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Oral Medicine

How do I manage the patient with aphthous ulcers?

This Urgent Care Scenario (USC) is presented by the JCDA Oasis Team in collaboration with Dr. David Clark. The USC is also available through the Oasis Help system Dr. David Clark is clinical director of dental services at Ontario Shores Centre for Mental Health Sciences and associate in clinical dentistry with the department of oral medicine, faculty of dentistry, University of Toronto Aphthous Ulcers (a.k.a aphthous stomatitis, canker sores) Presentation Population Typical onset in childhood or early adulthood Women affected more often than men Signs Minor aphthous ulcerations (Fig. 1) Approx. % of cases: 80% Shape and dimensions: round to ovoid ulcers no ...

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How do I manage a patient with angular cheilitis?

This Urgent care Scenario is presented by the JCDA Oasis Team in collaboration with Drs. Eric Stoopler, Christine Nadeau, and Thomas P. Sollecito. It is also available through the Oasis Help system Dr. Eric Stoopler is Associate Professor of Oral Medicine and Director of the Postdoctoral Oral Medicine Program at the University of Pennsylvania School of Dental Medicine Dr. Thomas Sollecito is Professor and Chair of the Faculty of Oral medicine at the University of Pennsylvania Dr. Christine Nadeau is a dental medicine post-graduate student in Oral Biology at the University of Pennsylvania Inflammation of the angles of the mouth, ...

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Could Botulinum Toxin A be a treatment for trigeminal neuralgia and temporomandibular joint dysfunction?

This summary is based on the Rapid Response Report developed by the Canadian Agency for Drugs and Technologies in Health: Botulinum Toxin A for the treatment of trigeminal neuralgia and temporomandibular joint dysfunction: a review of the clinical effectiveness Full Report (PDF) CONTEXT Temporomandibular joint dysfunction (TMD) is a musculoskeletal and rheumatologic disorder of the temporomandibular joint, which may result in jaw deformities, malocclusion, inflammation, and compression of the bilaminar tissue, with pain and dysfunction being the most prominent clinical features. Trigeminal neuralgia (TN) is a disorder caused by proximal compression of trigeminal nerve root, which may bring about electric shock-like pain ...

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How Effective Is the Neuromuscular Occlusion Approach in diagnosing and treating TMD?

This summary is based on the Rapid Response Report developed by the Canadian Agency for Drugs and Technologies in Health:  Neuromuscular Occlusion Concept-based Diagnosis and Treatment of Tempromandibular Joint Disorders: A Review of the Clinical Evidence  Full Report (PDF) Key Messages Diagnosing TMD: The use of electromyograms (EMG) is not supported by evidence. There is insufficient evidence to determine the diagnostic value of kinesiography. Treating TMD: Electrical stimulation is not supported by evidence. The efficacy of occlusal splints is uncertain. Context Temporomandibular disorder (TMD) is a group of clinical problems involving the chewing muscles, the temporomandibular joint (TMJ), and related structures. Symptoms may ...

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Burning Mouth Syndrome (BMS): what should you know?

This Dental Urgent Care Scenario (USC) is adapted and presented by the JCDAOASIS team in collaboration with Dr. Deepika Chugh and Dr. David Mock You can find the full USC on JCDAOasis Mobile Context Burning Mouth Syndrome (BMS) is an idiopathic burning sensation of the oral mucosa with no apparent underlying cause. Although the origin of the condition is unknown, there is possible evidence of a neuropathic basis. BMS is most found in middle-aged and elderly people, predominantly in perimenopausal and postmenopausal women. Signs & Symptoms Usually, onset is spontaneous, but previous trauma or dental treatment may be precipitating factors Most commonly ...

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Recurrent Herpes Simplex: What Are the Possible Interventions?

This short consult is presented by Dr. Eric Stoopler, DMD; Dr. Arthur Kuperstein, DDS; and Dr. Thomas Sollecito, DMD Peer-reviewed content that appeared in the JCDA OASIS “point of care” searchable database at www.jcdaoasis.ca and in the sixth edition of the print JCDA. Primary and recurrent infection with herpes simplex virus (HSV-1 and HSV-2) can cause oral and/or genital lesions, although the majority of oral infections are caused by HSV-1. Symptomatic vesicles/ulcers of the oral mucosal tissues generally follow the onset of systemic symptoms and are often accompanied by significant erythema of the gingival tissues (i.e., “primary herpetic gingivostomatitis”). Treatment of primary HSV infections ...

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Should Aspirin therapy be stopped for Routine dental procedures?

From Dr. Cesare Ciavarro, Coronation Dental Specialty Group Dental patients often present while being treated with different forms of anticoagulation therapy, among which Aspirin remains one of the most commonly encountered drugs. Aspirin, or Acetylsalicylic Acid (ASA), works as a cyclo-oxygenase inhibitor, thereby blocking prostaglandin and thromboxane production and ultimately preventing  platelets from aggregating (1, 2).     Besides its anti-inflammatory and analgesic features, this drug can also be used alone or in combination with other anticoagulants to prevent unwanted thrombi, thereby diminishing Cerebrovascular and/or Cardiovascular embolic events.  (3, 4) Nonetheless, there are still many questions regarding the potential bleeding hazards associated with ...

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What is the most effective antibiotic therapy for an acute odontogenic infection?

(Content under development) The following question was submitted by a practising dentist: What is the most effective antibiotic therapy for an acute odontogenic infection? If you ask the oral surgeons they say doxycycline , when you ask the infectious disease specialists they say amoxicillin. In the literature some papers state clindamycin and then others the combination of flagyl. JCDA Editorial Consultant Dr. Mark Donaldson of Kalispell, Montana provided this initial response for consideration: The correct antibiotic is the one that works! If we remember that the basic tenet of infectious diseases is to match the right drug to the right ...

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