Health Authority of Anguilla, British West Indies
The contemporary workplace is evolving at a rapid and revolutionary rate. Contributing factors include: globalisation, competition; mergers, acquisitions and strategic alliances; technological advancements; innovative learning and development methods; delayering and downsizing of organisations; greater flexibility and autonomy of workers; an ageing population; extensive social and demographic changes; a multigenerational workforce and societal, political and economic changes. These transformations are bringing together persons from different cultures and backgrounds that possess varying skillsets, thereby, increasing diversity amongst the modern workforce.
Diversity can be considered as recognising, understanding and accepting individual differences. Diversity characteristics can be grouped into four dimensions: (i) personality: traits, skills and abilities; (ii) internal: gender, race, ethnicity, intelligence quotient and sexual orientation; (iii) external: culture, nationality, religion, marital or parental status and (iv) organisational: power, department, union or non-union. In healthcare, a diverse workforce has been acknowledged as attempting to positively overcome barriers in access for underrepresented groups.
The ever-changing workplace and increasingly diverse workforce have been important topics to transpire over the past three decades. The latter may contribute to organisational success and reputation; however, if managed unsuccessfully, it may lead to adverse outcomes including absenteeism, increased staff turnover, conflict, discrimination and litigation. Although there is vast literature on leadership and management theories, there are limited studies, which decisively examine how such theories can allow diverse teams to be better led and managed. Thus, the author considers the main leadership and management theories and their implications in leading and managing the increasingly diverse workforce within dentistry.
After qualifying as a dentist in 2012 from Peninsula College of Medicine and Dentistry, Universities of Exeter and Plymouth in the Southwest of England, UK, Dr Bhaven Modha has had both a varied and unique mix of experience in dentistry. From gaining worthwhile skills and experience from several general dental practices, Bhavenʼs journey in dentistry has also included dentist positions in secure units to include prisons and immigration removal centres; special care community clinics, university and educational establishments and as a senior dentist overseas.
King George Medical University, India
Introduction: The cytotoxic effects of chemo-radiation, in addition to their intended effects on cancer cells, unfortunately extents to normal tissue as well, such as gastrointestinal mucosa and bone marrow. This is mainly brought about by the oxidative damage caused by the generation of free radicals.
To the head and neck cancer patient, the most crippling ill-effect of chemo-radiations oral mucositis. In addition to being a potentially dose limiting complication of chemo-radiation, oral mucositis lends a devastating blow to patientʼs daily activities and brings about marked reduction in their quality of life (QOL).
Resurgence in the use of honey for wound management coupled with research into its excellent antioxidant and antiseptic profile has urged some researchers to investigate its role in amelioration of radiation mucositis.
Investigation into the viability of honey as a therapeutic agent for chemo-radiation induced mucositis and to find whether it causes quantifiable improvement in QOL forms the crux of this study.
Material and Method: A total of 50 patients of H&N cancer (25 cases, 25 controls) were enrolled in the study and their QOL was recorded, at regular intervals during radiotherapy. The study group received oral honey along with radiotherapy while the control group received standard oral hygiene instructions only.
Results: The QOL scores were significantly better in the study group compared to controls after completion of radiotherapy.
Arrowe Park Hospital, UK
Coronectomy is a surgical technique used to minimise the risk of damage to the inferior alveolar nerve (IAN) and is performed in many Oral & Maxillofacial Surgery (OMFS) units. The third molar is decoronated, leaving the roots in situ and theoretically minimising the risk of damage to the IAN. Damage to the IAN can result in significant morbidity and affect a patientʼs quality of life. There is risk of damage to the inferior alveolar nerve (IAN) following extraction of mandibular third molars, which are increased inso-called “high-risk” teeth.
A retrospective review was carried out, reviewing case notes of patients who underwent coronectomies in the OMFS unit at Arrowe Park Hospital in the UK from March 2019 to March 2020. Of the patients in the study, three had post-operative complications. Two had significant pain in the weeks following the procedure, which had subsided on further review. The third patient developed a post-operative infection requiring oral antibiotics, their symptoms subsequently subsided. No patients in the sample required procedures to remove the remaining roots and no patients had symptoms of IAN damage.
This review found a 79% success rate of coronectomies. This is similar to the success rate of previous studies. Coronectomies have a reduced risk of damage to the IAN when compared with extraction of mandibular third molars and should be considered as an alternative to extraction when indicated.
Sandeep Acharya is currently a DCT2 working at Liverpool University Dental Hospital. He has worked at Oral and Maxillofacial Surgery units across numerous hospitals in the United Kingdom. He has a keen interest in Oral Medicine and Surgery and wants to pursue further training and research in these fields.
University of Liverpool Dental Hospital, UK
An 8 year old male patient presented with failure of eruption of permanent teeth. This patient is fit and well with no family history of this. All deciduous teeth were still present and radiographic examination showed all permanent teeth (apart from third molars) were unerupted and of sound anatomy.
No cause for this patientʼs delayed eruption has been found. The patient has attended genetic specialists and multiple dental specialists to diagnose. The working diagnose currently is primary failure of eruption with no genetic or anatomical cause.
At age 9 the patient underwent surgery to expose upper central incisors and all permanent first molars. Initially this appeared to have been successful, however, at a review 10 months after, only one cusp tip from the Lower left molar and part of the labial surfaces of upper incisors was erupted.
Following a multidisciplinary meeting, a complete upper overdenture and a lower partial denture was made for the patient. These will need to be replaced every 18 months roughly until the patient has fully grown. Considerations for the future will be to reattempt exposure of permanent teeth although unsuccessful before or providing implant retained prosthesis.
Maria Jackson graduated from University of Liverpool in 2017 in Bachelor of Dental Surgery. She has since worked in a general dental practice, community dental service centre, 2 different dental hospitals and 3 different general hospitals. She is looking to specialise in Special care dentistry and is currently undertaking a DCT 3 year at Liverpool Dental Hospital.
Wirral University Teaching Hospital, UK
Retained roots are commonly seen as an incidental finding, with many being asymptomatic. A general dental practioner (GDP) may notice this incidental finding in practice following radiographic examination. Over time they may have the ability to migrate, develop pathological change and become symptomatic for the patient. In this circumstance, they may be referred to an oral and maxillofacial department for further investigation. This paper uses an interesting clinical case to demonstrate where these roots can migrate to, how they can present and the surgical techniques required in their removal. In this particular case, the retained root of a lower right second molar migrated to below the right side of the inferior alveolar nerve.
Melissa Loh is currently undertaking her second year as a Dental Core Trainee in an Oral and Maxillofacial Unit at Arrowe Park Hospital in the Wirral, Merseyside. She has enjoyed the challenges and various clinical exposures in relation to managing patients in a secondary care setting. She hopes that the skills that she has acquired during her time as a Dental Core Trainee will be transpired into my career in the Dental Profession.
King George Medical University, India
Background: Teledentistry can provide an innovative solution to continue dental practice during the current pandemic. It involves rationale use of information and communication technologies that provides care remotely.
Method: Articles on Teledentistry, pertinent to this review, were searched and consulted from Cochrane database PubMed & Google Scholar.
Results: Teledentistry enables dentists to cater various kinds of dental care needs, while maintaining physical distancing with patients. Various domains of Teledentistry include Teleconsultation & Telescreening, Telediagnosis, Teletriage & Telemonitoring. Telediagnosis platforms are used worldwide to reduce the need of close clinical oral examinations. The current pandemic has shown that the dental practice using teledentistry can be considered as safest method of patient care.
Polytechnic University of Marche, Italy
“Save the teeth” should be the final aim of every dentist. In the era of implantology, the attempt to maintain the tooth is critical; sometimes removing the whole tooth is easier than saving it. When the tooth is decayed, the clinician should remove the damaged tissue and try to reconstruct it. In this phase, decision making is an important task and the knowledge of all possible treatments and materials is essential in helping the clinician to take the right decision. Dentistry has recently gone through a technological revolution: important innovations have involved all dental disciplines, including Conservative dentistry, which is devoted to the care and maximum preservation of the tooth tissues.
Preventive dentistry represents the initial and the most conservative method to accomplish the mission of preserving the teeth and it is important to develop new devices for dental care and oral disease.
If the tooth is decayed or traumatically injured, clinicians have a vast variety of dental materials to repair it. Now a days, resin-based materials have become the gold standard replacements for damaged dental tissues, that can be restored using direct or indirect techniques. Recent developments and potential applications of some new resin-based materials will be the second aim of this presentation. In particular, physical and chemical properties of bulk fill composites and their behaviour after polishing procedures have been investigated. Furthermore, the cementation of indirect restoration has been evaluated by studying the kinetics of degree of conversion of luting resin agents and the effects on them of two different curing protocols.