Contributors xi
Contributors to the Previous Edition xii
Acknowledgments xiv
Introduction xv
1. In-Hospital Care of the Dental Patient 1
Dental Admissions 1
The Patients Medical History 2
The Admission Note 2
Physical Examination 8
Admission Orders 12
Overview of Patient Admission Procedures 14
Preoperative Considerations 14
Preoperative Note 18
Preoperative Orders 18
Intraoperative Considerations 19
Operative Notes 22
Brief Operative Note 23
Postoperative Orders 23
The Postoperative Note 29
Follow-Up Notes 30
Discharge Notes and Requests 30
Discharge Summary 30
Examples of Hospital Charts 31
Examples of Emergency Room Admissions 32
Suggested Reading 32
2. Outpatient Management of the Medically Compromised Patient 33
Medical History 33
Allergy to Drugs 34
Bleeding Disorders 36
Specific Coagulopathies 37
Medications that Predispose to Bleeding 39
Cancer 41
Radiation Therapy to the Head and Neck Region 41
Cardiovascular Disorders 50
Diabetes Mellitus 58
Drug Abuse 62
Prescription and Non-Prescription Drugs 62
Alcohol 64
Fever of Unknown Origin 65
Human Immunodeficiency Virus Infection 65
Intellectual Disability 67
Down Syndrome (Trisomy 21) 67
Fragile X Syndrome 69
Autistic Spectrum Disorders (ASD) 69
Attention Deficit Hyperactivity Disorder 70
Liver and Spleen 71
Hepatitis 71
Liver Failure and Transplantation 73
Glycogen Storage Diseases 74
Asplenia 74
Neurologic Disorders 75
Cerebral Palsy 75
Dementia 76
Degenerative Neuromuscular Disorders 78
Myasthenia Gravis 78
Motor Neuron Disease 80
Multiple Sclerosis 80
Neural Tube Defects 81
Parkinsons Disease 83
Seizures and Epilepsy 83
Orthopedic and Bone Disorders 85
Arthritis 85
Prosthetic Joint Replacement 86
Osteogenesis Imperfecta 88
Paget Disease (Osteitis Deformans) 88
Osteomalacia 89
Osteopetrosis 90
Osteoporosis 90
Pregnancy 91
Psychiatric Disorders 91
Renal/Adrenal Disorders 92
Adrenal Disorders 92
Renal Disorders 94
Respiratory Disease 95
Cystic Fibrosis 95
Asthma 96
Chronic Obstructive Pulmonary Disease 97
Tuberculosis 98
Sickle-Cell Anemia 98
Disorders of the Thyroid Gland 100
Hyperthyroidism 100
Hypothyroidism 100
Suggested Reading 101
3. Oral Medicine: A Problem-Oriented Approach 150
Altered Mucosa 151
White Lesions (or Lesions with a Predominantly White Component) 152
Red Lesions 157
Ulcerative Lesions 161
Exophytic Lesions 165
Pigmented Lesions 168
Pain and Altered Sensation 171
Orofacial Pain 171
Changes in Taste and Olfaction 181
Dry Mouth/Xerostomia 184
Malodor/Halitosis 186
Slow Healing 187
Swelling 188
Bleeding 188
Altered Oral Function 191
Problems with Teeth 191
Suggested Reading 193
4. Consultations 195
Requesting and Answering Consultations 195
Requesting Consults from Other Services 196
Answering Consult Requests from Other Services 197
Consult Format 198
Examples of Consultation Requests from Other Clinical Services 200
5. Dental, Oral, and Maxillofacial Emergencies 220
Medicolegal Aspects of Emergency Care 221
Emergency Department Medical Records 222
Intra-Oral Urgencies 226
Odontogenic Pain 226
Soft Tissue Lesions 229
Postoperative Emergencies 233
Bleeding 233
Postextraction Pain 235
Nausea and Vomiting 236
Odontogenic Infections 237
General Concepts 237
Diagnosis of Infection 237
Medical Management of Odontogenic Infections 239
Surgical Management of Odontogenic Infections 242
Most Common Reasons for Infection Management Failure 245
Salivary Gland Emergencies 246
Acute Parotid Infections 246
Obstructive Sialadenitis 247
Maxillofacial Trauma 248
General Principles of Care 248
Diagnosis of Facial Trauma 250
Dental and Dentoalveolar Trauma 256
Midface Trauma 264
Soft Tissue Wounds 266
Temporomandibular Joint (TMJ) Emergencies 278
Acute Condylar Dislocation 278
Acute Myofascial Pain 279
Traumatic Hemarthrosis or Joint Effusion 280
Suggested Reading 281
6. Medical Emergencies 283
Syncope 284
Respiratory Difficulty 286
Cardiac and Vascular Emergencies 292
Epilepsy: Seizures 301
Diabetic Emergencies 303
Allergic Reactions 306
Miscellaneous 308
Foreign Bodies or Instruments Swallowed or Aspirated 308
Emesis and Aspiration 309
Bleeding 310
Shock 311
Drug Overdose and Toxicity 313
Malignant Hyperthermia 316
Venipuncture Complications 317
Suggested Reading 318
7. Maxillofacial Prosthetics 319
Obturator Prosthesis: Types 319
The Maxillary Resection Patient 321
Rationale for Immediate Obturation 321
Presurgical Treatment Planning 322
Immediate Surgical Obturator 324
Extraoral Prostheses 328
Suggested Reading 332
Appendices 333
1. Abbreviations 335
2. AcidBase Balance 357
3. Allergy: Common Examples of Pseudoallergic Drug Reactions 358
4. Biopsy 360
5. Cincinnati Prehospital Stroke Scale (CPSS) 362
6. Classifications 363
ASA Physical Status Classification System (Table A6-1) 363
Immunologic Reactions (Gell and Coombs) (Table A6-2) 363
New York Heart Association Functional Classification System (Table A6-3) 364
Classification and Management of Blood Pressure for Adults Aged 18 Years or Older (Table A6-4) 365
Sjögrens Syndrome: Proposed International Classification Criteria (Table A6-5) 366
7. Coagulation and Hemostasis 367
Coagulation Cascade (Table A7-1) 367
Hemostasis (Table A7-2) 368
Procedures to Ensure Hemostasis (Table A7-3) 368
8. Conversion Tables 369
Centigrade to Fahrenheit (Table A8-1) 369
Kilograms to Pounds (Table A8-2) 370
Metric Equivalents (Table A8-3) 371
CorticosteroidsSystemic Equivalents (Table A8-4) 371
9. Cranial Nerves 372
10. Decimal Factors: Prefixes 373
11. Diets 374
12. Drugs and Medications 377
Asthma Medications (Table A12-1) 377
Bisphosphonates (Table A12-2) 378
Chemotherapy Drugs Associated with Mucositis (Table A12-3) 379
Common Medications Used in Dental Practice (Table A12-4) 380
Dilutions for Parenteral Drugs (Table A12-5) 411
Drugs and Medications of Concern in Dental Practice (Table A12-6) 412
Drugs Used in Dental Practice with Significant Allergic Potential and Alternative Medication(s) (Table A12-7) 413
Drug Interactions (Table A12-8) 413
Drugs with Fetal Effects from Maternal Exposure (Table A12-9) 417
Drugs for Use During Pregnancy (Table A12-10) 418
Drugs Used in Dentistry Considered Safe While Breastfeeding (Table A12-11) 419
Emergency Medications and Equipment (Table A12-12) 419
Federally Controlled Drugs (Table A12-13) 421
Renal Function: Adjustment of Dosage (Table A12-14) 422
Renal Drugs with Major Excretion Route via Kidneys (Table A12-15) 426
13. Emergency Room Kit 427
14. Facial Pain: Diagnostic Features 429
15. Fluid Management 432
Fluid Deficits (Table A15-1) 432
Types of Intravenous Fluid (Milliequivalents/L) (Table A15-2) 433
16. Glasgow Coma Scale 434
17. Hepatitis B Virus Infection 436
18. HIV Test Technologies 438
19. Hospital Charting 441
Examples of Hospital Charts (Table A19-1) 441
Examples of Emergency Room Admissions (Table A19-2) 446
20. Operating Room 453
Dress Code (Table A20-1) 453
Scrub Technique (Table A20-2) 454
21. Patient Transfer 455
22. Primary Dentition: Chronology 458
23. Prophylaxis 459
American Heart Association (Table A23-1) 460
American Dental Association and American Academy of Orthopedic Surgeons (Table A23-2) 461
Steroid Prophylaxis for Adrenal Insufficiency (Table A23-3) 462
24. Splint and Tray Construction 463
Anesthesia Splint (Table A24-1) 463
Medication Tray Construction (Table A24-2) 464
25. Staging 465
Staging and Management of BRONJ (Table A25-1) 465
TNM Staging for Tumors of the Lip and Oral Cavity (Table A25-2) 466
26. Trauma: Head Injury Sheet 468
27. Venipuncture 469
Index 471
