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Congenital Platelet Dysfunction and von Willebrand Disease
Published in Harold R. Schumacher, William A. Rock, Sanford A. Stass, Handbook of Hematologic Pathology, 2019
A 19-year-old woman has had a life-long history of easy bruising. When she was younger, she experienced frequent nosebleeds, although these have been occurring less frequently over the past 5 years. Menses have been quite heavy, to the point that they are of concern both to the patient and to her primary care physician. The most immediate concern, however, is an impacted wisdom tooth that her dentist would like to see extracted. The patient was adopted shortly after birth, and virtually no medical history pertaining to her biologic relatives is available.
Otalgia
Published in John C Watkinson, Raymond W Clarke, Christopher P Aldren, Doris-Eva Bamiou, Raymond W Clarke, Richard M Irving, Haytham Kubba, Shakeel R Saeed, Paediatrics, The Ear, Skull Base, 2018
Dental pain arising from the teeth and periodontal tissues poses a diagnostic problem to a trained dentist, so it is understandable that referred otalgia from dental pathology may present more of a challenge when presenting to an ENT clinician. The commonest cause of inflammation of the dental pulp (pulpitis) is dental caries. The pain of pulpitis is often poorly localized as the sensory innervation is mainly via non-myelinated type C pain fibres. Chronic pulpitis may fluctuate over a period of weeks or months and, with poor localization of pain and lack of physical signs, is difficult to recognize. Pain associated with acute apical periodontitis and acute apical abscess tends to be severe, throbbing and localized to the affected tooth but, if the inflammation is mild and chronic, localization may be poor. Partially erupted or impacted wisdom teeth can lead to inflammation of the surrounding soft tissue (periconitis). Chronic periconitis can present as poorly localized facial/jaw pain with referred otalgia.15
Rights and responsibilities in dentistry
Published in Paul Lambden, Dental Law and Ethics, 2018
What is accepted by the profession as good practice may not remain static but is subject to change. For instance, case law is an important source of law in the United Kingdom and can have a considerable impact on professional standards. The management of impacted wisdom teeth illustrates how changes in clinical practice can come about as a result. In the 1980s a number of court cases concerned residual numbness following the extraction of wisdom teeth.11,12 The result of the debate within the profession is that dentists now recognise the importance of warning people about the possibility of numbness and fewer symptom-free wisdom teeth are extracted.
Is dental panoramic tomography appropriate for all young adults because of third molars?
Published in Acta Odontologica Scandinavica, 2021
Tommi Vesala, Marja Ekholm, Irja Ventä
Based on the Cochrane review, it is unclear if asymptomatic and disease-free impacted wisdom teeth should be removed [2]. Thus, there are differences in recommendations of third molar treatment among countries. For example, in 2000, the National Institute of Clinical Excellence (NICE) introduced guidelines against prophylactic removal of third molars in the UK and listed specific clinical indications for surgery [3]. On the other hand, according to the Finnish Current Care Guidelines, in addition to the extraction of symptomatic third molars, preventive removals of asymptomatic teeth are also recommended in certain cases [4]. Also, according to a recent study, many of the organisational policy statements regarding third molar treatment in the US are in favour of prophylactic removals, while also a critical view is presented [5]. Thus, the differences in clinical practices affect the radiographic examination protocols of third molars.
What should I tell my patient? Disclosure in anaesthesiology: difficulties, requirements, guidelines and suggestions
Published in Southern African Journal of Anaesthesia and Analgesia, 2018
Complaints regarding professional fees make up a large proportion of complaints of unethical behaviour handled by the HPCSA. Full details of fees and costs should be supplied, and this is one item you should not omit from your list of IC topics. If you use a pre-printed form with, amongst others, details of your fees you should not presume that the patient/responsible person has read and understood it without confirmation of some sort. Discussing money when patients are anxious may seem callous and may make one feel uncomfortable, but it is a defensive habit we should simply acquire.‘I heard you talking to the surgeon, I couldn’t move!’: Your patient is a young man who had impacted wisdom teeth removed under GA. As usual, you used a totally intravenous (TIVA) technique combined with non-depolarising relaxants, and did explain this preoperatively, though you omitted the fact that the incidence of awareness may be higher under TIVA plus relaxants, and did not offer an alternative.20 Neither did you mention the possibility of awareness during GA (in one study, 25/19 575 cases or 1–2/1 000, plus 45 possibly aware21).
The effectiveness of integration of virtual patients in a collaborative learning activity
Published in Medical Teacher, 2018
Hesham F. Marei, Jeroen Donkers, Jeroen J. G. Van Merrienboer
The study was conducted at a dental school that involves two separate campuses for male students and female students. All students who were registered for the first time in the oral and maxillofacial surgery course for the academic year 2015/2016 (1st semester) were invited to participate voluntary in the study (n = 96). The study involved the use of eight VPs for teaching, learning and assessment purposes. It targeted two topics, which are impacted wisdom teeth (Topic 1) and maxillofacial trauma (Topic 2) within the same course.