This paper explores the reasons for multiple caries in children from the viewpoint of clinical practice, namely General Dental Practitioners (GDPs) and their teams, to identify obstacles to reducing inequalities in caries experience. The context of the research is the distribution of dental caries in UK communities where disease prevalence correlates with deprivation and these sub-groups are not attending for dental care on a regular basis. A focus group of dentists, along with individual interviews with dentists and dental support staff were chosen to explore the perceptions of GDPs, Dental Therapists, and Dental Nurses. The content analysis of the data highlighted six main themes. These included sugar, in terms of the amount, availability and the marketing of it; socioeconomic associations with dental caries experience; the dentists’ role; the National Health Service (NHS) dental contract in terms of time-constraints in meeting targets and finally, the management of the child with multiple caries. This research suggests that there are possible barriers to the delivery of equitable care to populations. These include availability and access to GDPs along with the perceptions held by GDPs. Training aimed to develop a targeted behavioural approach towards deprived sub-groups is required in order to avoid unintended social exclusion.

People with dementia commonly experience pain, but it is often unrecognised, unrelieved and remains an underlying issue as the condition progresses. As a result, pain management for people with dementia is inadequate. Community nurses have a fundamental role in the assessment and management of pain and in supporting family carers. This article details the causes and effects of pain in people with dementia, explains the components of a holistic approach to individualised pain assessment, and describes various pharmacological and non-pharmacological interventions that can be used to manage pain in this population.

Background/Objectives: This study aimed to assess whether income was associated with dental caries experience and dental care levels among 12-year-old children in two contrasting economic contexts, Sri Lanka (lower-middle-income) and Wales (high-income), regardless of national income status. Methods: An ecological study design was used with published data. For Sri Lanka, the income parameters used included household income, mean per capita income, and the Gini coefficient. For Wales, the Welsh Index of Multiple Deprivation was used. Dental caries was assessed using the DMFT index and its components (DT, MT, FT), while dental care was assessed using the care index, restorative index, and treatment index. Pearson correlations were used to explore associations between income measures and both caries experience and dental care indices across districts in Sri Lanka and unitary authorities in Wales. Results: The mean DMFT for 12-year-old children was 0.6 in both Sri Lanka and Wales, with caries prevalence of 30.4% and 29.6%, respectively. In Sri Lanka, both mean household income and per capita income showed moderate, statistically significant positive correlations with DMFT (r = 0.47, p = 0.01). Income inequality, measured by the Gini coefficient, was positively associated with caries experience (r = 0.42, p = 0.03). In Wales, higher deprivation (lower income) was moderately associated with increased DMFT, in areas within the 20% (r = 0.54, p < 0.01), 30% (r = 0.53, p < 0.01), and 50% (r = 0.61, p < 0.01) deprived quintiles. The dental care indices showed no clear association with income in either of the countries. Conclusions: Income-related disparities in dental caries were evident in both countries. Prevention strategies should focus on higher-income groups in Sri Lanka and on deprived populations in Wales. However, as this was an ecological study, the results are subject to ecological fallacy and should therefore be interpreted with caution.