Background: Over 1% of the UK population have a diagnosis of autism, and yet there is minimal information regarding the experiences of dental professionals working with people on the autistic spectrum. The current study is the first to investigate UK dental professionals' knowledge of autism, their perceived confidence when treating autistic patients, and the factors that affect this. Methods: An online, self-report survey was completed by 482 UK dental professionals and included questions on participants' training, prior experiences and knowledge of autism, and confidence when treating autistic patients.Results: Over half the respondents reported having no formal autism training however average knowledge levels across the whole sample were good. Conversely, levels of confidence were only moderate. Respondents often cited conflict between understanding the additional needs for successful treatment of autistic patients and a lack of resources to implement support strategies. Despite this, the vast majority were positive about making the necessary modifications to support autistic patients.Conclusion: This study highlights ways in which UK dental professionals adapt their practices to meet the needs of their autistic patients, yet report only moderate confidence levels when doing so. Implications for future training initiatives are discussed.

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Periodontal disease and coronary heart disease incidence: a systematic review and meta-analysis.

Objective.-Annually, more than 100,000 US and international military and civilian personnel work in Afghanistan within terrain harboring venomous snakes. Current literature insufficiently supports Afghan antivenom treatment and stocking guidelines. We report the clinical course and treatments for snakebite victims presenting to US military hospitals in Afghanistan.Methods.-All snakebite victims presenting to 3 US military emergency departments between July 2010 and August 2011 in northern and southern Afghanistan were examined via chart review. Case information included patient demographics, snake description, bite details and complications, laboratory results, antivenom use and adverse effects, procedures performed, and hospital course.Results.-Of 17 cases, median patient age was 20 years (interquartile range [IQR], 12-30), 16 were male, and 82% were Afghans. All bites were to an extremity, and median time to care was 2.8 hours (IQR, 2-5.8). On arrival, 8 had tachycardia and none had hypotension or hypoxia. A viper was implicated in 5 cases. Ten cases received at least 1 dose of polyvalent antivenom, most commonly for coagulopathy, without adverse effects. Six received additional antivenom, 6 had an international normalized ratio (INR) 4 10, and none developed delayed coagulopathy. Three received blood transfusions. Hospital stay ranged from 1 to 4 days. None required vasopressors, fasciotomy, or other surgery, and none died. All had resolution of marked coagulopathies and improved swelling and pain on discharge.Conclusions.-We report the largest series of snake envenomations treated by US physicians in Afghanistan. Antivenom was tolerated well with improvement of coagulopathy and symptoms. All patients survived with minimal advanced interventions other than blood transfusion.

Aims Previous international research has shown that autistic people have difficulty accessing dental care due to sensory processing, anxiety and communication issues. However, it is not known whether autistic adults in the United Kingdom are experiencing similar dental care barriers. The current study investigated autistic adults’ dental experiences in the United Kingdom. Methods and results A mixed methods survey was given to self‐selecting autistic (n = 37) and non‐autistic adults (n = 43) to compare whether autistic individuals had more negative experiences than non‐autistic individuals. Closed questions asked about anxiety, patient‐practitioner communication, satisfaction and the dental environment. Open questions asked about autism‐specific dental challenges, what works well at the dentist, and improving autistic individuals’ experiences. Responses were analyzed using thematic analysis. Overall, results demonstrated that autistic adults in the United Kingdom have more negative dental experiences than non‐autistic adults. These predominantly related to interactions with dental practitioners, a challenging sensory environment, anxiety, pain, and disclosure. Participants recommended sensory environment adaptations, ways to increase preparedness, longer appointments, and individual accommodations. Conclusion This study offers best‐practice strategies for working with autistic patients and highlights the importance of dentists working with autistic individuals to maximize the quality of care and outcomes for this underserved population.

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Pandemic COVID-19 has put unprecedented pressure on NHS providers to offer non face-to-face consultation. This study aims to assess acceptability of patients and clinicians towards teleconsultation in oral and maxillofacial surgery compared with an expected face-to-face assessment. 340 telephone clinic patient episodes were surveyed over the initial 7-week period of pandemic-related service restriction. Appointment outcomes from a further 420 telephone consultations were additionally scrutinised. A total of 59.1% of patients expressed a strong preference for teleconsultation with only 13.1% stating a moderate or strong preference for face-to-face assessment. Diagnostic accuracy was highlighted as a concern for both clinicians and patients due to inherent inability to conduct a traditional clinical examination, notable in 43.5% of qualitative comments. Logistical concerns, communications needs and other individual circumstances formed the other emerging themes. The majority of remote consultations (59.5%) were outcomed as requiring further review. A total of 29.3% of patients were discharged. These findings suggest that the increasing use of remote follow-up in carefully selected subgroups can facilitate efficient and acceptable healthcare delivery. Although 'in-person' clinical appointments will continue to be regarded as the default safe and gold standard management modality, OMFS departments should consider significant upscaling of teleconsultation services.