Aim This study's aim was to assess whether the use of Short Message Service (SMS) text reminders sent to patients prior to their dental appointments improved attendance rates for two dentists at a dental access centre in Kirkcaldy, Fife, Scotland. Method Automated SMS text reminders were set up through practice management software at Kirkcaldy Dental Access Centre. Two audits, using a research methodology, were then performed. Failure to attend appointments with the two dentists at 150 consecutive appointments was assessed before and after implementing the SMS text reminders. The null hypothesis that SMS reminders do not improve attendance rates at the dental access centre was tested. The Yates’ corrected chi-square test was applied to the resulting data, with the level for statistical significance set at P<0.05. Results Patients readily accepted the text messages and found them to be non-intrusive. Failed attendance at appointments for the two dentists was reduced from 46/150 (31%) before the SMS text reminders were introduced to 21/150 (14%) after its introduction ( P=0.00088). Thus the use of SMS text reminders resulted in a statistically significant reduction in the number of failed attendances at appointments for the two dentists. Conclusions In this preliminary study, SMS appointment reminders reduced the number of failed appointments significantly. They can provide an automated, non-intrusive, and cost-effective method of improving patient attendance at dental appointments.

Objective: (a) To establish baseline lateral craniofacial morphology and soft tissue profile outcomes for New Zealand children with complete unilateral and complete bilateral cleft lip and palate (CUCLP/CBCLP) and determine differences in relation to demographic characteristics including cleft type, sex and ethnicity and (b) To compare these outcomes to similar international studies. Settings and Sample Population: Nation-wide prospective and retrospective cephalometric analysis of 76 patients with CUCLP and 23 patients with CBCLP presecondary alveolar bone graft.Materials and Methods: Assessment was undertaken by three experienced orthodontists blinded to patient identity. A total of 13 hard tissue and 8 soft tissue landmarks were identified allowing for an assessment of 16 angular, three linear and one ratio variables. Inter-assessor reliability was determined by pre-defined measurement error thresholds. Results:Inter-assessor reliability of cephalometric landmarks restricted reporting to 10 hard tissue, four soft tissue and one ratio variables. CUCLP had greater midface and mandibular retrusion than CBCLP. Females had greater midface and mandibular prominence and smaller nasal projections. The Pacific and Māori groups had more retrusive midfacial profiles, and the Pacific group had more prominent mandibles. A sub-analysis of New Zealand European CUCLP results found they were closely aligned to Eurocleft and Americleft study centres with less favourable outcomes. Conclusions:The reliability of a number of cephalometric measurements was poor.

We select the letters for these pages from the rapid responses posted on bmj.com favouring those received within five days of publication of the article to which they refer. Letters are thus an early selection of rapid responses on a particular topic. Readers should consult the website for the full list of responses and any authors' replies, which usually arrive after our selection. lp woods Candour on unfunded treatments Ignorance is a public health issue Marcus indicates the importance of candour in outlining the choices available to individuals. 1 However, there is also the effect on wider issues of public health and the availability of treatment options from which patients can choose. Unacceptable radiotherapy waiting times have been highlighted by the Royal College of Radiologists for over a decade. 2 They have now started to improve, but the last audit in September 2005 still showed that over half our patients wait longer than one month for curative treatment. What is probably not made clear to patients is the impact that this can have on their prognosis. A systematic review has shown that for breast cancer a wait of longer than eight weeks carries a 60% increase in the risk of local recurrence over five years. 3 For postoperative radiotherapy of head and neck cancer, a delay of six weeks increases the risk of local recurrence 2.6-fold. 3 Worse than this, delay may render patients untreatable. An audit of waiting times in lung cancer patients showed that 20% progressed so that they were unsuitable for radical radiotherapy while on a waiting list. 4 An update in 2007 showed no change. 5 These are serious risks to patients. Our failure to communicate them or to bring them into the public arena has contributed to the current lamentable state of our radiotherapy services. The report of the National Radiotherapy Advisory Group, which is currently with ministers, proposes a plan to tackle these issues.

THE subject of varicose aneurism has been lately SQ fully and ably treated by M. Breschet*, and its pathology has received from him so much patient and acute investigation, that the present state of our knowledge furnishes little which can be added to his history of the disease. A fact, however, has lately come under my observation, which is not adverted to as even possible, either-by M. Breschet, or any preceding writer that I am acquainted with, and which, from its practical importance, seems to me of sufficient moment to be made the subject of a separate communication to the Society.