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Medically Compromised Patients

How effective are non-pharmacological interventions in the relief of dry mouth?

This summary is based on the review published in the Cochrane database of systematic reviews: Interventions for the management of dry mouth: non-pharmacological interventions (September 2013) Furness S, Bryan G, McMillan R, Birchenough S, Worthington HV     Context Xerostomia is the subjective sensation of dry mouth. Common causes of xerostomia include adverse effects of many commonly prescribed medications, disease (e.g. Sjogren’s Syndrome) and radiotherapy treatment for head and neck cancers. Non-pharmacological techniques such as acupuncture or mild electrostimulation may be used to improve symptoms. Purpose of the Review To assess the effects of non-pharmacological interventions administered to stimulate saliva ...

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Dealing with the most frequent medical emergencies in the dental office

This summary is based on the article published in the British Dental Journal: General medicine and surgery for dental practitioners: part 3. Management of specific medical emergencies in dental practice (August 2014) M. Greenwood and J. G. Meechan Note: The article could contain medication that is not similarly labelled in Canada.      Purpose of the Article The actions needed to manage specific medical emergencies are discussed. Each emergency requires a correct diagnosis to be made for effective and safe management. Contemporar The article: Discusses treatment for specific emergencies and where appropriate the drugs used. Recognises signs and symptoms of relevant ...

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What are some of the immunological diseases encountered in dental practice?

This summary is based on the article published in the British Dental Journal: General medicine and surgery for dental practitioners: part 5. Immunological disease and dental practice (August 2014) M. Greenwood, J. G. Meechan and C. Stroud   Context At some stage in clinical practice all dental practitioners will encounter patients with disorders of the immune system. It is therefore important that dental practitioners are aware of the potential implications for safe practice. Purpose of the Paper Provides an overview of clinical immunology and how it interfaces with dentistry. Highlights signs of possible immunodeficiency. Discusses oral conditions that may be ...

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Diagnosis and Treatment of the BRONJ Case

Revisit the Case Presentation and Clinical Evaluation This case is presented by:  Dr. Eric T. Stoopler, D.M.D., FDS RCSEd, FDS RCSEng Dr. Juan M. Bugueno, D.D.S. Dr. Kevin Sweeney, D.D.S. Dr. David C. Stanton, D.M.D., M.D., F.A.C.S  We would like to thank all our dentists who submitted their responses to the diagnosis and treatment challenge. Case Diagnosis The Clinical diagnosis was bisphosphonate-related osteonecrosis of the maxilla. Treatment The patient’s oncologist discontinued the ZA therapy. The patient was evaluated by an oral and maxillofacial surgeon who recommended surgical debridement of the affected areas and the patient underwent the procedure five months after cessation ...

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What are the immediate and long-term considerations for the GP dentist providing dental care to children who have undergone cancer therapy or bone marrow transplantation?”

This question was submitted by a general dentist: What are the immediate and long term considerations for the GP dentist providing dental care to children who have undergone cancer therapy or bone marrow transplantation?” Dr. Carol Janik and Caroline Fulop provided this initial response.  The focus of this article is to provide practitioners with guidance on the clinical considerations for pediatric patients who have undergone cancer therapy or bone marrow transplantation. For more information on patients who have been diagnosed and are planned to initiate treatment or those patients currently undergoing therapy please consider referral to a hospital pediatric dentist and ...

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What’s your diagnosis of this case?

This case is presented by:  Dr. Eric T. Stoopler, D.M.D., FDS RCSEd, FDS RCSEng Dr. Juan M. Bugueno, D.D.S. Dr. Kevin Sweeney, D.D.S. Dr. David C. Stanton, D.M.D., M.D., F.A.C.S  Click here to view the BRONJ Case Diagnosis and Treatment Case Presentation A 64-year-old Caucasian female presented for evaluation of symptomatic exposed bone of a two-year duration post extraction of maxillary teeth with immediate placement of four dental implants. Medical history: Is at stage IV breast adenocarcinoma treated with surgery and trastuzumab. Received intravenous zoledronic acid (ZA) 4 mg monthly for approximately two years for metastatic bone disease. Underwent dental surgery ...

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“Failure to Erupt Syndrome”: Myth or Reality?

This question was submitted by a general dentist: Three siblings have been diagnosed with “failure to erupt syndrome.” The oldest had removal surgery and implants. How rare is this syndrome and how common for all three to have it?  Dr. Ian McConnachie, pediatric dentist at Woodroffe Pediatric Dentistry, provided the following initial and quick response. I am unaware of any condition called “Failure to Erupt Syndrome.” There is a small list of conditions where one finds a failure of at least several teeth to erupt. The one we all remember from our dental student days is cleidocranial dysplasia and the slide of ...

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How would you treat this case?

This case was submitted by a team of dental faculty members in the Oral Medicine and Pathology departments of the University of Pennsylvania School of Dental Medicine.  Alicia M. Houston, D.D.S. (Resident – Department of Oral Medicine) Faizan Alawi, D.D.S. (Associate Professor of Pathology – Department of Pathology) Eric T. Stoopler, D.M.D., FDS, RCSEd, FDS RCSEng  (Associate Professor of Oral Medicine) Case was edited by Dr. Suham Alexander, Oasis Clinical Editor  Case Presentation Findings Extraoral – NSF Intraoral – 2x2cm ulceration at R posterior lateral border of the tongue with indurated borders No herpes simplex virus found in direct fluorescent ...

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