Background: Breastfeeding is commonly accepted as the preferred method of infant nutrition for various reasons, both nutritional and emotional. For some who have become parents by adoption, there is a strong desire to induce lactation for adoptive nursing.Methods: Information regarding adoptive nursing was initially obtained for the author's personal experience from searching the internet and speaking with other adoptive mothers. The medical literature was also searched through OVID/MEDLINE using pertinent terms, including induced lactation, adoptive nursing, domperidone, and metoclopramide. Both the American Academy of Family Physicians and the American Academy of Pediatrics have policy statements on breastfeeding that include assisting or encouraging adoptive mothers to induce lactation for adoptive nursing.1,2 That said, there is very little in the medical literature on how to help an adoptive mother in her endeavor to induce lactation. Probably, most physicians and adoptive parents are unaware of this potential opportunity. Many adoptive parents have little notice of placement dates or are adopting older infants who are less likely to want to nurse.Although undoubtedly a small trend, many women are attempting to nurse their adopted babies. Much of what information is available comes from various Internet sources and a few publications. Parents are able to access lactation protocols on the Internet and from other laypersons via Internet groups. These protocols involve using various methods from simply performing nipple stimulation to using multiple medicines and herbs to mimic the physiology necessary to produce milk. MethodsFor this article, the medical literature was reviewed in search of evidence to support currently popular recommendations for inducing lactation. The terms adoptive nursing, induced lactation, metoclopramide, domperidone, galactogogue, fenugreek, and blessed thistle were searched in the databases OVID/ MEDLINE, Micromedex, and Natural Medicines Comprehensive Database. Searches were limited to English language articles. Articles that had to do with medication effects on lactation, placebo-controlled trials or drug-drug comparisons, and reviews of induced lactation cases were reviewed. Articles that were referenced frequently by other sources were also reviewed. Also because of the attention given to domperidone by the US Food and Drug Administration (FDA), specific articles were searched using domperidone or metoclopramide and arrhythmia. There were no large studies and no randomized controlled trials. Most of the objective data were obtained from women already lactating.

This article summarises recently updated guidelines produced by the Clinical Governance Directorate of the British Orthodontic Society through the Clinical Standards Committee of the Faculty of Dental Surgery, Royal College of Surgeons of England (FDSRCS) on the management of unerupted maxillary incisor teeth in children. The maxillary incisor teeth usually erupt in the early mixed dentition but eruption disturbances can occur and are often attributable to local factors. A failure of eruption will affect the developing occlusion and potentially influence psychological development of the child. The general principles of management for delayed eruption or impaction of these teeth is to ensure that adequate space exists in the dental arch and to remove any obstruction to eruption. Consideration should also be given to further promoting eruption through surgical exposure of the incisor, with or without subsequent orthodontic traction. A number of factors influence the decision-making process, including patient age, medical history, potential compliance, aetiology and position of the unerupted incisor. Treatment planning should be complemented by careful clinical assessment and the use of appropriate special investigations. To optimise the treatment outcome a multidisciplinary specialist approach is recommended.

In our patient cohort the risk of developing a BRONJ following dental extractions was greatest in those patients receiving IV BPs and those on oral BPs with concomitant steroid medication.

Addresses the evolving advice and guidance from leading government dental bodies affecting the profession. Provides a working example for setting up and developing an urgent dental care centre. Discusses the current and future challenges likely to face the profession amid this international crisis.

Isolated bilateral macrodontia of the mandibular second premolars is a rare condition. We believe that the case reported here is the first in which isolated bilateral macrodontia of the mandibular second premolars presents with numerous dental anomalies affecting other teeth. A 14-year-old boy was referred to the Paediatric Dental Department of King’s College Hospital with a partially erupted mandibular left second premolar. Clinical and radiographic examination subsequently revealed macrodontia of both mandibular second premolar teeth and multiple other dental anomalies. This report discusses the presentation and multidisciplinary management of this case. Clinical relevance: This case report describes an already rare condition made even more extraordinary owing to its presentation with multiple other dental anomalies.