BACKGROUND: This study aims to describe the Libyan oral health care system in terms of its structure, function, workforce, funding, reimbursement and target groups.
METHODS: A single descriptive case study approach and multiple sources of data collection were used to provide an in-depth understanding of the Libyan oral health care system. A purposeful sample of the key informants (Managers of oral health centers, dentists of various specialties with experience in the field, dentists, nurses, dental technicians, and officials in the affairs of medical insurance) was recruited. The case and its boundaries were guided by the study\'s aim. Both qualitative and quantitative analyses were conducted. Descriptive statistics were used for quantitative data. Framework analysis, informed by the study objectives, was used to analyze interviews and documents.
RESULTS: The analysis showed that oral health services are integrated into medical services. The provision of dental care is mainly treatment-based, in the private sector. The oral health services in the public sector are mainly emergency care and exodontia. The dental workforce included in the study were mostly dentists (89% General Dental Practitioners (GDPs), 11% specialists), with a marked deficiency in dental technicians and nurses. Around 40% of dentists work in both the private and public sectors. The government provides the funding for the public sector, but the private sector is self-funded. No specific target group(s) nor clear policies were reported. However, the system is built around primary health care as an overarching policy. Dental caries is the most common oral problem among Libyan preschool children affecting around 70% and is the most common cause of tooth loss among adults.
CONCLUSIONS: The oral health care system in Libya is mainly privatized. The public health services are poorly organized and malfunctioning. There is an urgent need to develop policies and plans to improve the oral health care system in Libya.

BACKGROUND: The American Dental Association\'s (ADA) specialty recognition process has long been the gold standard in dentistry. Specialty advertising regulations have been challenged as inconsistent with commercial speech rights of dentists wishing to advertise as specialists in areas not recognized as ADA specialties. Commission of Dental Accreditation-approved postdoctoral education exists to support this process using standard-based education, continuous quality review and accountability.
OBJECTIVE: In 2017, a federal court declared Texas dental specialty advertising rules unconstitutional noting the state did not present evidence demonstrating the public was being misled. A state dental association commissioned a professional survey to assess state residents\' understanding of the term \"specialist\" in dental advertising.
METHODS: Telephone interviews conducted with 812, 18+-year-old Ohio residents focused on advertising related to dental implants and TMJ disorders (not recognized specialties) and orthodontics and oral surgery (recognized specialties).
RESULTS: Respondents indicated they would be inclined to think a dentist who advertised as a specialist had completed an accredited dental residency program and was more qualified to perform specialty care than a general dentist. Respondents also indicated that they would be less likely to choose a dentist who advertised as a specialist who did not have accredited residency training.
CONCLUSIONS: Tying specialty status to completion of a residency program accredited by an agency recognized by the U.S. Department of Education is important to the public\'s expectations and has implications for dental education.

BACKGROUND: Access to health services is a right for every individual. However, there is evidence that people with disabilities face barriers in accessing dental health. One of the reasons associated with this is the unclear referral pathway existing in the Irish dental health service. The appropriate assignment of patients to relevant services is an important issue to ensure better access to healthcare. This is all the more pertinent because there are only a few trained dental practitioners to provide dental treatment for people with disabilities, as well as even fewer qualified specialists in special care dentistry.
OBJECTIVE: The aim of this part of the study was to assess the use of the BDA Case Mix Model to determine the need for referral of patients to specialist dental services, and to determine any association between patient complexity and the need for adjunct measures, such as sedation and general anaesthesia for the management of people with disabilities and complex needs.
METHODS: A retrospective analysis of dental records using the BDA Case Mix Model.Results The results showed that patients with different levels of complexities were being referred to the special care dentistry clinic at the Dublin Dental University Hospital. The results also showed that the need for supportive adjunct measures such as sedation and general anaesthesia was not necessarily the main reason for referring patients to specialist services. The assessment with the BDA Case Mix Model was comprehensive as it looked at many factors contributing to the cases\' complexity. Not all categories in the Case Mix Model had significant association with the need for an adjunct.Conclusion The BDA Case Mix Model can be used to measure the need for supportive adjunct measures, such as sedation and general anaesthesia.

OBJECTIVE: To evaluate, in a case series, survival rate and complications of Brånemark Integration BioHelix(™) dental implants, placed according to conventional procedures in patients treated consecutively in a Swedish specialist private practice after 5 years.
METHODS: Eighty-three consecutively-treated patients received 89 final fixed prostheses supported by 310 implants placed according to \'conventional\' procedure, i.e. no implants shorter than 10 mm, no immediate post-extraction implants and no bone-grafting procedures. In 70 patients, implants were left to heal submerged, whereas 13 patients were treated according to the one-stage protocol. All implants were incorporated in a prosthetic restoration. Probing was only performed when clinical signs of inflammation were present and this was then evaluated further with intra-oral radiographic examination. Outcome measures were implant survival and prosthetic complications.
RESULTS: Five years after implant placement, two fixtures were removed because of loosening. One fixture was lost after 12 months in the lower jaw in one patient and one fixture was lost in the upper jaw in another patient after 3 years, both inserted using the two-stage technique. No other prosthetic complications occurred, giving a 99.3% cumulative survival rate.
CONCLUSIONS: Brånemark Integration BioHelix(™) dental implants placed according to one- or two-stage procedures in patients in a private practice produced excellent 5-year results. Randomized clinical trials with suitable controls are suggested to confirm these results.

There are international grumbles from those perturbed by an impending identity crisis within oral and maxillofacial surgery (OMFS). This unrest is further compounded by scattered suggestions that a name change may prove beneficial in raising the profile of OMFS. The purpose of this paper is to consider novel methods of increasing awareness of the specialty amongst the public, primary and secondary care colleagues by collecting a consensus of thoughts and opinions regarding the specialty\'s identity and the appropriate and holistic nomenclature of OMFS. Approximately 300 eight-point questionnaires were distributed internationally with a response rate, via both email and post, of approximately 25% (72). Thirty-two percent of respondents considered there to be an identity crisis within OMFS although just 18% felt that a specialty name change would be beneficial. The results suggest that the problem with identity relates more to incapacity to convey the message of OMFS rather than nomenclature.

Several specialists can co-operate in the treatment of patients with missing teeth. Orthodontists can succesfully improve the clinical possibilities for the construction of implants or fixed partial dentures, teenagers or young adults. In some of the cases orthodontic treatment can eliminate the use of implants or partial dentures.

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