Dental update
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Endotracheal intubation is widely used in anaesthesia. Although it offers many advantages to the anaesthetic management of patients, this procedure carries the possibility that damage to the teeth may result. Dental damage in fact accounts for one-third of all medicolegal claims against anaesthetists and, although this problem has been widely discussed in anaesthetic circles, few dental articles have addressed the problem.
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The term 'hidden caries' is used to describe a carious lesion seen in dentine on a bitewing radiograph where clinically the occlusal enamel appears sound or only minimally demineralized. The relative rise in the number of clinically sound occlusal surfaces over the past two decades could be a reason why hidden caries has come into sharper focus for practitioners and researchers. ⋯ This underlines the importance of careful examination of the radiograph. It is important that the practitioner appreciates the possibility of hidden caries, and the value of the radiograph in its diagnosis.
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The dental practitioner who has to examine a child who has suffered dental trauma also has to manage the parents, who are often as upset as the patient. This paper, the first in a short series of management of various types of dental trauma, presents the steps necessary to formulate a treatment plan for such patients in a logical, step-by-step sequence.
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Normal haemostasis depends on a balance between coagulation and fibrinolytic processes. Because of this concept of balance between coagulation and fibrinolysis, drugs which retard or inhibit the breakdown of fibrin encourage haemostasis. Such drugs are used in patients undergoing dental extractions and as prophylactic agents to prevent spontaneous bleeding. Blood clotting factors produced by genetic engineering are now becoming available and these offer exciting prospects for the management of patients with bleeding disorders.
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Dentists and other members of the dental team are well placed to advise mothers of young babies about protecting their children's dental health, and there is general agreement that sugar is the "arch criminal of dental caries". However, sugars are present in a surprising range of foods, and it can be difficult to plan a diet to avoid them. This article reports on the sugar content of baby foods and drinks, and makes some policy recommendations.