Faculty Bibliography

Many in the dental field often practice with blinders-they focus on the decay in front of them, the crown that must be prepared, the canal that must be shaped. The series of events that led to that existing issue, the underlying habit, disease, etc. is often overlooked. Many in our profession have gotten into the habit of becoming "tooth mechanics," fixing several issues and ensuring that our patients leave with adequate oral health, rather than addressing the larger, often systemic issues that resulted in the state of their oral health. Although the steps within this large diagnostic process often require the formation of a multidisciplinary healthcare team comprised of different fields in healthcare unique to each patient, this idea is often overlooked. Our case report examines unique and surprising oral health findings that prompted the formation of such a team. Our role as a valued member of the healthcare team should be of paramount importance to our practice, and this case discusses a patient whose health required such. The conversation between physician and dentist is of continued importance and in this case one will be able to identify how systemic health is ultimately preserved and improved in this conversation.

Dental practitioners must be comfortable with treating medically compromised patients, including those with cancer. In particular, dental practitioners must be aware of the comorbidities of non-Hodgkin lymphoma in order to treat patients with an appropriate standard of care. This case report describes the oral healthcare of a patient whose recurrent non-Hodgkin lymphoma created a degree of medical complexity that required a unique treatment path. As with many patients with non-Hodgkin lymphoma, the patient's compromised systemic health ultimately contributed to the deterioration of oral health, which in turn perpetuated the deleterious systemic concerns. As a result, both intensive medical and dental interventions were required to salvage the health of the patient. Secondary to the comprehensive medical treatment for managing the patient's cancer, there are several considerations that dentists must consider. This article explores those pretreatment and posttreatment considerations in the context of rehabilitative dentistry.

Data sourcesThe Cochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, CINAHL, OpenGrey, the Chinese BioMedical Literature Database, the China National Knowledge Infrastructure and the VIP database, the US National Institutes of Health Trials Register, the World Health Organisation (WHO) Clinical Trials Registry Platform and Sciencepaper Online databases were searched with no restrictions on language or date.Study selectionTwo reviewers independently selected studies and only randomised controlled trials (RCTs) and quasi-RCTs with follow-up times >/= one year were considered.Data extraction and synthesisData extraction and risk of bias assessment were carried out independently and in duplicate. Standard Cochrane methodological approaches were used.ResultsOnly one trial involving 303 patients that compared scaling and root andomiz (SRP) with community care was included. It was considered to be at high risk of bias. No data on deaths (all-cause or CVD-related) were reported. There was insufficient evidence to determine the effect of SRP and community care in reducing the risk of CVD recurrence in patients with chronic periodontitis (risk ratio (RR) 0.72; 95% confidence interval (CI) 0.23 to 2.22; very low quality evidence). The effects of SRP compared with community care on high-sensitivity C-reactive protein (hs-CRP) (mean difference (MD) 0.62; -1.45 to 2.69), the number of patients with high hs-CRP (RR 0.77; 95% CI 0.32 to 1.85) and adverse events (RR 9.06; 95% CI 0.49 to 166.82) were also not statistically significant. The study did not assess modifiable cardiovascular risk factors, other blood test results, heart function parameters or revascularisation procedures.ConclusionsWe found very low quality evidence that was insufficient to support or refute whether periodontal therapy can prevent the recurrence of CVD in the long term in patients with chronic periodontitis. No evidence on primary prevention was found.