The Journal of the American Dental Association
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Many oral diseases/conditions associated with aging are complex and can have a significant effect on the quality of life for ambulatory older adults. Among these are oral cancers and premalignant lesions, vesiculoerosive diseases, candidiasis, aphthous ulcers and herpes virus reactivation. The practitioner should establish the diagnosis so that appropriate management can be instituted. ⋯ Recognition of benign and malignant mucosal lesions will accelerate proper treatment that will help control a variety of oral diseases and conditions. It also will improve the quality of life for many elderly patients who experience associated pain and altered oral functions.
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The purpose of this statement is to update the recommendations by the American Heart Association (AHA) for the prevention of infective endocarditis, which were last published in 1997. ⋯ The major changes in the updated recommendations include the following. (1) The committee concluded that only an extremely small number of cases of IE might be prevented by antibiotic prophylaxis for dental procedures even if such prophylactic therapy were 100 percent effective. (2) IE prophylaxis for dental procedures should be recommended only for patients with underlying cardiac conditions associated with the highest risk of adverse outcome from IE. (3) For patients with these underlying cardiac conditions, prophylaxis is recommended for all dental procedures that involve manipulation of gingival tissue or the periapical region of teeth or perforation of the oral mucosa. (4) Prophylaxis is not recommended based solely on an increased lifetime risk of acquisition of IE. (5) Administration of antibiotics solely to prevent endocarditis is not recommended for patients who undergo a genitourinary or gastrointestinal tract procedure. These changes are intended to define more clearly when IE prophylaxis is or is not recommended and to provide more uniform and consistent global recommendations.
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Patients with undiagnosed obstructive sleep apnea (OSA) represent a major public health problem, and studies suggest that the incidence of OSA may be even higher than estimated. ⋯ Dental professionals have a unique doctor-patient relationship that affords them a role in recognizing sleep disorders by exploring the history of patients who are sleepy.
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To achieve profound dental local anesthesia, it is necessary for the dentist to have a thorough knowledge of the details of sensory innervation to the maxilla and mandible. Since the early 1970s, dentistry has experienced a resurgence of interest in the neuroanatomical basis of local anesthesia, resulting in numerous scientific reports on the subject. ⋯ An understanding of the potential variations in innervation should help the dentist improve his or her ability to induce profound local anesthesia.
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Review Comparative Study
Selecting new drugs for pain control: evidence-based decisions or clinical impressions?
Selecting drugs for pain control in dentistry should be based on scientific research rather than clinical impressions. This article highlights the scientific attributes of analgesic medications that make them practical for treating postoperative dental pain. ⋯ Selecting drugs for the short-term relief of postoperative dental pain should be based on a careful assessment of all relevant pharmacological characteristics of a given agent, especially those related to maximum dosage, duration of action and efficacy.