Preoperative Preparation and Planning of the Oral and Maxillofacial Surgery Patient.

Every patient is different and has the potential to respond unfavorably to anesthetic and surgical intervention. Preparation is the key to optimizing patient outcome.

Simulation Training for the Office-Based Anesthesia Team.

An OMS office is a complex environment. Within such an environment, a diverse scope of complex surgical procedures is performed with different levels of anesthesia, ranging from local anesthesia to general anesthesia, on patients with varying comorbidities. Optimal patient outcomes require a functional surgical and anesthetic team, who are familiar with both standard operational principles and emergency recognition and management.

Improving the Medical Curriculum in Predoctoral Dental Education: Recommendations From the American Association of Oral and Maxillofacial Surgeons Committee on Predoctoral Education and Training.

Dental procedures are often performed on patients who present with some level of medical fragility. In many dental schools, the exercise of taking a medical history is all too often a transcription of information to the dental chart, with little emphasis on the presurgical risk assessment and the development of a treatment plan appropriate to the medical status of the dental patient. Changes in dentistry, driven by an increasingly medically complex population of dental patients, combined with treatment advances rooted in the biomedical sciences necessitate the adaptation of our dental education to include a stronger background in systemic health.

Systemic Disease and Bleeding Disorders for the Oral and Maxillofacial Surgeon.

There are multiple systemic diseases that have an impact on coagulation, of which oral and maxillofacial surgeons must be cognizant. Recent evidence has supported the potential for both hypocoagulable and hypercoagulable states in patients with liver and kidney disease with an even less understood impact on prolonged bleeding in the oral cavity. These systemic diseases are not limited to diseases affecting the liver, kidney, and bone marrow; however, these diseases are common among the patient population and surgeons must be capable of making appropriate judgment and modifying care appropriately.

Platelet Abnormalities in the Oral Maxillofacial Surgery Patient.

Platelet abnormalities result from a wide range of congenital and acquired conditions, which may be known or unknown to patients presenting for oral maxillofacial surgery. It is critical to obtain a thorough history, including discussion of any episodes of bleeding or easy bruising, to potentially discern patients with an underlying platelet disorder. If patients indicate a positive history, preoperative laboratory studies are indicated, with potential referral or consultation with a hematologist.

How safe is deep sedation or general anesthesia while providing dental care?

Background: Deep sedation and general anesthesia are administered daily in dental offices, most commonly by oral and maxillofacial surgeons and dentist anesthesiologists.

Methods: The goal of deep sedation or general anesthesia is to establish a safe environment in which the patient is comfortable and cooperative. This requires meticulous care in which the practitioner balances the patient's depth of sedation and level of responsiveness while maintaining airway integrity, ventilation, and cardiovascular hemodynamics.

Comparison of Direct Laryngoscopy and Video Laryngoscopy in Intubating a Mannequin: Should Video Laryngoscopy Be Available to Manage Airway Emergencies in the Oral and Maxillofacial Surgery Office?

Purpose: Video laryngoscopy (VL) is an innovation in tracheal intubation that could be beneficial in an emergency situation. However, the technique could be detrimental if it prolongs intubation performed by an inexperienced physician. The purpose of this study was to compare direct laryngoscopy (DL) with VL skill for oral and maxillofacial surgery (OMS) residents and practitioners to assess the practicality of recommending the inclusion of VL as a component of OMS emergency airway management.

The dentist as doctor: a rallying call for the future.

Background: When the future status of dentistry is considered, scholarship in the profession plays a key role. It is by scholarship that dentistry distinguishes itself as a learned and esteemed profession, and this position paper aims to explore and promote this vital core value.

Methods: As Fellows of the American Dental Education Association's selective Leadership Institute, the authors spent over a year critically examining the role of scholarship in dentistry, which was identified as a critical issue for the profession.

Undiagnosed myasthenia gravis owing to a very unusual primary presentation.

Myasthenia gravis (MG) is an uncommon autoimmune disorder presenting with fluctuating, progressive muscle weakness. The typical initial presentation includes ocular symptoms of ptosis, diplopia, or both. In the literature, other late symptoms have been described.

Measuring surgical competency in facial trauma: the Arch Bar Placement Assessment Scale.

Background: Surgical education is in a period of significant change. Assessment of surgical competency is imprecise compared with cognitive knowledge and judgment. A surgical competency measurement tool may be useful for plastic surgery training programs and certification societies.