Pharmacologic Treatment for Temporomandibular Disorders

Pharmacologic agents play an integral role in the overall management of temporomandibular joint disorder. The general dentist should be familiar with the different classes of drugs currently in use for dealing with this often complex medical/dental problem.

Why is dental treatment of the gravid patient regarded with caution? When is the appropriate time for care--be it emergent or routine--in the gravid patient?

There are myths surrounding pregnancy and the oral cavity, such as, "having a baby causes your gums to swell and your teeth to weaken," or "I don't need to see a dentist, there's nothing wrong with my teeth" or "with each child say bye to a tooth or two." All these myths are just that, myths. During pregnancy, women may experience pregnancy gingivitis or may suffer from pre-existing periodontal disease. The myth of tooth loss during pregnancy, according to the ADA (American Dental Association), has "no histological, chemical or radiographic evidence to support [it]". The biggest myth or misconception is that dental care is unnecessary during pregnancy, and until problems arise, some gravid women draw back from seeking dental treatment. Also, professionals sometimes shy away from care of the gravid patient for reasons associated with teratogenicity and fetotoxicity. Teratogenic effects take place from three to eight weeks after conception, and fetotoxicity can occur at the latter end of the initial trimester on to delivery, according to Donaldson and Goodchild, authors of Pregnancy, breast-feeding and drugs used in dentistry in JADA's (The Journal of the American Dental Association) August, 2012 issue. This article includes reasons dental treatment is regarded with caution; therefore, appropriate timing of dental care and suggested clinical recommendations as they relate to the pregnant patient are reviewed.

Dental management of liver transplant patient

The dental management of a liver transplant patient requires an awareness of the problems associated with controlling infection, bleeding and pain. Consultation with the patient's physician is most important. Laboratory tests to determine liver function, complete blood count (CBC)-including white blood cells and platelets-and clotting ability (international normalized ratio [INR]) are a necessity. In the case report presented here, the dentist, in consultation with the patient's physician, outlines a dental management plan that includes the need for antibiotic prophylaxis and delineates the types of antibiotics, analgesics and local anesthetics that may be used.

Drug abuse identification and pain management in dental patients: a case study and literature review

Properly identifying patients with a history of drug abuse is the first step in providing effective dental care. Dental professionals need to be fully aware of the challenges associated with treating this population. In the current study, the authors analyzed the physical and oral manifestations of illicit drug abuse to aid in the identification of patients who abuse drugs and the pain management strategies needed to treat them. The authors also present a clinical case of a patient with unique skin lesions and discuss the typical clinical findings of drug abuse based on a literature review.

What every dentist should know about zinc

Zinc plays an important role in human physiology, from its involvement in the proper function of the immune system to its role in cellular growth, cell proliferation, and cell apoptosis as well as its essential role in the activity of numerous zinc-binding proteins. However, zinc also plays a key pathophysiological role in major neurological disorders and diabetes. Zinc deficiency is a worldwide problem, whereas excessive intake of zinc is relatively rare. Many patients are exposed to zinc on a regular basis through dentistry as a result of its use in certain restorative materials, mouthwashes, toothpastes and, notably, denture adhesives. Of particular importance to dental professionals are various case reports concerning the neurologic effects of excess zinc intake by patients who routinely use large quantities of zinc-containing denture adhesives. This review presents relevant information concerning the use of zinc in dentistry.

Use of botulinum toxin in dentistry

A growing number of dentists are providing botulinum toxin to patients. The research presented here outlines potential uses of Botox related to oral health and facial problems as compared to traditional treatment methods. The administration of Botox (historically done by dermatologists and neurologists) may fall under dentists' jurisdiction, as their training and knowledge encompasses the entire head and neck. A review is made of the literature, based on Ovid and PubMed searches, selecting articles describing the injection of botulinum toxin A in areas related to the oral cavity and the face, excluding cosmetic purposes.

Oral health care for the pregnant patient

Pregnancy is a unique time in a woman"s life, accompanied by a variety of physiologic, anatomic and hormonal changes that can affect how oral health care is provided. However, these patients are not medically compromised and should not be denied dental treatment simply because they are pregnant. This article discusses the normal changes associated with pregnancy, general considerations in the care of pregnant patients, and possible dental complications of pregnancy and their management.

Ozone therapy in medicine and dentistry

AIM

The purpose of this review is to present the potential for the incorporation of ozone therapy into the practice of dentistry.

BACKGROUND

Ozone gas has a high oxidation potential and is 1.5 times greater than chloride when used as an antimicrobial agent against bacteria, viruses, fungi, and protozoa. It also has the capacity to stimulate blood circulation and the immune response. Such features justify the current interest in its application in medicine and dentistry and have been indicated for the treatment of 260 different pathologies. It can be used for the treatment of alveolitis as a replacement for antibiotic therapy, as a mouthwash for reducing the oral microflora, as well as the adherence of microorganisms to tooth surfaces. Ozone has been shown to stimulate remineralization of recent caries-affected teeth after a period of about six to eight weeks.

CONCLUSION

The future of ozone therapy must focus on the establishment of safe and well-defined parameters in accordance with randomized, controlled trials to determine the precise indications and guidelines in order to treat various medical and dental pathologies. Scientific support, as suggested by demonstrated studies, for ozone therapy presents a potential for an atraumatic, biologically-based treatment for conditions encountered in dental practice.