The Journal of the American Dental Association
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Probably the most common procedure in dentistry is the administration of local anesthetic, or LA. Immediate complications of LA administration include positive blood aspiration, blanching of the tissue and burning sensation on impingement of the nerve. Because studies about the immediate complications of LA administration were conducted before 1980, more recent data regarding this procedure are needed. ⋯ LA is a safe procedure when the appropriate technique is used. It is even safer when an inferior alveolar nerve block is administered.
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Basal cell carcinoma, or BCC, is a malignant epithelial tumor of the skin, commonly seen in the head and neck. Because dentists routinely evaluate the head and neck, the authors present three examples of BCC of the face and jaw to help clinicians recognize the condition. They also provide a literature review regarding BCC's etiology, classification, treatment and prevention. ⋯ Oral health care providers may play an important role in the recognition and diagnosis of BCC involving the head and neck. Early recognition and diagnosis may lead to management that results in improved cure rates, with reduced morbidity and reduced treatment costs.
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Comparative Study
Dental unit waterlines: biofilms, disinfection and recurrence.
Transmission of microbial pathogens to patients from biofilm within dental unit waterlines, or DUWLs, is a concern. To reduce the risk of toxicity to dental patients when water coolants are used, numerous chemical agents have been tested. In a series of trials, the authors investigated the recurrence of microbial growth after treating DUWLs with sodium hypochlorite (bleach), or B; glutaraldehyde, or G; or isopropanol 15.3 percent, or I. ⋯ The residual effect of these agents raises concerns about the slow release of potentially toxic substances from the residual biofilm matrix. These agents reduce microorganisms in effluent water but do little to destroy the biofilm matrix in the DUWL, even with periodic treatments. Bacterial populations in the dental unit water rapidly recolonize the DUWL. Chemical agents or agents that potentially could be trapped in the matrix can represent an additional risk to the patient.
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New guidelines for the management of patients at risk of developing hypertension and associated conditions have recently been published. These guidelines include a new risk stratification and blood pressure classification, as well as an altered approach to drug therapy. This article describes the major changes from previous recommendations, highlights the role of oral health care providers and emphasizes the dental implications of caring for patients with blood pressure conditions.