A Patient with an Unknown Latex Allergy Presenting for Sealant Placement
Dentists should be trained to treat any allergic reaction in a dental office, and in this scenario, allergic reaction to latex-based product (rubber dam) is illustrated. Identification of signs and symptoms related to latex allergies is vital, and all dentists should be trained in the appropriate management of such a patient. The dental management of the scenario describes details of the diagnosis and management of latex-related allergies in a dental office for both adults and children. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - April 15, 2023 Category: Dentistry Authors: Nikhil Mistry, Mel Mupparapu, Neeraj Panchal Source Type: research
Treatment of a Mandibular Abscess in a Patient with Coronary Artery Disease and Intermittent Angina
An in-depth understanding of coronary artery disease will be critical to providing safe and effective dental care. Individuals with ischemic heart disease are at increased risk for anginal symptoms during dental care. Consultation with a cardiologist is advisable to ascertain cardiac stability for dental care if a patient has undergone recent coronary artery bypass graft surgery (less than 6 months ago). Judicious use of vasoactive agents during dental treatment is recommended. Antiplatelet and anticoagulant medications should be continued and local hemostatic measures used to control bleeding. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - April 12, 2023 Category: Dentistry Authors: Miriam R. Robbins, Kimberly A. Strauch Source Type: research
Crown Preparation in a Patient with Hypertension and Type 2 Diabetes Mellitus
Management of the diabetic dental patient should focus on the delivery of comprehensive dental care with an emphasis on maintaining periodontal health. Gingivitis, periodontitis, and associated bone loss independent of plaque accumulation are associated with poorly controlled diabetes. Periodontal status should be monitored carefully in patients with diabetes and underlying disease managed aggressively. Likewise, the dental team plays an important role in the identification of hypertension and managing dental-related side effects of anti-hypertensives. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - April 7, 2023 Category: Dentistry Authors: Miriam R. Robbins, Kimberly A. Strauch Source Type: research
A Patient with a History of Extrinsic Asthma Presents for Endodontic Therapy for the Upper Molar
With increasing rates of asthma in the general population, dental professionals need to be able to recognize the signs and symptoms of poorly controlled asthma and modify dental treatment accordingly. Prevention of an acute asthma exacerbation is key. Patients should be reminded to bring their rescue inhaler with them to every dental appointment. Patients who are using inhaled corticosteroids to manage their asthma are at greater risk of oral candidiasis, xerostomia, and caries. Regular dental visits and good oral hygiene are important among this population. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - April 7, 2023 Category: Dentistry Authors: Miriam R. Robbins, Kimberly A. Strauch Source Type: research
Patient Receiving Hematopoietic Stem Cell Transplantation Reports for Dental Clearance
Patients planned for hematopoietic stem cell transplantation (HSCT) routinely undergo dental evaluation. Conditioning before HSCT engenders immunosuppression that may lead to flares of oral infections. Before transplantation, the dental provider should educate the patient on the oral complications of HSCT and identify and treat dental needs as appropriate to the patient ’s medical status. Dental evaluation and treatment must be performed in close coordination with the patient’s oncology team. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - April 7, 2023 Category: Dentistry Authors: Payam Mirfendereski, Katherine France Source Type: research
Penicillin Allergy in a Patient Presenting for Scaling and Root Planing
Dentists should be equipped to treat any allergic reaction in a dental office and in this scenario, anaphylaxis is noted after administration of a penicillin derivative given before a dental procedure. Identification of signs and symptoms related to anaphylaxis is vital and appropriate management of the patient is the key. The dental management of the scenario goes into the diagnosis and management of anaphylaxis in a dental office. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - April 7, 2023 Category: Dentistry Authors: Nikhil Mistry, Kenneth Kufta, Mel Mupparapu, Neeraj Panchal Source Type: research
A Patient with Known Allergy to Local Anesthesia Presenting for a Dental Restoration
Dentists should be equipped to treat an allergic reaction in a dental office, and in this scenario, the potential allergic reaction is noted after administration of a common local anesthetic lidocaine with epinephrine. The allergic reaction quickly escalates to a full-blown anaphylaxis, and the management of such an episode is detailed in this article. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - April 7, 2023 Category: Dentistry Authors: Nikhil Mistry, Kenneth Kufta, Mel Mupparapu, Neeraj Panchal Source Type: research
Diabetic Patient in the Chair for Implant Surgery
Although dental treatment in a patient with well-controlled type 2 diabetes mellitus is uncomplicated, hypoglycemia is one of the most dreaded complications among diabetics and remains as one of the leading causes of endocrine medical emergencies. Identification and prompt treatment is important to all dental practitioners. This scenario goes into the diagnosis and management of medication-induced hypoglycemia. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - April 5, 2023 Category: Dentistry Authors: Nikhil Mistry, Kenneth Kufta, Mel Mupparapu, Neeraj Panchal Source Type: research
Complete Denture Fabrication in a Patient with Chronic Obstructive Pulmonary Disease and Active Tobacco Use
Patients with chronic obstructive pulmonary disease (COPD) have varying degrees of compromised airway function that can affect their ability to tolerate dental treatment. Thus, the delivery of dental care to individuals with COPD may need to be modified based on an understanding of the severity and control of the patient ’s disease, exacerbating factors, frequency of signs/symptoms, and disease management protocols. There is a strong association between aspiration of plaque organisms and pneumonia in individuals with COPD. Good oral hygiene and tobacco cessation education can help mitigate COPD exacerbations. (Source: De...
Source: Dental Clinics of North America - April 4, 2023 Category: Dentistry Authors: Miriam R. Robbins, Kimberly A. Strauch Source Type: research
An Adolescent with Poorly Managed Asthma Referred for Pulp Therapy in a Permanent Tooth
A 13-year old male patient with uncontrolled asthma presents with a grossly decayed permanent first molar. Medical consultation was obtained from a pulmonologist to understand the type and severity of asthma, history of allergies, aggravating factors, and medications. The patient was treated in the dental setting with nitrous oxide and oral conscious sedation with benzodiazepine. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - April 4, 2023 Category: Dentistry Authors: Jayakumar Jayaraman, Paula L. Coates Source Type: research
M önckeberg Medial Arteriosclerosis in a Geriatric Patient with Chronic Kidney Disease and Poorly Controlled Diabetes Reporting for a Dental Recall Visit
M önckeberg medial arteriosclerosis is a condition characterized by the calcification of the tunica media layer of the blood vessels that are visible on plain radiography or sectional tomography. In dentistry, a properly acquired panoramic radiograph may show the condition incidentally. It is also kn own as medial arterial calcinosis and can be associated with diabetes mellitus or chronic kidney disease. This condition is different from the more common atherosclerosis where the tunica intima remains unaffected, and the diameter of the vessel lumen is preserved. Dental treatment can be performed when the patient is stable ...
Source: Dental Clinics of North America - April 4, 2023 Category: Dentistry Authors: Leonard Jensen, Ali Z. Syed, Scott Odell, Karoline E. Genung, Mel Mupparapu Source Type: research
A Patient with Severe Anxiety and Episodes of Fainting in Need of Dental Restoration
Patients with extreme dental anxiety and dental phobia are candidates for syncope attacks in a dental chair. Early recognition and management of these episodes is important. Vasovagal syncope is often preceded by prodromal signs and symptoms like facial pallor, diaphoresis, fainting, dizziness, nausea, or vomiting. If any element of the patient ’s airway, breathing, or cardiovascular system is no longer intact, the provider should commence emergency basic life support protocols and notify emergency medical services immediately. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - April 4, 2023 Category: Dentistry Authors: Nikhil Mistry, Kenneth Kufta, Mel Mupparapu, Neeraj Panchal Source Type: research
A Patient with a History of Myocardial Infarction and a Stent Presenting for Full Mouth Extractions
The scenario presented is of a patient in the dental chair who had history of myocardial infarction and history of stent placed in the left anterior descending coronary artery who now presents with acute chest pain, chest tightness, and extreme dizziness. Confirming cardiopulmonary arrest and beginning basic life support are the first steps in the management followed by defibrillation, advanced cardiac life support, post-resuscitation care, and long-term management. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - April 4, 2023 Category: Dentistry Authors: Nikhil Mistry, Kenneth Kufta, Mel Mupparapu, Neeraj Panchal Source Type: research
Young Hemophilia Patient Presenting with Avulsed Maxillary Permanent Incisor
A 7-year-old girl came to the Emergency Department following an avulsion of the maxillary central incisor. The tooth was replanted and splinted. The patient was referred to a hematologist for follow-up and maintenance of adequate levels of Factor VIII. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - April 4, 2023 Category: Dentistry Authors: Jayakumar Jayaraman Source Type: research
Restorative Dental Treatment in a Patient with Mild to Moderate Chronic Kidney Disease (Stages 1 –3)
Patients with chronic kidney disease (CKD) stage 2 have mildly damaged kidneys but they still work well. The dentist can proceed with the required restorative dental treatment, which is considered a low-risk non-surgical dental procedure, with no major complications expected. Patients with CKD stage 3 have moderate impairment of renal function with altered drug metabolism, bioavailability, and rate of excretion. Diabetes is a common comorbidity in patients with CKD. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - March 27, 2023 Category: Dentistry Authors: Dalal Alomar Source Type: research
