Dental update
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The removal of mandibular third molars can be complicated by injury to the inferior alveolar nerve (IAN). Coronectomy retains the tooth root; this method has been found to be preferable to extraction in the context of mandibular third molars. A failed coronectomy may cause mobilization of these roots, thereby requiring a subsequent extraction. ⋯ Longer studies need to be conducted to evaluate the long term benefits of coronectomy. CPD/CLINICAL RELEVANCE: The removal of mandibular third molars can be complicated by the presence of the close lying inferior alveolar nerve. Coronectomy can be useful in this setting and therefore it is important to be aware of the pros and cons of this technique.
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Acute trigeminal pain is a common presentation in the dental surgery, with a reported 22% of the US adult population experiencing orofacial pain more than once during a 6-month period. This article discusses the mechanisms underlying the pain experience, diagnosis and subsequent management of acute trigeminal pain, encompassing pre-, peri- and post-operative analgesia. The dental team spend most of their working lives managing patients and acute pain. ⋯ Prevention and managing intra-operative and post-surgical pain are implicit in providing your patient with optimum care. CPD/CLINICAL RELEVANCE: This paper aims to provide an overview of conditions that may present with acute orofacial pain and their management using the most recent evidence base. Intra-operative and post-surgical pain management are also scrutinized and evidence based treatment is recommended.
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Review
Paediatric dentistry in the new millennium: 3. Use of inhalation sedation in paediatric dentistry.
Provision of General Anaesthesia is now limited and restricted to the hospital setting. Sedation for paediatric patients is an essential tool in anxiety management and is used as an adjunct to behaviour management. Inhalation sedation with nitrous oxide/oxygen sedation to reach a plane of relative analgesia may be administered easily and safely to children in general dental practice and is a potential alternative to general anaesthesia.
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The General Dental Council guidelines regarding the use of general anaesthesia in general practice have changed; inhalation sedation with nitrous oxide has been shown as a safe alternative to general anaesthesia for many patients and is a technique particularly suited to the practice environment.
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Mouth ulcers are one of the most common oral complaints. The term ulcer is used usually where there is damage to both epithelium and lamina propria, and a crater, sometimes made more obvious clinically by swelling caused by oedema or proliferation in the surrounding tissue. The term erosion is usually used where the damage is somewhat more superficial. ⋯ Some are caused by aphthae or malignant neoplasms, and a few have aetiology in obvious systemic disease. Ulcers of local cause, drugs, aphthous ulcers, Behcet's syndrome and malignant ulcers are discussed in this article. The next two articles discuss the ulcers due to systemic disease including disorders of the blood, gastrointestinal disorders, skin diseases, connective tissue disease and infective diseases.