Faculty Bibliography

BACKGROUND: The objective of this literature review is to summarize information about the etiology, diagnosis, oral sequelae and treatment of dry mouth in elderly patients. TYPES OF STUDIES REVIEWED: The authors conducted a comprehensive review of the English-based scientific literature from the past 10 years. They selected the studies on the basis of clinical investigations to provide an objective assessment of dry mouth problems among older people. RESULTS: Dry mouth (salivary hypofunction, xerostomia) is a common problem among older people. It causes significant oropharyngeal disorders, pain and an impaired quality of life. Dry mouth has many causes, from local salivary disorders to a plethora of medications and medical conditions. Treatments are designed to correct the underlying cause and/or to enhance salivation with topical and systemic stimulants. Early intervention for dry mouth problems helps prevent the deleterious consequences of this disorder in elderly people. CLINICAL IMPLICATIONS: Clinicians must be aware of dry mouth problems in older patients, and they should be prepared to provide a diagnosis and administer treatment to protect a patient's oropharyngeal health and quality of life.

PURPOSE: This article describes a new endoscopic approach for orbital floor fractures, reduction, and fixation and reports the clinical results. PATIENTS AND METHODS: Ten patients who sustained either a comminuted or trap door orbital floor fracture were treated in 2 medical centers following the same surgical protocol. The indications for orbital reconstruction were limited eye movement, diplopia, and significant enophthalmos. The new approach is discussed in detail. RESULTS: All patients healed uneventfully. No major complications were noted in the postoperative period, and good functional and esthetic results were obtained. CONCLUSIONS: Our results demonstrate that endoscopic intraoral plating is a safe and effective procedure for treating orbital floor fractures.

Dapsone is a leprostatic agent commonly prescribed for the management of leprosy, malaria, and the immunosuppression-induced infections of Pneumocystis carinii and Toxoplasma gondii. In susceptible patients, methemoglobinemia, a potentially life-threatening event, can occur. We report a case of dapsone-induced methemoglobinemia which was observed during general anesthesia for the management of a fractured mandible. The pathophysiology, diagnosis, and management of dapsone-induced methemoglobinemia will be discussed.

Gravidity is defined as the development of the young in utero. It initiates hormonal, psychological and physiological changes in the female patient, providing the dentist with many questions about the management of these patients. These physiologic alterations, as well as the embryologic development of the fetus, will be discussed along with the treatment alterations that should be considered. The changes are often subtle, but can lead to disastrous complications if proper precautions are not taken. Conversely, appropriate management of routine and dental emergencies can be denied by the practitioner because of misconceptions about pregnancy and fetal tolerance. Anesthetic and pharmacology of agents used in dentistry in treating the pregnant patient will be reviewed.

BACKGROUND: During the last 13 years, there has been a growing interest in and use of minimally invasive treatment techniques. Salivary gland endoscopes provide an accurate means of diagnosing and providing minimally invasive surgical treatment for salivary gland diseases. METHODS: The authors review the relevant literature and provide the history of sialoendoscopy. They also report on the treatment methods they use, including instruments and techniques, and their experiences. RESULTS: The authors' overall success rate for parotid endoscopic sialolithotomy is 86 percent, and their overall success rate for submandibular endoscopic sialolithotomy is 89 percent. Their success rate for treating strictures is 81 percent. CLINICAL IMPLICATIONS: The endoscopic technique opens new horizons in the field of salivary gland diseases. Salivary gland stones and sialadenitis no longer are absolute indications for sialadenectomy. Owing to growing experience and surgical skills, new endoscopic techniques are in clinical use, and there is constant improvement in endoscopic treatment success rates. CONCLUSIONS: Sialoendoscopy is a promising new method for use in the diagnosis, treatment and postoperative management of sialadenitis, sialolithiasis and other obstructive salivary gland diseases.