General dentistry
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Anticipated demographic changes in the U. S. during the next 20 years will bring increasing numbers of geriatric patients into dental practices. ⋯ Dental practitioners must stay informed concerning newly marketed drugs and those commonly prescribed to geriatric patients, and the potential dental implications of those drugs. Specialized training in geriatric dentistry, continuing education, and consultation with medical and pharmacy practitioners can provide valuable tools for managing this special patient population.
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This assessment sought to identify and quantify complications that occur with anesthesia administration during dental treatment of consecutive patients who received care through the University of Pittsburgh School of Dental Medicine's (UPSDM) Department of Anesthesiology. This prospective study was completed by participating anesthesia caregivers at the UPSDM as a case-by-case evaluation. A standardized form delineating possible complications was used to collect data following 286 consecutive outpatient anesthetic cases administered within the UPSDM. ⋯ The complications encountered most frequently were airway obstruction (18 reports) and occurrence of nausea/vomiting (12 reports). ASA classification, anesthetic technique, pre-existing medical findings, and the type of dental procedure performed all were variables that were found to affect the incidence of anesthesia-related complications. The overall complication rate from anesthesia administered during dental care is similar to or less than that reported within the hospital operating system environment.
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New epidemiologic evidence suggests that referred craniofacial pain in coronary heart disease is more common than previously believed. Current medical reports suggest that in addition to coronary disease, thoracic disorders such as aortic dissection, pericarditis, and lung cancer can cause referred craniofacial pain. Recent physiologic evidence from animals and humans suggests that the vagus nerve mediates this referral of cardiac pain to the maxillofacial region. This article discusses the critical role of the dentist in patient education and recognition of referred head and neck pain in thoracic disease, in relation to the need for prompt medical treatment for these life-threatening conditions.
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This study considered 120 cases of localized gingival overgrowths that had been clinically diagnosed, surgically excised, and submitted for histopathological examination from 2000 to 2006. Data regarding the patient's age and gender and the lesion's anatomical location, clinical diagnosis, and recurrence were retrieved from case records. The percentage of concurrence and discrepancy between clinical and histopathological diagnosis was calculated using a discrepancy index. ⋯ The diagnosis of peripheral giant cell granuloma showed a high discrepancy (88.89%). Recurrence was seen in five cases. The high discrepancy between the clinical and histopathological diagnosis of localized gingival overgrowths indicates the need for a confirmatory histological examination for diagnosis and complete management of the lesion.
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Herpes zoster (HZ, also known as shingles) is caused by the reactivation of a dormant varicella zoster virus and can be a source of significant morbidity. Oral manifestations can include vesicular eruptions of the mucosa, osteonecrosis with tooth loss, and postherpetic neuralgia (PHN). This article discusses treatment for trigeminal nerve involvement with herpes zoster, as well as for the painful syndrome PHN.