INTRODUCTION During the first wave of the COVID-19 pandemic, routine dental care in Wales stopped with only urgent dental care being provided. Postgraduate trainees (dental core trainees [DCTs] and dental specialty registrars [StRs]) in Wales experienced disruption to their training as a result. The aim of this study was to explore the impact of the pandemic on DCTs and StRs in Wales in terms of trainee learning, development, mental health and wellbeing. METHODS Postgraduate trainees (66 DCTs, 26 StRs) across Wales were invited to complete a survey exploring their experiences during the pandemic. Results were analysed and compared quantitatively and qualitatively. RESULTS Of the 92 postgraduate trainees contacted, 44 responded, yielding a 48% total response rate. Nineteen DCTs (76%) and seventeen StRs (90%) stated that the pandemic had caused a negative impact on their mental health. Eleven DCTs (44% DCTs) and nine StRs (32%) were redeployed to different clinical roles. Twenty-one DCTs (84%) and fourteen StRs (74%) felt concerned about the effects on training/careers, with around three-quarters (76% DCTs, 74% StRs) believing the impact was negative. Twenty-two DCTs (88%) and fifteen StRs (79%) performed fewer clinical procedures while twenty DCTs (80%) and sixteen StRs (84%) had educational events cancelled. CONCLUSIONS The COVID-19 pandemic has had a negative impact on postgraduate trainees in Wales owing to reduced clinical training and redeployment. Despite this, different experiences/skills were gained such as improved leadership skills. DCTs and StRs feel that extending their training, increasing departmental teaching and carrying over the annual study budget to the next year would be beneficial.

Rehabilitation of a patient after hemi-mandibulectomy without reconstruction represents a prosthodontic challenge. Indeed, mandibular deviation and decreased occlusal contacts are a common presentation post-surgery. This paper reports on a patient who presented with these challenges and where chronic osteoradionecrosis has resulted in significant mandibular deviation. A maxillary cobalt chrome mandibular deviation device, designed with palatal bite plane and constructed using 3D printing methods, resulted in a successful outcome. The authors aim to show how restorative management of similar patients can be successful using a modern approach.

First trimester miscarriage is common, occurring in approximately 6.4-12.0% of pregnancies. Women who experience first trimester miscarriage will often have no other significant health conditions and the healthcare professional they most frequently visit could be their dentist or dental care professional. For this reason, it is important that the dental team is aware of the management of first trimester miscarriage in order to allow for a better understanding of the patient's experience and situation. The choice of language used by healthcare professionals with patients who are grieving is also important to ensure effective and open communication.This article aims to provide the dental team with knowledge of first trimester miscarriage, how the effects of this can be relevant within the dental setting, and how to communicate effectively and appropriately with patients who have experienced this traumatic event.

Histological, haematological and microbiological investigations are essential in the field of oral medicine and are a crucial adjunct to clinical findings, often being relied on to obtain a definitive diagnosis. Importantly, in some cases, these investigations can help exclude or confirm the presence of malignancy. This project highlighted some problems regarding labelling and recording of specimens in an oral medicine department and a lack of clear specimen management processes. It aimed to improve specimen management by reducing reported incidents surrounding diagnostic tests. Quality improvement methods such as process mapping were key to understanding the journey of specimens and the departments involved at each stage of the system. Initiatives included a recording log book, staff training, information signage around the clinic and delegation of responsibilities, all of which were implemented over multiple plan, do, study, act (PDSA) cycles. The project was extremely successful and since implementation there has been a clear and sustained reduction in reported incidents. The small number of incidents which did occur all involved transportation of specimens and none involved labelling or recording. One can conclude that the change in test management systems in terms of recording and labelling of specimens in the department has been sustained. Ongoing engagement with stakeholders and senior leaders is the priority to ensure further reduction in incidents in the future and that the improvements are maintained. This project demonstrates how simple, realistic, cost-effective, quality improvement initiatives can have a significant positive impact on patient care and hospital management systems.

Dental UpdateVol. 44, No. 11 Technique: TipsTechnique tips: a complicated crown fracture: the Cvek pulpotomyOlivia Barratt, Carly C Dixon, Siobhan M BarryOlivia BarrattSearch for more papers by this author, Carly C DixonSearch for more papers by this author, Siobhan M BarrySearch for more papers by this authorOlivia Barratt; Carly C Dixon; Siobhan M BarryPublished Online:22 Dec 2017https://doi.org/10.12968/denu.2017.44.11.1096AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail View article References 1. Cvek M. A clinical report on partial pulpotomy and capping with calcium hydroxide in permanent incisors with complicated crown fracture. J Endod 1978; 4: 232–237. Medline, Google Scholar2. Lilleker R. Technique Tips – Traumatized Fractured Incisors: Re-attachment of the Fragment. Dent Update 2017; 44: 164–165. Link, Google Scholar3. Fong C, Davis M. Partial pulpotomy for immature permanent teeth, its present and future. Pediatr Dent 2002; 24: 29–32. Google Scholar4. American Academy of Pediatric Dentistry (AAPD). Guideline on Pulp Therapy for Primary and Immature Permanent Teeth. (2015) (online). Available at: http://www.aapd.org/media/policies_guidelines/g_pulp.pdf (Accessed 11 April 2017). Google Scholar5. Cohen S, Hargreaves K. Pathways of the Pulp. 1st edn. St Louis, Mo: Mosby Elsevier, 2006. Google Scholar6. de Blanco L. Treatment of crown fractures with pulp exposure. Oral Surg Oral Med Oral Pathol 1996; 82: 564–568. Google Scholar FiguresReferencesRelatedDetails 2 December 2017Volume 44Issue 11ISSN (print): 0305-5000ISSN (online): 2515-589X Metrics History Published online 22 December 2017 Published in print 2 December 2017 Information© George Warman Publications (UK) LimitedPDF download