Faculty Bibliography

Migraine headache is a common, disabling clinical problem afflicting millions of Americans. Many dental problems are related to headaches and many conditions can cause orofacial pain and headaches, which complicates a definitive diagnosis. Temporomandibular joint disorders, toothache, jaw and sinus pain often coexist with headaches. A toothache of nonodontogenic origin may require a team of dentists and physicians to diagnosis and manage. It is important for the dentist to recognize and understand the management of common headaches, such as migraine, and be able to differentiate between a nonodontogenic headache and a "real" toothache.

Dermatosis is defined as a disorder involving lesions or eruptions of the skin that areacute (lasting days to weeks)or chronic (lasting months to years). Acute lesions are relatively common and exhibit a wide range of clinical conditions. Usually, these conditions are triggered by local or systemic immunologic factors (e.g., allergic reaction); however, the exact etiology remains unclear. Acute inflammatory dermatosis conditions include erythema multiforme (EM), pruritus (urticaria), and eczema (TABLE 1). Treatment options differ for acute and chronic lesions. This article reviews the conditions and treatment of common acute dermatosis lesions. A table is presented

The American Society of Anesthesiologists Physical Status (ASA-PS) classification is a preoperative rating given to each patient by an anesthesia provider with the sole purpose of assessing the physical state of the patient before anesthesia is administered. It was designed originally as a standardized way for dentists and physicians to convey information about the patient's overall health status and allow outcomes to be stratified by a global assessment of their severity of illness. However, in practice, the ASA-PS classification is often misused as a measure of operative risk, which is the basis of much criticism. Modification of periodontal treatment may be necessary in certain medically complex patients. The ASA-PS classification serves an integral part of risk assessment in determining how a patient should be managed by the periodontist. It should be incorporated into all periodontal practices. Medical assessment of patients has become an essential part of dentistry, as even the most common medical problems may require modifications to routine periodontal care. Periodontists must assess and manage patients for underlying medical conditions and are required to provide dental care to a diversity of medically complex patients. Today many patients in a periodontal practice have multiple medical conditions and are taking many medications. It is more difficult to manage these types of patients, and proper assessment of their physical status is an important part of clinical practice. The ASA-PS classification system is a valuable assessment tool that subjectively categorizes patients into subgroups by preoperative physical fitness prior to administering anesthesia

BACKGROUND: This article discusses the nasopharyngeal carcinoma (NPC) of American baseball icon Babe Ruth, as well as the diagnosis and treatment of NPC. CASE DESCRIPTION: NPC is a tumor originating from the epithelium of the nasopharynx. It is the leading form of cancer in certain well-defined populations in areas such as southern China, Southeast Asia, the Arctic, North Africa and the Middle East; it is relatively rare in the United States. Despite the fact that Babe Ruth's family was of German descent and NPC is not prevalent in Germany, reports regarding Ruth's autopsy demonstrate that his head and neck cancer was NPC. CLINICAL IMPLICATIONS: Dentists play a pivotal role in the recognition of oral signs and symptoms and in the diagnosis of NPC, as well as the subsequent oral care of patients during and after treatment

BACKGROUND: Doxycycline-induced esophageal ulcer is a documented adverse drug reaction. Unfortunately, many health care professionals are not familiar with this particular drug reaction. Because doxycycline frequently is prescribed in the clinical practice of periodontics, it is important for dentists to be aware of this potential drug reaction. METHODS: The authors describe the case of a patient who was taking doxycycline after undergoing periodontal surgery and experienced a complication. The diagnosis revealed that the patient had developed an esophageal ulcer as a result of taking the doxycycline. RESULTS: The patient's esophageal ulcer resolved with the aid of dietary changes and a prescription of rabeprazole, a proton pump inhibitor. CONCLUSIONS: and CLINICAL IMPLICATIONS: The etiology of doxycycline-induced esophageal ulceration is complex, and proper diagnosis is essential for its resolution. Dentists should be aware of the potential for this adverse drug reaction

Individuals with chronic pain that lasts for more than three to six months may experience multiple types of pain in the head and neck region, including headache and facial pain. Approximately 18% of women and 6% of men suffer from some form of frequent headaches, and many cases go undiagnosed and undertreated. Headaches have a major socioeconomic impact on society. This article will review the classifications and pathogenesis of migraine, various pharmacologic and nonpharmacologic treatments, and the pharmacist's role in patient education

The concept of periodontal reevaluation of initial therapy needs to be revisited. From interviewing selective periodontists and reviewing the literature, it is apparent that the time period to perform a reevaluation is an ambiguous topic. This seems to be a dichotomy because today everything in dental medicine and medicine is evidence based. When reviewing selective literature sources, it was found that either a time period for reevaluation was given that was different in almost every publication, or a time period was not given but the subject of reevaluation was addressed. The objective of this commentary is to define reevaluation and to determine the best time interval after initial therapy to perform a reevaluation based on classic and current literature. Some questions that need to be addressed are the following: 1. Does too short of a time frame for reevaluation lead to the over treatment of patients? 2. Is there a danger in reevaluating over too long of a time frame that will lead to disease progression and the return of pathogenic microbial flora? This would mean unnecessary periodontal break-down could be occurring without appropriate further treatment. Many concerns need to be addressed, including when the appropriate time period is to measure the effects of initial therapy. After this time period, the stability of the periodontium should be evaluated rather than the effects of therapy