Background A recent report has suggested that vocational trainees within London experienced racial or gender disadvantage during their selection. This exploratory study did not investigate the extent or the nature of this disadvantage.Aim To undertake a survey using a pre-tested questionnaire with dental vocational trainees on the Thames Scheme. The questionnaire explored perceived and experienced aspects of gender and racial disadvantage during their vocational training programme.Results 127 trainees completed the questionnaire (response rate 92%). Minority ethnic respondents were more than twice as likely to feel their selection was influenced by gender (odds ratio [OR] 2.25, 95% Confidence Interval [CI] 1.02, 5.10) and more than three times likely to feel selection was influenced by their race when compared with their white colleagues (OR 3.05, 95%; CI 1.01,11.45). The majority of trainees did not perceive any disadvantage whilst on the vocational training course. For example, only five respondents (4%) felt that minority ethnic individuals were treated less favourably during the vocational training course.Conclusion In conclusion, this preliminary study has attempted to explore inter-ethnic differences within the profession on perceived racial disadvantage and possible strategies for change. It is clear that the perception of disadvantage is greater than the reality within the experience of most trainees.

We retrospectively reviewed the clinical records and radiographs of 100 patients who had had supernumerary teeth removed. Their mean (SD) age was 9 years 3 months (2). The 100 patients had a total of 127 unerupted maxillary incisors associated with supernumerary teeth. The supernumerary tooth was removed without exposure of the permanent tooth more often among the 79 younger children (aged 10 years or less) (SND=3.52, P<0.01), and when the incisors were less mature (Cvek classification 1,2, and 3) (SND=5.27, P<0.01). Of these incisors with immature roots that were treated conservatively, 60 (72%) erupted and 24 (28%) required further operation. Of the mature incisors treated conservatively, 10 (63%) required further operation. In this study, almost three-quarters of immature incisors erupted spontaneously after removal of the associated supernumerary teeth. Over half of the mature teeth required further operation. Mature teeth should be exposed with or without bonding at the time of removal of the supernumerary teeth.

The occurrence of multiple supernumerary teeth is a rare phenomenon. Three cases of multiple supernumeraries are presented which illustrate problems which may arise during long-term follow-up: resorption of adjacent teeth, enlargement of the follicles, movement of the unerupted teeth and development of further supernumeraries. These cases highlight the importance of adequate initial surveillance, anticipation of potential problems, assessing the risk-benefits of surgery and long-term monitoring, in some cases following the surgical removal of supernumeraries.

Day-stay general anaesthesia facilities may be employed to provide comprehensive dental care for children who are unable to accept treatment using alternative methods of patient management. This approach to delivery of care has been shown to be cost-effective, acceptable and efficaceous. This study was set up to investigate changes in the pattern of care provided in day-care facilities at a London dental teaching hospital over a 20-year period--1972 to 1992. The results show that the use of the facilities at this centre has increased with time, with a greater increase amongst older children in recent years. Although the main use is still for the treatment of caries, oral surgery procedures, especially those related to orthodontic treatment, have increased by 200% between 1982 and 1992. This correlates with the increase in older age groups being treated. Details of mean numbers of teeth restored and extracted for each age group are presented for 1992. They indicate, for the younger age groups, not only the high treatment needs of patients referred to the hospital, but also suggest a trend for more radical treatment planning in order to avoid further general anaesthesia. Readers are reminded that, despite its advantages, general anaesthesia should be avoided if possible

Supernumerary teeth are relatively common in the general population and appear to be more likely to occur in patients with a family history of such teeth. It is important that these teeth are identified and in some cases removed before undertaking orthodontic treatment. This article describes two patients who presented with supernumeraries, and their treatment.

This evaluation was based on replies from a random sample of general dental practitioners who were asked to complete questionnaires before and after being sent a video and accompanying booklet on partial denture design. Forty per cent (257) of the original sample (636) completed and returned both questionnaires. A total of 212 respondents (82%) felt the video had been of value and 175 (68%) said they would be more likely to provide metal partial dentures after having watched it. The positive effects of the video were greatest amongst the most recently qualified. Despite some improvement after watching the video, there remained 105 (40%) who indicated that they would leave all partial denture design decisions to the technician on at least some occasions. Comparison of data from first and second questionnaires showed little evidence of substantial shifts in choice of denture design for a series of specific situations. It was concluded that whilst the programme had been well received and had produced changes in intention, there was less objective evidence of change.

Following publication of the Poswillo report, the continued use of general anaesthesia in dentistry became the subject of a major debate. In particular, the provision of general anaesthetic services by general dental practitioners in order to carry out simple extractions for child patients has been called into question. Other authors have strongly supported the continued need for general anaesthesia and insist that for some patients it remains the technique of choice. There is, however, little evidence of current patterns of attendance from which argument may be advanced to support or refute the differing views. In this study data was drawn from three London dental teaching hospitals providing outpatient general anaesthesia for extractions. During the 12-month period investigated 7852 general anaesthetics had been administered for child patients. There was evidence of an increase in numbers at one centre when results were compared to those of a previous study and some evidence of a change in pattern of referral with time at the same centre, with an increase in the numbers of patients referred by general dental practitioners. Eighty-three per cent of the anaesthetics had been given for the extraction of carious primary teeth, with an average of 3.3 being extracted per child. Nearly one-third of the anaesthetics were for children under the age of 5 years.

Day-stay facilities are gaining in popularity in general surgery, especially in surgery for children. In dentistry, day-stay care has been shown to be of great value for the treatment of specific groups of child patients, including handicapped and those too young to tolerate treatment with local anaesthetic alone. The present study considered the characteristics of 103 patients attending for treatment in the day-care facilities of the Eastman Dental Hospital, the morbidity of the technique and the acceptability of the service to those using it. Of the 103 patients, 46 were seen in the unit because they required minor oral surgery and 22 because of particular problems with management. Ninety-four patients had one or more symptoms following treatment. In at least 53 cases this related to the treatment and not to the anaesthetic. Despite a cost to the families in terms of money and time, the service proved acceptable to almost all of those who used it.

Bitewing radiographs remain the most universally accepted aid in the detection of approximal caries in posterior teeth. The aim of this study was to evaluate their use in 5-year-old children. A total of 435 selected sets of films were read and the numbers of readable and unreadable surfaces were recorded. Of the total, 57 per cent of the sets of films were wholly readable; out of a maximum of 8700, 7490 readable surfaces were seen. Of the 248 wholly readable sets of films, 172 (69 per cent) had no evidence of caries, fillings or extracted teeth. The most common reason for loss of information was that surfaces were absent from the film (accounting for 7 per cent of all surfaces). Blurring of the surface affected 4 per cent of surfaces and overlaps a further 3 per cent. Despite the deficiencies seen, caries was diagnosed from more than one-third of all sets of films.

The feeding value of sprouted, soft white wheat was compared with that of sound (unsprouted) wheat and barley in the diets of 95 Simmental-Hereford beef cattle. There were no differences (P > 0.05) in daily gains, feed intakes or feedgain ratios of cattle fed on either sound wheat, wheat with 9% sprouted kernels (low-sprout) or wheat with 58% sprouted kernels (high-sprout), when the wheat was included at 25 or 50% of the diet. When sound and sprouted wheats were given to 44-kg sheep, at 75% of the diet, dry matter intake of the sound-wheat diet was 21% less than that of the high-sprout-wheat diet; dry matter digestibility and the digestible energy content of the former diet were slightly greater (74.3 vs 70.7% and 3.2 and 3.0 kcal g−1), but neither difference was significant (P > 0.05). It was concluded that sprouting does not affect the feeding value of wheat for finishing beef cattle when offered at 50% of the diet, and reduces it only slightly for sheep when given at 75% of the diet.

Although the direct bonding of composite resins to hypoplastic teeth has been well documented, currently employed techniques often produce aesthetically disappointing results, as considerable expertise is necessary to ensure satisfactory gingival and interstial contours. A short clinical procedure is reported which was developed and carried out using universally available materials. The method involves the preparation of acetate matrices on a stone model prior to acid etching in order to bond composite resin to the hypoplastic teeth. The case history presented illustrates the technique and permits a comparison of the aesthetic results produced by this and an alternative method.

A midline dermoid cyst of the lower lip is reported, together with a description of the relevant clinical and pathological features. The embryological basis for the aetiology of the lesion is also discussed.