Faculty Bibliography

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).

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

Knowledge of a little known New York State regulation and its insurance implications can be used to provide dental benefits to people who have congenital diseases or anomalies. An explanation of the regulation is provided, and some of the more common congenital diseases that may affect the dentition, such as amelogenesis imperfecta, dentinogenesis imperfecta, ectodermal dysplasia, cleft lip/palate and trisomy 21, are reviewed