Faculty Bibliography

Oral sores can occur anywhere in the oral cavity and oropharyngeal region. Since not all oral sores are benign, a careful differential diagnosis is important. The two most common types are canker sores (recurrent aphthous stomatitis) and cold sores (herpetic lesions). Early intervention is important with both. The pharmacist will most likely be the primary source for recommending medications (e.g., topical corticosteroids, oral and topical antivirals) for the treatment of these conditions

The choice of treatment for head and neck cancer usually depends on the origin and stage. The majority of patients undergo radiation therapy or surgery, or a combination of both, and caring for individuals undergoing radiotherapy involves multifaceted management. Counseling patients before, during, and after head and neck radiotherapy is important to help them become aware of several oral complications that may be severe and may interfere with everyday living. The pharmacist's role is to help lessen oral discomfort and morbidity in this population. The three major types of treatment for managing head and neck cancer are radiation therapy, surgery, and chemotherapy.1 The majority of patients undergo radiation therapy or surgery, or a combination of both. Chemotherapy is usually used as a supplement to the above treatments. Combining chemotherapy and radiotherapy does not improve long-term survival rates over those achieved by radiotherapy and surgery. The choice of treatment usually depends on the origin and stage of the head and neck cancer. Approximately 50,000 new head and neck cancers are diagnosed annually in the United States, and there are about 350,000 deaths yearly worldwide. Most head and neck cancer starts in the squamous cells of the mucosal tissue that lines the head and neck region, such as the tonsils and tongue. Squamous cell carcinoma represents more than 90% of all head and neck cancers. Head and neck cancer can occur anywhere in the head and neck region, and radiation therapy to this area usually results in numerous oral adverse effects that require additional palliative treatment to alleviate these troublesome symptoms

Many dentists are unaware of the documented adverse drug reaction of doxycycline-induced dizziness. Because doxycycline is frequently prescribed in dentistry, it is important for dentists and patients to be aware of this significant adverse reaction to prevent medical complications. A clinical case is reported in which a patient developed dizziness after taking doxycycline that was prescribed following periodontal surgery. The dizziness resolved when the doxycycline was stopped. Patients and dentists should be educated to recognize the signs and symptoms of doxycycline's adverse reactions

Background: Dental implant surgery in the posterior maxillary often involves the maxillary sinuses. Sinus surgery for dental implants is highly successful yet, preoperative risk is difficult to assess as routine preoperative evaluation does not include intranasal examination by an otolaryngologist. The purpose of the present study was to attain the opinions of ear, nose, and throat specialists (ENTs) located within New York State in an effort to establish a referral protocol prior to performing a maxillary sinus elevation. This study assesses the need to consult an ENT specialist for evaluation and treatment recommendations in the pretreatment workup. Methods: A questionnaire was mailed to 302 ENT specialists who maintain a current ENT specialty practice or practice that specialty in a hospital or clinic setting in New York State. The requirement was a valid address and specialty designation. A stamped return envelope with an identification number was returned with the completed survey. Up to two follow-up phone calls were made, and another questionnaire was mailed 30 days after. The questionnaire included eight CT scan images representing different sinus configurations. Answers to the five questions were statistically evaluated and analyzed. A total of 63 recipients mailed back the completed questionnaires and were included in the study. Results: 58.7% (95% CI =46.9-71.1%) of respondents recommended that a maxillary sinus CT scan routinely be prescribed prior to sinus lift surgery. Patient symptoms that ENTs suggested indicated referral included nose complications/problems (40.1%) and sinus issues (23.6%). Of the eight CT scan images, referral suggestions were greater than 50% for the following: occluded sinus with septum, inflammation at the base of the sinus only, a sinus with a generalized thickened membrane, an oro-antral fistula, a thickened sinus membrane in association with teeth that had endodontic and/or periodontic involvement, and a nearly completely occluded sinus that was missing palatal bone. For patients with seasonal allergies, ENTs suggested delaying surgery (20.6%) or controlling symptoms prior to surgery (41.3%). Concerns included a past history of sinus surgery (87.3%), chronic sinusitis (85.7%), presence of ostium stenosis (68.3%), nasal or sinus obstruction (82.5%), and oro-antral fistulation (74.6%). Conclusions: Within the limits of the study, an attempt was made to develop a preoperative protocol, and 63 responses from ENTs suggested that the majority (58.7%) of ENT specialists would recommend a maxillary CT scan prior to sinus lift surgery. Their greatest concerns were prior sinus surgery, severe sinus inflammation, nasal/sinus obstruction, and oro-antral fistulation

Many dentists are unaware of the documented adverse drug reaction of doxycycline: induced dizziness. Because doxycycline is frequently prescribed in dentistry, it is important for dentists and patients to be aware of this significant adverse reaction to prevent medical complications. A clinical case is reported in which a patient developed dizziness after taking doxycycline that was prescribed following periodontal surgery. The dizziness resolved when the doxycycline was stopped. Patients and dentists should be educated to recognize the signs and symptoms of doxycycline's adverse reactions

Acute gastrointestinal (GI) bleeding is a common life-threatening medical emergency requiring hospital admission. GI bleeding can originate in the upper GI tract proximal to the ligament of Treitz; the esophagus, stomach, or duodenum; or (relatively uncommon) the lower GI tract, including the small intestine or colon. This article focuses on the etiology and management of acute upper GI bleeding (UGIB).