Reviews | British Dental Journal

UNDERSTANDING YOUR TEETH AND MOUTH D WRAY, A WRAY A FAMILY DOCTOR PUBLICATIONS, 2000 pp76, price £3.50 ISBN 1-898205-59-0 In an increasingly better informed, knowledge-orientated world,

patients are now asking more questions than ever before about their health. This is surely to be encouraged as this promotes better preventive health awareness and patient compliance.

Indeed, the United States National Library of Medicine's PubMed (free Medline on the Web) database was launched in 1997 with the specific aim of helping to inform both the general

public as well as the medical professional community. Dentists frequently encounter patients who want to learn more about the treatment they are receiving or are about to receive. This

concise book is ideal to recommend to patients who either always want to know more or who might benefit from reading about ways in which to preserve their teeth and gums.

_'Understanding your teeth and mouth'_ covers most topics that a patient would need to know about from abscesses to xerostomia. The book's authors, David and Alyson Wray use

sensible, clearly understandable language and explain any technical words for the benefit of a lay audience. Additionally, because of its straightforwardness and comprehensiveness, the book

would make excellent background reading for anyone thinking of embarking on a career in dentistry, be it as a dentist, dental hygienist, dental therapist or dental nurse. What is important

also is that this little handbook packs a lot of information into its 76 pages, and means that a patient can understand more of what is going on before it happens, root canal treatment and

periodontology being good examples of this. The reader is not overburdened with too much text, there are many excellent illustrations and it is well indexed. It is published by Family Doctor

Publications in association with the British Medical Association and therefore has a good pedigree. Another major bonus is the low price. At an astonishing £3.50 it is remarkably good value

for money, well within the grasp of most patients and a good read to boot. Pound for pound it must rank as one of the best value books on the market but it is a credible and useful book

irrespective of the price. [BDJ 834A] R. FARBEY PROSTHODONTICS FOR THE ELDERLY – DIAGNOSIS AND TREATMENT E BUDTZ-JØRGENSEN QUINTESSENCE PUBLISHING CO INC, 1999 pp266, price £59, ISBN

0-86715-368-7 The book is clearly laid out and well illustrated, making good use of colour clinical photographs, line drawings, graphs and tables. Its text is well written and readable

making it a volume that can be dipped into as required or read right through. The author takes a logical approach to the subject matter in ten chapters. The first chapter looks at the

epidemiology and dental/prosthetic status of older people who are categorised into three groups for this purpose. These categories – functionally independent, frail and functionally

dependent – continue throughout the book so that most chapters consider the situation and/or treatment for each of these three categories of older people. Chapter 2, 'Age-Related

Changes in the Masticatory Apparatus', considers the evidence and concludes that: 'relatively little is known about the age-related changes of the masticatory apparatus, but the

changes that do occur and are recognised seem to have relatively limited consequences'. The main risk factors are caries and periodontal disease leading to tooth loss, alveolar ridge

resorption, destabilised occlusal conditions and impaired masticatory ability. Additionally, compromised general health is often reflected in poor oral health status caused by poor oral

hygiene, reduced salivary flow rate and general oral discomfort. 'Prosthodontic Treatment Planning' (Chapter 3) takes the commonsense stance of maintaining existing, natural,

functional, tooth contacts for life. The stages involve identifying treatment needs and demands, risk factors, general health, socio-economic aspects and attitudes. This chapter also

considers the long-term effects of prosthetic treatment in terms of failures and complications. It summarises treatment planning recommendations as emergency care; hygiene and maintenance

care; preprosthetic corrective care (which encompasses restorative therapy, orthodontic treatment, preprosthetic surgery and implants); rehabilitative care (treatment with a definitive fixed

or removable prosthesis); and maintenance care. The following chapter looks specifically at treatment planning for the frail or dependent elderly and incorporates the legal and ethical

considerations of treatment; obtaining informed consent; and making clinical decisions in this situation. Chapters 6, 7 and 8 consider the prosthodontic treatment of the partially dentate

elderly person with tooth/implant-supported, fixed prostheses (including treatment of the worn dentition); tooth/ implant-supported, removable partial dentures; and root-supported

overdentures respectively. Only one chapter is dedicated to the treatment of edentulous patient – no doubt a reflection of the changing oral status and treatment needs of elderly people. It

gives a succinct account of diagnosing and dealing with problems of existing dentures (including when to refer to a specialist); providing immediate, new and copy dentures; and implant

supported complete dentures. My only criticism of this chapter is that in recommending modifications to existing dentures, it does not emphasise the point of never carrying out an

irreversible procedure. The whole ethos of the book is underpinned by the prevention of dental disease and the maintenance or restoration of oral health by establishing adequate preventive

measures without excessive therapeutic intervention. This is summarised in the final chapter, 'Preventive Measures and Maintenance After Treatment'. Throughout, the author draws on

the evidence-base of the scientific literature. He manages to combine this with clinical experience (often drawing on case reports) and a practical approach which results in a book which

will be useful to undergraduate and postgraduate dental students, as well as to the busy general dental practitioner. [BDJ 831] J. FISKE RIGHTS AND PERMISSIONS Reprints and permissions ABOUT

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