General dentistry
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Inter-examiner reliability of physical assessment methods for assessing temporomandibular disorders.
The purpose of this study was to evaluate whether non-expert examiners could reliably use the physical assessment methods described in the Research Diagnostic Criteria for temporomandibular disorders (RDC/TMD). Screening examinations were performed on patients with self-reported TMD symptoms by two examiners using techniques specified in Axis I of RDC/TMD diagnostic criteria. ⋯ Concordance for diagnostic signs was good for determining opening click, closing click, and coarse crepitus, while concordance for determining protrusive click and joint space pain categories was poor. Using the examination and diagnosis procedures specified in the RDC/TMD, conscientious nonexpert examiners can assign diagnostic labels to the major subcategories of TMD with a satisfactory level of reliability.
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The general dentist's ability to perform an anesthesia block of the temporomandibular joint (TMJ) can be very beneficial, especially when trying to diagnose or treat patients with temporomandibular dysfunction who have joint and/or muscle pain. There are three common types of internal joint disorders--orthopedic, inflammatory, and degenerative--producing pain in the ligaments, TMJ capsule, or retrodiscal tissues. ⋯ Dentists providing care for these individuals may need to schedule longer appointments and deal with mid-treatment facial or TMJ pain as well as more postoperative discomfort. An anesthesia block for the TMJ can reduce pain and protective muscle splinting, increase the mandibular range of motion, and assist in providing a more manageable treatment.
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This literature review evaluates the significance of dental injuries and their relationship to specific sports activities. Many studies have been published on individual sports or groups of sports but most pertain to specific age groups or levels of competition. Research suggests that many sports that do not require mouthguards should encourage male and female participants to use orofacial protectors. ⋯ Any sport where the potential for dental trauma can exist (such as basketball, soccer, or wrestling) should consider utilizing mouthguards to protect the competitors. The establishment of mouthguard programs for athletes of all ages, genders, and sports may help to reduce the incidence of dental trauma. A sports-related, orofacial/dental trauma reporting system is considered.
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The dentist is integral to managing care for patients with head and neck cancer. Oral complications may manifest during and/or following radiation therapy and can last for the lifetime of the individual. This article reviews a number of these complications as well as the resources available to dentists for managing care of radiation oncology patients and improving their quality of life.