Paul Ashley

Paul Ashley

Paediatric Dentist working at the UCL Eastman

Location London, UK


  • Yes - and the other concern with the 3 week delay is whether or not the parent is acting in the childs best interest. Could they be neglecting any other aspects of their health, schooling etc etc

  • To get a certificate you need to pay for the course

  • Well for that you should probably consider our MSc. However we are probably going to set-up a different course for dentists who want to know how to look out for orthodontic problems and when to refer

  • Yes - there is some evidence to suggest dentists are more nervous about it than children are!

  • do you mean pulpotomy/pulpectomy for primary teeth? Or permanent

  • Yes - I like to give them the mirror to hold whilst I put on my gloves etc

  • Agree - but I wouldn't overestimate the impact of fluoride release from GICs

  • I guess it depends on what you see? So if there is obvious contamination with soil or something you really want to get that out. But I would still start with rinsing.

  • Perfect

  • It should be somewhere - let me check

  • Yes - that's why I prefer the term primary teeth, rather than deciduous teeth

  • No agree - you might even go straight for the extraction. But better to start off small if you can

  • Of course - but changing behaviour is really difficult to do

  • Definitely

  • so diet and toothbrushing advice are definitely important. But fluoride advice is the big one - make sure you do that first

  • It's a tricky one because fluoride is important. I think it's probably best if you can convince them to use it. If not then you I guess you throw everything else at them - tooth mousse, hydroxyapatite toothpastes, fissure sealants etc etc

  • Sterile saline or sterile water

  • It's tricky to make a denture for a three year old and you need to ask yourself who you are making it for. Is it the child or the parents! I find it hard to believe that a three year old would be bullied meaningfully by their peers

  • I think that with the new IADT guidelines they are keen for you to get the tooth back in the mouth as soon as possible. So maybe reimplant first and then do the endo

  • Always a difficult problem to manage. Do you leap in with something difficult eg extraction? Or do you try and build cooperation by doing something simpler. I think it depends very much case by case. If the pain is manageable I prefer to usually try and build up cooperation

  • Yes this has always interested me. I agree that the evidence for sealing primary molars is not as good as for permanent molars.

  • I don't think anyone knows really. We tend to just place SDF and not put anything else on top

  • That is definitely a viable option

  • So in terms of caries really the most important thing we can do is to make sure they are using a fluoride toothpaste

  • we tend to use duraphat but I'm not sure it's better or worse than anything else

  • If the seal is good yes - modern concepts of caries removal are moving towards this approach

  • You can put a crown on using the Hall technique

  • If they follow it!

  • There is (potassium nitrate I think?). Doesn't seem to work for me

  • What like a consent? There are examples on the BSPD website if you would like to do that

  • Futurelearn handles all of this - I think if you want a certificate you need to pay

  • It was probably already non-vital. Did you have a pre-op radiograph?

  • So antibiotic requirement is as dictated by the IADT guidelines. Yes - tetanus is their GP

  • NHS. I think 4-6 months?

  • In the UK it's from 10

  • I'm not aware of SSCs causing pulp inflammation

  • I think that's no longer recommended

  • Actually I think soaking in fluoride has been removed from the guidelines now

  • Oranurse

  • Hi - when I've looked at it I wasn't convinced by the evidence so we don't tend to bother with the KI

  • Hello Hangama - I am sorry the video doesn't work. Unfortunately I think this is probably a problem with your computer or connection, I am not aware of problems with other users. Is it just the one video or all of them?

  • Interesting point re the ceiling picture. Yes - chatty nurse is very helpful!

  • I don't think it makes any difference and not aware of any evidence