits or moderation of diet, for example children with severe autism. Families were recruited from local specialist residency programmes within the city or by direct referral from local CHWs. Evaluation of the parental education was established through use of electronic surveys at baseline level and follow up following CHWs' intervention. The data was collected between 2015 and 2017 and required follow up appointments that were completed via telephone and other remote methods. Data collection separated caries risk factors into six domains with 26 factions across the pre- and post-intervention period. These addressed both parental knowledge of the aetiology of caries and factors that can contribute to this. Domains included titles such as saliva factors, hygiene, diet, severity/susceptibility, and outcome expectations. Parents were asked to note their agreement with the statements using a four-point scale (Strongly Agree, Agree, Disagree and Strongly Disagree). The survey was made up of statements including themes of caries risk factors, and behavioural science that can contribute to caries development. Examples include 'drinking juice can cause tooth decay' and 'all kids get tooth decay'. Correct answers would be given as part of the targeted advice and education given by the CHWs at subsequent visits. Data was collected from a total of 669 parents of 977 taking part in the study. Analysis focussed on the trend of changing knowledge of parents from baseline to follow up. The analysis also assessed features of the participants including the parents' first language, education level, country of birth, average age of the children and their insurance status - this was then assessed to see if this influenced the parents' beliefs and associations. Results found there was an improvement in the parental knowledge of salivary risks for caries, hygiene input and dietary effect post intervention. The only differing result was the statement that 'tooth decay is very common' - this showed a reduced change. The study concluded that the MySmileBuddy programme did improve parental education on Early Childhood Caries and factors influencing the risk of this, though acknowledges that there should be further exploration in the clinical impact that this education would have on the patients' caries status from the CHW input.