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The suspension of routine dental care to save lives will lead to the closure of many dental practices due to substantial financial impact. The return to routine care will be slow, with prioritisation of non-aerosol generating procedures while we look to further understand methods to mitigate transmission risk via infected aerosol and spatter. Inevitably, the cost of personal protective equipment and the lower volume of patients pose a continued threat to businesses.Introduction and context This paper describes how research and evidence influenced Welsh Government policy to fund a programme (Gwên am Byth - A Lasting Smile) with the aim of improving the oral health of older people living in care homes. It describes how collaborative multi-agency working supported development and delivery of the programme. The context was policy in Wales. This included the Welsh Government response to the public inquiry into Mid Staffordshire NHS Foundation Trust, the report into care homes by the Older People's Commissioner for Wales, and the Welsh Government Health and Care Standards for Wales which include a standard relating to oral health. The aim was to introduce a programme, Gwên am Byth, to support 'oral hygiene and mouth care for older people living in care homes through the development of a consistent all-Wales approach'; this aligns with contemporaneous NICE guidelines.Materials and methods Recurrent Welsh Government funding was identified to support a community dental service (as been positive feedback from care home staff, residents, carers and CDS staff, although barriers to delivery remain.Discussion This paper describes programme delivery in the four years since Gwên am Byth began. The drivers for change are described and the need to influence Welsh Government policy decisions when funding was available. The authors discuss issues which can impact on the pace of change, and ways in which health and care staff can effectively work together to implement improvements.Conclusions Starting with a blank page, a national programme has been established with the aim of improving the oral health of older people living in care homes in Wales. The paper describes the lessons learnt in implementing the programme and notes that Welsh Government has recognised the value of Gwên am Byth by committing to double the recurrent programme funding.Background Antimicrobial resistance is a growing concern globally. It has previously been demonstrated that antibiotic prescribing for dental implants within the UK is varied with an apparent lack of guidance. This study aimed to establish current use of antibiotic prophylaxis during dental implant placements in the UK.Method An anonymous validated online questionnaire was distributed to members of the BAOS, BSSPD, BSP, ADI and ITI. Data were then collated and analysed.Results Two hundred and twenty-nine responses were received during April-July 2018. Fifty-five percent of dentists routinely prescribed antibiotics during implant placements. One-third did sometimes, but not routinely. Thirteen percent never prescribed. Reported protocols contained 61 different drug/dose combinations given over 124 different regimens. Tinengotinib order Those who prescribed routinely had significantly higher levels of training/qualification (P = 0.008), placed more implants (P = 0.014) and undertook more complex placements (P = 0.002) than non-prescribers. Seventy-three percent believed antibiotics decrease post-operative infection. One in ten felt they gave no benefit. Half believed they decrease implant failure. Over 90% would like national guidelines.Conclusion Significant variance in practice is clear. Almost half of practitioners did not routinely prescribe. Those who did were significantly more experienced, highly trained and did more complex placements. There was a difference between practitioners' perceived benefits of antibiotic prophylaxis and the evidence in the literature. There was a great desire for clearer guidance.Local anaesthesia forms the backbone of pain control techniques in dentistry and has a major role in dentistry for children and adults alike. Dental anxiety is still prevalent among children, causing delays in seeking dental care and leading to increased rates in childhood caries, resulting in increased hospital admissions for dental care under general anaesthesia. There is a constant search for more comfortable means of achieving local anaesthesia to provide a more positive experience for paediatric patients when seeking dental treatment. This article aims to provide an overview of local anaesthetic techniques used in paediatric dentistry, as well as methods utilised to make local anaesthetic administration more comfortable and how to increase acceptability.This case report describes the conservative management of generalised tetracycline stains by means of the injectable composite resin technique. This time-efficient technique obtained optimal and satisfactory aesthetic outcomes. Both the patient and the clinician were very satisfied with the results. Composite veneers realised with injected flowable resin composites are an effective treatment, with minimally invasive possibilities, providing the case selection protocol is correct. In addition, it can be considered as a more economical treatment option.The oral ecosystem is shaped by complex interactions between systemic health disease and the resident oral microbiota. Research in the last two decades has produced datasets describing the genetics and physiology of the host and the oral microbiome in health and disease. There are inter-individual differences in the ability to tolerate oral disease-promoting challenges. Identification of the key factors that drive a healthy and resilient oral ecosystem is urgently needed. So far, progress is being made towards replicating the host-microbiota interplay in vitro. Clinical studies may shed light on the mechanisms of oral health resilience. However, most clinical studies are cross-sectional and are insufficient for understanding resilience or for identifying biomarkers that correlate with the point of transition from oral health to dysbiosis. Mathematical and computational models, including artificial intelligence approaches, offer an opportunity to inform the design of clinical studies by identifying key biomarkers and interaction networks in complex datasets and predicting important parameters.