Dental update
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The general features of the movement disorders are outlined and the effects of inhalational sedation with nitrous oxide and oxygen and intravenous sedation, using midazolam, are described.Two case reports of patients with cerebral palsy treated in a community care setting are presented, and the advantages of intravenous and inhalational sedation are explained. ⋯ Inhalational sedation (IS) with nitrous oxide and intravenous sedation (IVS) with midazolam can be useful aids to reduce unwanted movements in patients with movement disorders during dental treatment.
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Correct diagnosis is the key to managing facial pain of non-dental origin. Acute and chronic facial pain must be differentiated and it is widely accepted that chronic pain refers to pain of 3 months or greater duration. Differentiating the many causes of facial pain can be difficult for busy practitioners, but a logical approach can be beneficial and lead to more rapid diagnoses with effective management. Confirming a diagnosis involves a process of history-taking, clinical examination, appropriate investigations and, at times, response to various therapies. ⋯ Although primary care clinicians would not be expected to diagnose rare pain conditions, such as trigeminal autonomic cephalalgias, they should be able to assess the presenting pain complaint to such an extent that, if required, an appropriate referral to secondary or tertiary care can be expedited. The underlying causes of pain of non-dental origin can be complex and management of pain often requires a multidisciplinary approach.