1/6. glycogen storage disease and von Willebrand's disease implications for dental treatment: dental management of a pediatric patient.Glycogen storage diseases (GSD) are metabolic disorders which impair the body's ability to store glucose and utilize it later, requiring patients to take multiple daily dietary supplementation with a high carbohydrate content. patients undergoing this treatment modality are placed at increased risk for gross dental caries and other oral abnormalities. Additionally, GSD may prolong the patient's bleeding time, which may necessitate consultation with the treating physician. In the following case, our patient required a multidisciplinary approach to address not only her dental needs, but also to coordinate the management of both her GSD and an additional complication, von Willebrand's disease. This was best achieved in a hospital setting.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/6. Congenital neutropenia. Report of a case and a biorationale for dental management.Congenital neutropenia is characterized by a marked decrease in or lack of circulating PMN's in children with no prior history of drug intake. The neutropenia is persistent and the clinical course is one of early onset of severe, recurrent, and eventually fatal infections. bone marrow studies show a maturation arrest of neutrophilic precursors. Because of their greatly increased susceptibility to infection, patients with congenital neutropenia present a difficult dental management problem. A case of congenital neutropenia has been presented, as well as a biorationale for dental treatment. On the basis of reports in the literature, the following recommendations for the management of patients with congenital neutropenia are made: 1. The prevention and control of infection and the interception of dental disease before surgical intervention becomes necessary should be the overriding considerations in the management of patients with congenital neutropenia. 2. The carious breakdown of teeth should be prevented by the daily application of a 0.4 per cent stannous fluoride gel in addition to oral hygiene and limitation of sucrose intake. 3. Periodontal therapy should be palliative only, since alveolar bone loss is progressive despite frequent oral hygiene instruction and prophylaxis. The goal of periodontal therapy for patients with congenital neutropenia should therefore be a decrease in gingival inflammation to make the patient's mouth more comfortable and to slow down alveolar bone loss. Periodontal surgery is contraindicated. 4. bacteremia and subsequent septicemia should be prevented since a minor infection can become life threatening in patients with congenital neutropenia. The patient should rinse for 30 seconds and the gingival sulci should be irrigated with a phenolated antiseptic mouthwash prior to all dental manipulations of the soft tissue. This will significantly reduce the incidence of bacteremia. 5. Surgery should be avoided if at all possible because of the high risk of post-operative infection. All surgery sholld be performed in the hospital, and the patient should be given antibiotics as determined by his physician. Primary closure should be done with fine polyglycolic acid sutures to reduce the chance of infection. If postoperative infection can be prevented, wound healing will progress normally despite the complete absence of PMN's.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/6. Incidental finding of an intranasal foreign body discovered on routine dental examination: case report.A nasal foreign body was discovered radiologically on an initial dental examination of a young child. The child was a candidate for dental rehabilitation, using nasotracheal intubation under general anesthesia. The parents were unaware of the object's presence, and the child had no nasal symptoms. The child was referred to the otolaryngology-head and neck Surgery Service to have the object removed; this was accomplished successfully without sequelae on an outpatient basis. dentists and physicians who treat children should be alert to the possible presence of intranasal objects in their patients.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/6. Oral diseases in older adults.In the case presented, a 65-year-old man with multiple dental, medical, and social problems benefited from interdisciplinary assessment and treatment. Despite his poor oral-health status and oral-health behaviors upon admission, patient education and dental therapy resulted in improved daily oral hygiene, elimination of oral diseases, and improved oral function. The overall quality of life of any individual, particularly an older one, can be enhanced through oral-disease prevention, health promotion, and, when indicated, dental therapy. This patient was treated in a hospital environment with a well-established team approach to geriatric care. However, regardless of the care setting, the physician can play a key role in improving the oral health status and quality of life of older adults by including an oral screening examination as part of the periodic comprehensive geriatric assessment, recognizing oral pathology, requesting dental consultations and encouraging appropriate dental service utilization.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/6. Dental management of patients with hereditary angioedema: report of case.Dental management and treatment of a patient with hereditary angioedema can be accomplished safely and satisfactorily in an outpatient setting by a dentist in collaboration with a physician. However, as acute attacks can occur as a complication of treatment, we recommend that dental treatment be provided in a hospital environment with adequate medical emergency resources.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/6. Chronic urticaria associated with bacterial infection. A case of dental infection.In most cases of chronic urticaria, a specific etiology cannot be determined. This should not discourage the physician from continuing to search for its underlying cause. infection has long been considered a cause of urticaria, although the incidence is probably low when all other common causes are considered. A case of chronic urticaria of five years duration, which was associated with chronic extensive dental infection and periodontal disease, is presented to show the importance of infection as a trigger mechanism of urticaria.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |