One Provider Anesthesia Model in Oral and Maxillofacial Surgery.

The one provider anesthesia model used in oral and maxillofacial surgery (OMS) practices has been a subject of debate due to concerns about patient safety, inadequate attention, and mortality and morbidity rates. Historically, OMS specialists have made significant contributions to modern anesthesia; however, recent changes in Centers for Medicare and Medicaid Services have led to increased scrutiny of the OMS anesthesia model. Proponents argue that the model is safe and effective, thanks to well-trained Dental Anesthesia Assistants and OMS surgeons' extensive experience in dental anesthesia cases.

Medication Management of Neuropathic Pain Disorders.

It is important for Oral and Maxillofacial Surgeons to be familiar with the various neuropathic facial pain disorders and their appropriate treatments. Neuropathic pain can be characterized by the nature of the pain experienced by patients; episodic or continuous. Episodic neuropathic pain disorders include trigeminal neuralgia and glossopharyngeal neuralgia.

Pharmacological Management of Common Soft Tissue Lesions of the Oral Cavity.

Soft tissue lesions commonly seen in the oral cavity tend to overlap in their onset, presentation, and location making it difficult to appreciate their etiology. In some instances, common oral soft tissue lesions can create confusion due to similar clinical appearance or unusual presentation; therefore, proper diagnosis of the lesion is key in pharmacologic management. In ulcerative conditions, topical steroids can decrease the symptoms and improve healing time, but do not affect the recurrence rate.

Update on Medications for Oral Sedation in the Oral and Maxillofacial Surgery Office.

Dental anxiety is a leading cause of postponing treatment and/or complete avoidance of professional oral care. Therefore, effective sedation and pain control are integral components of dental care for the fearful and anxious patient. The application of oral sedation aids the trained practitioner to provide care to the anxious dental patient and remains the safest, most established, and most commonly used route of drug administration.

Mouth Gags: Advantages and Disadvantages.

Mouth gags have been in use since 1220 as a solution to the cumbersome limitations encountered when visibility and access to the oral cavity, pharynx, and larynx are needed. The instruments being used today range from the simple but effective design of the bite block to the sophisticated and intricate design of the Feyh-Kastenbauer. This article highlights the most frequently used well-designed mouth gags and the applications for which they provide the most benefit.

Soft Tissue Injury in Preparation for Implants.

Diagnosis and treatment planning are critical in preparation for implant placement. Adequate evaluation, preoperative imaging, and surgical planning minimize early and late-stage soft tissue injuries. Correct placement of dental implants can be challenging with several contributing factors such as lack of proper preoperative soft tissue evaluation and surgical experience in dealing with soft tissue incisions and flap reflection, resulting in injury and complications involving the soft tissues.

How to Avoid Life-Threatening Complications Associated with Implant Surgery.

Life-threatening complications of dental implant surgery are rare, but include hematoma/hemorrhage of the floor of the mouth, aspiration, and ingestion. Prevention of lethal hemorrhagic complications stem from knowledge of anatomic structures and precise surgical planning. Prevention of aspiration and ingestion can be improved by simple techniques while understanding clinical settings and factors that put patients at higher risk.

Implant Surgery Update for the General Practitioner: Dealing with Common Postimplant Surgery Complications.

It is essential for practitioners who place dental implants to be able to diagnose and treat common complications or know when to refer to a specialist. Common complications can include nerve injuries, infections, sinus membrane perforations, and edema. This article discusses these complications, incidence rates, tips to avoid common complications, and management options when a patient returns with a complication.

Treatment of the Dental Patient with Bleeding Dyscrasias: Etiologies and Management Options for Surgical Success in Practice.

The oral health care provider sees a significant number of patients in his or her practice who suffer from systemic diseases affecting the ability to clot. These medical issues can be acquired or inherited bleeding dyscrasias requiring pharmacologic therapy during the perioperative period. Patients with inherited or acquired bleeding disorders require careful attention with respect to the assessment of bleeding risk.

Botox and Dermal Fillers: Review and Its Role in the Dental Office.

For the general dentist, the use of BTA and dermal fillers confers the ability to exert control over the soft tissues surrounding the mouth to better create a harmonious smile. The injection of BTA and fillers into the facial musculature and dermis requires a level of finesse to achieve the desired outcomes. A sound understanding of the mechanisms of action and the ability to manage potential complications are also necessary, because the dentist administering BTA and dermal fillers must be competent to the same level as other providers who have traditionally been the gatekeepers of such agents.

Atypical Facial Pain.

Atypical facial pain (AFP), or persistent idiopathic facial pain, is a chronic and diffuse distribution of facial pain along the territory of the trigeminal nerve. This condition occurs in the absence of any neurologic deficit or any other obvious etiology. AFP is one of the most challenging conditions to diagnose due to lack of clear diagnostic criteria.

Oral Viral Infections: Diagnosis and Management.

This article focuses on common viral infections in the oral cavity with associated systemic manifestations. Discussed are the clinical features, histopathology, diagnosis, treatment, and prevention of viral infections in oral cavity. This will be a useful aid for general practitioners and other dental personnel wanting to expand their pathologic knowledge.

Botulinum Toxin Type A: Review and Its Role in the Dental Office.

For the general dentist, the use of botulinum toxin type A (BTA) confers the ability to exert control over the soft tissues surrounding the mouth to better create a harmonious smile. The injection of BTA into the facial musculature requires a level of finesse to achieve the desired outcomes. A sound understanding of the toxin's mechanism of action and the ability to manage potential complications are also necessary, as the dentist administering BTA must be competent to the same level as other providers who have traditionally been the gatekeepers of such agents.

Basic concepts and techniques of dental implants.

Dental implants provide completely edentulous and partial edentulous patients the function and esthetics they had with natural dentition. It is critical to understand and apply predictable surgical principles when treatment planning and surgically restoring edentulous spaces with implants. This article defines basic implant concepts that should be meticulously followed for predictable results when treating patients and restoring dental implants.

Use of recombinant factor VII for tooth extractions in a patient with severe congenital factor VII deficiency: a case report.

Background And Overview: Patients with factor VII deficiency have an increased risk of prolonged perioperative hemorrhage. In this article, the authors present a case of severe factor VII deficiency in a patient who required tooth extraction.

Case Description: A 44-year-old woman with severe congenital factor VII deficiency sought care for a symptomatic, carious, and nonrestorable maxillary right second molar that required extraction.

Incidental treatment of maxillary dysesthesia with maxillary sinus lift procedure--a case report.

A 54-year-old woman presented with an 8-month history of dysesthesia to the left palate with referred pain to the left infraorbital distribution after extraction of the left maxillary first and second premolars. The clinical and radiologic examination revealed an alveolar crestal bone dehiscence suggestive of an occult oral antral communication (OAC) that had spontaneously healed. Stimulation of the mucosa at this bony dehiscence consistently reproduced the dysesthesia.

Thyroid crisis in the maxillofacial trauma patient.

Thyroid crisis, also known as thyroid storm, is a rare complication of thyrotoxicosis that results in a hypermetabolic and hyperadrenergic state. This condition requires prompt recognition and treatment because the mortality from thyroid crisis approaches 30%. Thyrotoxicosis alone will usually not progress to thyroid crisis.

Risk of airway embarrassment during root canal therapy.

Background: Root canal therapy (RCT) is a commonly performed dental procedure that has a good success rate. Complications of RCT usually are minor, but severe complications can occur.

Case Description: A 59-year-old Hispanic man with no history of coagulopathy started to hemorrhage profusely from the mesiolingual canal of the right mandibular first molar (tooth no.

Tonsillitis, peritonsillar and lateral pharyngeal abscesses.

Oral and maxillofacial surgeons are occasionally called on to diagnose, treat, and rule out peritonsillar abscesses. In this article, the anatomy of the peritonsillar area, its contents, surgical approaches, and possible complications are discussed.

Diagnosis and management of common postextraction complications.

Extraction of impacted teeth is one of the most common surgical procedures performed by oral and maxillofacial surgeons. Every surgical procedure results in some degree of postoperative bleeding and inflammation, typically manifesting as pain and edema. Although the complex physiology of the human body is beyond the scope of this article, the educated clinician should have an understanding of the time line associated with these processes so as to determine whether a patient's complaint of postoperative bleeding, pain, or swelling represents a normal response to surgical trauma or an aberrant reaction.

Management and marketing for the general practice dental office.

This article reviews trends in the dental marketplace. Marketing is an essential element of dentistry. Communicating treatment options with patients is one aspect of marketing.

Perioperative management of the patient with liver disease and management of the chronic alcoholic.

Each year millions of Americans undergo surgical procedures requiring local, general, or spinal epidural anesthesia. A disproportionate number of the patients are older than age 65, and up to 10% of the patients have end-stage liver disease. Most patients do not suffer complications as a result of the surgical procedure or the anesthetic.