General dentistry
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The general dentist can play an important role in the recognition and initial diagnosis of patients with obstructive sleep apnea syndrome. Obstructive sleep apnea is defined as the repetitive airway obstruction during sleep due to the collapse of the pharyngeal airway potentially causing cessation of breathing. Although many Americans suffer from symptoms of sleep apnea syndrome, most remain undiagnosed until significant problems occur, such as cardiopulmonary and neurologic dysfunction. ⋯ Both medical and dental practitioners have become increasingly aware of sleep apnea. Early detection of this condition by the dental practitioner can lead to the prevention of comorbid diseases and improved quality of life for many patients. This article will provide a greater understanding of the pathophysiology, diagnosis, indications, risks, and benefits of treatments available so that dental practitioners can make better treatment recommendations.
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This study sought to identify and quantify complications with local anesthetic administration and reversal on consecutive patients seen for comprehensive dental care in a school-based, portable dental clinic, and includes data on the patients seen by the participating portable dental providers. In 923 dental visits where local anesthetic was administered, a standardized form was used to gain further information and identify any complications; this was accompanied by a questionnaire for the student's teacher, in order to quantify the student's distraction and disruption ratings following the dental visit. After statistical analysis of the 923 consecutive cases, the overall complication rate was 5.3%. ⋯ Whereas safe administration of dental care is achievable with or without phentolamine mesylate as a local anesthetic reversal agent, its use was determined to improve safety outcomes. Three factors appeared to directly increase the incidence of complications: the administration of an inferior alveolar nerve block, attention deficit disorder, and obesity. Teacher evaluations demonstrated that children receiving care by a portable dental team were able to reorient back to classwork and were not disruptive to classmates.