Introduction Providing dental care to persons with special healthcare needs is often seen as complex; however, this complexity is difficult to capture given the spectrum of presentations patients may present with.Aims This study discusses the development, validation and pilot use of a complexity checklist (CC): a brief (12-item) instrument designed to characterise the complexity of dental care provided to persons with special healthcare needs.Methods The CC was developed by the authors and then discussed and refined by clinicians who specialise in the dental management of persons with special healthcare needs. Firstly, validation of the tool included a test-retest study using simulated cases based on real-world clinical scenarios. Analysis included assessment of inter-dentist and intra-dentist reliability, as well as correlation with 'gold-standard' responses. Secondly, the tool was piloted in a tertiary specialist referral service over a six-month period where the CC was completed at the end of each appointment.Results Analysis of the test-retest study revealed good reproducibility, criterion validity, and interpretability. Pilot study data revealed variations in how complex patients presented.Conclusion Initial validation and use of the CC has shown encouraging results but warrants further investigation. Results of the study suggest that aspects of complexity are not captured in existing case mix tools.

Background The objective of this study was to develop a deep learning (DL) model for the detection and segmentation of six types of dental restorations and applications in panoramic radiographs of paediatric patients with mixed dentition.Material and methods A total of 2,033 panoramic radiographs were labelled for six different dental restorations. The dataset was divided into three parts: 80% for training, 10% for validation, and 10% for testing. The YOLOv8 model was trained for 500 epochs with a learning rate of 0.01. The success of the model was evaluated using sensitivity, precision and F1 score metrics.Results The YOLOv8 multiclass-DL model achieved high performance, with an overall F1 score of 0.89, supported by a sensitivity of 0.85 and precision of 0.93. Among the evaluated restoration types, dental fillings achieved the highest F1-score of 0.97, followed by stainless steel crowns with 0.94, space maintainers with 0.93, pulpotomies with 0.90, and root canal fillings with 0.84. The lowest performance was observed in the detection of dental brackets, which reached an F1-score of only 0.46.Conclusion YOLOv8-based DL models demonstrate a high level of success in detecting and segmenting dental restorations in panoramic radiographs of patients in the mixed dentition period.

Objective To explore secondary school students' perceptions of a metaverse platform called Meta-OHE (metaverse for oral health education).Methods Focus group discussions (FGDs) were conducted with purposively sampled 16-year-old secondary school students from semi-government schools in Malaysia. Participants engaged with the Meta-OHE platform on Mitoworld for one week before the FGDs sessions on https://mitoworld.io/world/w/2808/meta-ohe . The FGDs, conducted in both English and Malay, each lasted between 30-60 minutes and were guided by a semi-structured topic guide until data saturation was achieved. The data were analysed through framework analysis, using NVivo 14.0 to systematically code and develop themes.Results A total of 81 students participated in 16 FGDs. Emerging themes in their perceptions of the metaverse platform Meta-OHE included freedom and exploration, interactive features, access to oral health information, and immersive learning experiences. Participants favoured visually appealing environments, customisable avatars, diverse oral health education content, and the integration of augmented reality and virtual reality technologies. Desired platform features from the participants also included gamification, reward systems, up-to-date information, diverse environments, social features, short videos, educational simulations, and age-appropriate content.Conclusion The study revealed positive perceptions of Meta-OHE for oral health education, suggesting its potential as an innovative tool for engaging secondary school students in oral health promotion and education. However, frequent updates, maintenance and expansions to content, technical diversity and features were emphasised to maintain interest and relevance.

Background Molar-incisor hypomineralisation (MIH) is a prevalent enamel defect affecting first permanent molars and incisors. Despite increasing awareness, variability persists in diagnostic consistency and treatment approaches. This study aimed to assess the knowledge, diagnostic confidence, and management strategies for MIH among postgraduate paediatric dentistry students in the United Kingdom (UK).Methods A cross-sectional survey was distributed online in November 2023 to all UK dental schools offering postgraduate paediatric dentistry programmes. Participants completed an anonymous questionnaire examining MIH aetiology, prevalence, clinical diagnostic criteria, and case management plans.Results In total, 17 of the 27 respondents (63%) completed the survey. While 71% reported encountering MIH multiple times per week, none provided a comprehensive definition aligning with European Association of Paediatric Dentistry guidelines. Although most recognised multifactorial aetiology, including perinatal and postnatal factors, fewer acknowledged genetic contributions. Frequently cited diagnostic criteria were post-eruptive breakdown and demarcated opacities; however, none identified all key features. Treatment preferences ranged widely, from microabrasion to composite restorations to uncertainty regarding early extractions.Conclusion The range of proposed management strategies underscores MIH's clinical complexity and highlights the need for enhanced educational resources and standardised protocols within postgraduate curricula.

Aim Antimicrobial resistance is an emerging global health challenge, driven largely by the overuse of antimicrobial drugs. However, the extent of mouthwash-induced antimicrobial resistance remains poorly understood. This systematic review aimed to assess the influence of commonly used mouthwashes on antimicrobial resistance, focusing on resistance genes, microbial alterations, and cross-resistance to antibiotics.Methods PubMed, Scopus, Web of Science, and grey literature, including Google Scholar, were searched for studies evaluating mouthwash-induced antimicrobial resistance. The search strategy included terms related to 'oral microbiome', 'mouthwash' and 'antimicrobial resistance', with Boolean operators tailored to each database. Risk of bias was assessed using In Vitro Critical Appraisal Tool for in vitro studies and the Modified Joanna Briggs Institute for ex vivo and in vivo studies, respectively.Results Twelve studies were analysed, comprising seven in vitro, four ex vivo and one in vivo study. A total of 91 patients and 213 bacterial isolates were assessed across various mouthwashes, including chlorhexidine digluconate, cetylpyridinium chloride, hydrogen peroxide and others. Due to heterogeneous outcomes, a meta-analysis was not conducted. The findings consistently revealed increased minimum inhibitory concentrations of oral bacteria and the presence of resistance genes, highlighting a potential rise in antimicrobial resistance.Conclusion This systematic review indicates a possible association between mouthwash use and resistance-related changes in the oral microbiome; however, the limited and heterogeneous evidence base warrants cautious interpretation. Further, longitudinal research is needed to elucidate the underlying mechanisms and inform evidence-based guidelines for mouthwash use.

Introduction This study determined the prevalence of endodontic prognostic factors and their association with periapical lesions (PL), cortical bone destruction (CBD), and buccal plate bone height (BPBH) in endodontically treated maxillary anterior teeth and premolars.Methods Analysed 203 cone-beam computed tomography scans for missed canals, obturation length, restoration type, fractured instruments, perforations, posts/screws, and PL presence. PL volume, CBD and BPBH were measured, with relationships analysed using the 'marginal model' and generalised estimating equations at p <0.05.Results Among 227 teeth, 48.9% had PLs. Significant associations with PL presence included fractured instruments, perforation, missed canals, and both overfilled and underfilled canals (p <0.01). PL volume was significantly associated with obturation length, perforation, post/screw, and restoration type (p <0.02). Perforated teeth exhibited the largest PL volumes (mean: 53.36 mm³), and composite restorations showed larger volumes than other restoration types. CBD was significantly associated with perforations (p <0.01), and BPBH was lower in teeth with perforations and crown restorations (p <0.01).Conclusions Missed canals significantly influenced PL presence, whereas perforations affected PL volume and were the only factor influencing BPBH and CBD. This highlights the importance of minimising endodontic errors and aids in patient risk stratification.

Children's dentistry, or paediatric dentistry as it is now called, has an illustrious history in London's dental schools. This paper examines the contributions of leading hospital staff of the Royal Dental Hospital, and its university colleagues of the London School of Dental Surgery (all physically part of one institution), to teaching, treatment and some other roles.

There is a high prevalence of traumatic events in our society and the number of trauma sufferers in the general population is significant, with lasting adverse impacts on health, including oral health. Despite the high likelihood of oral health practitioners encountering patients with trauma, trauma history may not be disclosed or evident. In healthcare, trauma-informed care is a comprehensive and multi-level approach to patient care based on the understanding of the widespread nature and the impact of trauma. Trauma-informed care has not been widely implemented in oral health and multiple yet limited definitions of trauma could be further impeding implementation of trauma-informed care in oral health. To respond to these issues, we propose a definition of trauma in trauma-informed care which directly relates to the oral healthcare setting. We also propose a model - 'Safe haven - a trauma-informed care model for oral health practitioners' - which aims to encourage oral health practitioners to practise trauma-informed care as a universal precaution for all patients in everyday practice.