Journal of the California Dental Association
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Analgesics most commonly prescribed in dentistry for acute pain relief include the nonsteroidal anti-inflammatory drug, acetaminophen, and various opioid-containing analgesic combinations. The NSAIDs and presumably acetaminophen act by inhibiting cyclooxgenase enzymes responsible for the formation of prostaglandins that promote pain and inflammation. Opioids such as codeine, hydrocodone, and oxycodone stimulate endogenous opioid receptors to bring about analgesic and other effects. ⋯ If an NSAID cannot be prescribed because of patient intolerance, analgesic preparations that combine effective doses of an orally active opioid with 600 to 1,000 mg of acetaminophen are preferred in the healthy adult. On occasion, prescribing both an NSAID and an acetaminophen-opioid combination may be helpful in patients not responding to a single product. In all cases, however, the primary analgesic should be taken on a fixed schedule, not on a "prn" (or as needed) basis, which only guarantees the patient will experience pain.
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Problem-based learning provides a mechanism for learning in a manner that most closely simulates the future practice environment. PBL was initiated in medical education in the 1960s, and two-thirds of U. ⋯ The University of Southern California School of Dentistry has moved to the PBL model to give its dental students the knowledge base required to meet accreditation standards and to prepare them to be beginning general practitioners. This article explains how USC uses PBL in its dental curriculum.
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The clinical management of cumulative trauma disorder is based upon the identification and treatment of individual component pathologies and, frequently, referral to a knowledgeable occupational therapist with an understanding of ergonomic behavioral, postural, and workspace modification. Most commonly these individual pathologic entities are carpal tunnel syndrome, cubital tunnel syndrome, trigger finger, and De Quervain's tenosynovitis. In this article, the anatomy, diagnosis, and treatment of each of these disorders will be considered separately. In addition, since these clinical entities are often use-related, special attention should be directed toward biomechanical and ergonomic considerations.