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Oral Diagnosis: the Clinician's Guide
Wright An imprint of Elsevier Science Limited Robert Stevenson House, 1-3 Baxter's Place, Leith Walk, Edinburgh EH I 3AF First published :WOO Reprinted 2002. 238 7X69. fax: (+ 1) 215 238 2239, e-mail: [email protected]. You may also complete your request on-line via the Elsevier Science homepage (http://www.elsevier.com). by selecting'Customer Support' and then 'Obtaining Permissions·. British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging in Publication Data A catalog record for this book is available from the Library of Congress ISBN 0 7236 1040 I _ your source for books. journals and multimedia in the health sciences www.elsevierhealth.com Composition by Scribe Design, Gillingham, Kent Printed and bound in China Contents Preface vii Acknowledgements ix 1 The challenge of diagnosis 1 2 The history 4 3 Examination 11 4 Diagnostic tests 33 5 Pain of dental origin 71 6 Pain of non-dental origin 99 7 Trauma 124 8 Infection 140 9 Cysts 160 10 Ulcers 185 11 White patches 210 12 Bumps, lumps and swellings 226 13 Oral changes in systemic disease 263 14 Oral consequences of medication 290 Index 299 Preface The foundation of any form of successful treatment is accurate diagnosis. Though scientifically based, dentistry is also an art. This is evident in the provision of operative dental care and also in the diagnosis of oral and dental diseases. While diagnostic skills will be developed and enhanced by experience, it is essential that every prospective dentist is taught how to develop a structured and comprehensive approach to oral diagnosis. -
Guideline # 18 ORAL HEALTH
Guideline # 18 ORAL HEALTH RATIONALE Dental caries, commonly referred to as “tooth decay” or “cavities,” is the most prevalent chronic health problem of children in California, and the largest single unmet health need afflicting children in the United States. A 2006 statewide oral health needs assessment of California kindergarten and third grade children conducted by the Dental Health Foundation (now called the Center for Oral Health) found that 54 percent of kindergartners and 71 percent of third graders had experienced dental caries, and that 28 percent and 29 percent, respectively, had untreated caries. Dental caries can affect children’s growth, lead to malocclusion, exacerbate certain systemic diseases, and result in significant pain and potentially life-threatening infections. Caries can impact a child’s speech development, learning ability (attention deficit due to pain), school attendance, social development, and self-esteem as well.1 Multiple studies have consistently shown that children with low socioeconomic status (SES) are at increased risk for dental caries.2,3,4 Child Health Disability and Prevention (CHDP) Program children are classified as low socioeconomic status and are likely at high risk for caries. With regular professional dental care and daily homecare, most oral disease is preventable. Almost one-half of the low-income population does not obtain regular dental care at least annually.5 California children covered by Medicaid (Medi-Cal), ages 1-20, rank 41 out of all 50 states and the District of Columbia in receiving any preventive dental service in FY2011.6 Dental examinations, oral prophylaxis, professional topical fluoride applications, and restorative treatment can help maintain oral health. -
Scabies in Healthcare Facilities
Scabies in Healthcare Facilities Tammra L. Morrison, RN BSN Healthcare Associated Infections Coordinator Communicable Disease Branch, Epidemiology Section December 9, 2016 Symptoms • In a person who has never had scabies: • May take 4-6 weeks for symptom onset • In a person who has had scabies in the past: • Symptoms may start in 1-4 days • May be spread PRIOR to symptom onset What to Look for • Intense itching • Especially at night • Pimple-like itchy rash • May affect entire body OR Dermatologie.md common sites: • Wrist, elbow, armpit, webbing between the fingers, nipple, penis, waist, belt-line, and buttocks • Burrows (tunnels) may be seen on the skin • Tiny raised and crooked grayish-white or skin- colored lines Transmission • Direct, prolonged, skin-to-skin contact with an infested person • Sexual partners • Household members • Quick handshake/hug will usually not spread scabies How Long Do Mites Live? • 1-2 months on a person • 48-72 hours off a person • Scabies mites will die at 122 degrees for 10 minutes Webmd.com 5 Diagnosis • Customary appearance and distribution of the rash and presence of burrows. • Confirm diagnosis: • Obtain a skin scraping to examine under a microscope for mites, eggs, or mite fecal matter • Person can still be infested even if mites, eggs, or fecal matter cannot be found • Typically fewer than 10-15 mites present on the entire body • **Crusted scabies may be thousands of mites and should be considered highly contagious** How Do You Treat Scabies? 7 Treatment • Available only by prescription • No "over-the-counter“ -
AHFS Pharmacologic-Therapeutic Classification System
AHFS Pharmacologic-Therapeutic Classification System Abacavir 48:24 - Mucolytic Agents - 382638 8:18.08.20 - HIV Nucleoside and Nucleotide Reverse Acitretin 84:92 - Skin and Mucous Membrane Agents, Abaloparatide 68:24.08 - Parathyroid Agents - 317036 Aclidinium Abatacept 12:08.08 - Antimuscarinics/Antispasmodics - 313022 92:36 - Disease-modifying Antirheumatic Drugs - Acrivastine 92:20 - Immunomodulatory Agents - 306003 4:08 - Second Generation Antihistamines - 394040 Abciximab 48:04.08 - Second Generation Antihistamines - 394040 20:12.18 - Platelet-aggregation Inhibitors - 395014 Acyclovir Abemaciclib 8:18.32 - Nucleosides and Nucleotides - 381045 10:00 - Antineoplastic Agents - 317058 84:04.06 - Antivirals - 381036 Abiraterone Adalimumab; -adaz 10:00 - Antineoplastic Agents - 311027 92:36 - Disease-modifying Antirheumatic Drugs - AbobotulinumtoxinA 56:92 - GI Drugs, Miscellaneous - 302046 92:20 - Immunomodulatory Agents - 302046 92:92 - Other Miscellaneous Therapeutic Agents - 12:20.92 - Skeletal Muscle Relaxants, Miscellaneous - Adapalene 84:92 - Skin and Mucous Membrane Agents, Acalabrutinib 10:00 - Antineoplastic Agents - 317059 Adefovir Acamprosate 8:18.32 - Nucleosides and Nucleotides - 302036 28:92 - Central Nervous System Agents, Adenosine 24:04.04.24 - Class IV Antiarrhythmics - 304010 Acarbose Adenovirus Vaccine Live Oral 68:20.02 - alpha-Glucosidase Inhibitors - 396015 80:12 - Vaccines - 315016 Acebutolol Ado-Trastuzumab 24:24 - beta-Adrenergic Blocking Agents - 387003 10:00 - Antineoplastic Agents - 313041 12:16.08.08 - Selective -
CCA Senior Care Options Formulary
Commonwealth Care Alliance Senior Care Option HMO SNP 2021 List of Covered Drugs Formulary 30 Winter Street • Boston, MA 02108 PLEASE READ: THIS DOCUMENT CONTAINS INFORMATION ABOUT THE DRUGS WE COVER IN THIS PLAN This formulary was updated on 08/01/2021. For more recent information or other questions, please contact Senior Care Options Program (HMO SNP) Member Services, at 1-866-610-2273 or, for TTY users, 711, 8 a.m. – 8 p.m., 7 days a week, or visit www.commonwealthcaresco.org. HPMS Approved Formulary File Submission ID 00021589, Version Number 13 Senior Care Options Program (HMO SNP) 2021 Formulary (List of Covered Drugs) PLEASE READ: THIS DO CUMENT CONTAINS INFORMATION ABOUT THE DRUGS WE COVER IN THIS PLAN HPMS Approved Formulary File Submission ID 00021589, Version Number 13 Note to existing members: This formulary has changed since last year. Please review this document to make sure that it still contains the drugs you take. When this drug list (formulary) refers to “we,” “us”, or “our,” it means Commonwealth Care Alliance. When it refers to “plan” or “our plan,” it means 2021 Senior Care Options Program. This document includes list of the drugs (formulary) for our plan which is current as of 08/01/2021. This formulary document applies to all SCO members. For an updated formulary, please contact us. Our contact information, along with the date we last updated the formulary, appears on the front and back cover pages. You must generally use network pharmacies to use your prescription drug benefit. Benefits, formulary, pharmacy n etwork, and/or copayments/coinsurance may change on January 1, 2022, and from time to time during the year. -
Oral Lesions in Sjögren's Syndrome
Med Oral Patol Oral Cir Bucal. 2018 Jul 1;23 (4):e391-400. Oral lesions in Sjögren’s syndrome patients Journal section: Oral Medicine and Pathology doi:10.4317/medoral.22286 Publication Types: Review http://dx.doi.org/doi:10.4317/medoral.22286 Oral lesions in Sjögren’s syndrome: A systematic review Julia Serrano 1, Rosa-María López-Pintor 1, José González-Serrano 1, Mónica Fernández-Castro 2, Elisabeth Casañas 1, Gonzalo Hernández 1 1 Department of Oral Medicine and Surgery, School of Dentistry, Complutense University, Madrid, Spain 2 Rheumatology Service, Hospital Infanta Sofía, Madrid, Spain Correspondence: Departamento de Especialidades Clínicas Odontológicas Facultad de Odontología Universidad Complutense de Madrid Plaza Ramón y Cajal s/n, 28040 Madrid. Spain [email protected] Serrano J, López-Pintor RM, González-Serrano J, Fernández-Castro M, Casañas E, Hernández G. Oral lesions in Sjögren’s syndrome: A system- atic review. Med Oral Patol Oral Cir Bucal. 2018 Jul 1;23 (4):e391-400. Received: 18/11/2017 http://www.medicinaoral.com/medoralfree01/v23i4/medoralv23i4p391.pdf Accepted: 09/05/2018 Article Number: 22291 http://www.medicinaoral.com/ © Medicina Oral S. L. C.I.F. B 96689336 - pISSN 1698-4447 - eISSN: 1698-6946 eMail: [email protected] Indexed in: Science Citation Index Expanded Journal Citation Reports Index Medicus, MEDLINE, PubMed Scopus, Embase and Emcare Indice Médico Español Abstract Background: Sjögren’s syndrome (SS) is an autoimmune disease related to two common symptoms: dry mouth and eyes. Although, xerostomia and hyposialia have been frequently reported in these patients, not many studies have evaluated other oral manifestations. -
Oral Manifestations of Systemic Disease Their Clinical Practice
ARTICLE Oral manifestations of systemic disease ©corbac40/iStock/Getty Plus Images S. R. Porter,1 V. Mercadente2 and S. Fedele3 provide a succinct review of oral mucosal and salivary gland disorders that may arise as a consequence of systemic disease. While the majority of disorders of the mouth are centred upon the focus of therapy; and/or 3) the dominant cause of a lessening of the direct action of plaque, the oral tissues can be subject to change affected person’s quality of life. The oral features that an oral healthcare or damage as a consequence of disease that predominantly affects provider may witness will often be dependent upon the nature of other body systems. Such oral manifestations of systemic disease their clinical practice. For example, specialists of paediatric dentistry can be highly variable in both frequency and presentation. As and orthodontics are likely to encounter the oral features of patients lifespan increases and medical care becomes ever more complex with congenital disease while those specialties allied to disease of and effective it is likely that the numbers of individuals with adulthood may see manifestations of infectious, immunologically- oral manifestations of systemic disease will continue to rise. mediated or malignant disease. The present article aims to provide This article provides a succinct review of oral manifestations a succinct review of the oral manifestations of systemic disease of of systemic disease. It focuses upon oral mucosal and salivary patients likely to attend oral medicine services. The review will focus gland disorders that may arise as a consequence of systemic upon disorders affecting the oral mucosa and salivary glands – as disease. -
Oral Candidosis: Aetiology, Clinical Manifestations, Diagnosis and Management Birsay Gümrü Tarçın
MÜSBED 2011;1(2):140-148 Derleme / Review Oral Candidosis: Aetiology, Clinical Manifestations, Diagnosis and Management Birsay Gümrü Tarçın Marmara University Faculty of Dentistry, Department of Oral Diagnosis and Radiology, Istanbul-Turkey Ya zış ma Ad re si / Add ress rep rint re qu ests to: Birsay Gümrü Tarçın Marmara University Faculty of Dentistry, Department of Oral Diagnosis and Radiology, Büyükçiftlik Sok. No: 6 34365 Nişantaşı, Şişli, İstanbul-Turkey Telefon / Phone: +90-212-231-9120 Faks / Fax: +90-212-246-5247 Elekt ro nik pos ta ad re si / E-ma il add ress: [email protected] Ka bul ta ri hi / Da te of ac cep tan ce: 22 Ağustos 2011 / August 22, 2011 ÖZET ABS TRACT Oral kandidozis: Etiyoloji, klinik özellikler, tanı Oral candidosis: aetiology, clinical ve tedavi manifestations, diagnosis and management Oral kandidozis dişhekimliği pratiğinde en sık karşılaşılan fungal Oral candidosis is the most common fungal infection encountered enfeksiyondur. Birçok farklı klinik görünümde ortaya çıkabildi- in dental practice. Clinical diagnosis and management of oral ğinden, klinik tanı ve tedavisi genellikle zordur. Hastalık sıklıkla candidosis is usually complicated, because it is encountered in a sistemik rahatsızlığı olan spesifik hasta gruplarında ortaya çık- wide variety of clinical presentations. The disease often manifests maktadır. Bu nedenle, oral kandidozis tedavisi öncelikle predis- in specific patient groups that are systemically compromised. pozisyon yaratan durumların kapsamlı tetkikini içermelidir. Bu Therefore, the management should always cover a thorough derlemede sık karşılaşılan oral kandidal lezyonların etiyolojisi, investigation of underlying predisposing conditions. This klinik görünümü, tanı ve tedavi stratejileri kapsamlı bir şekilde review provides a comprehensive overview of the aetiology, gözden geçirilmektedir. -
Salicylic Acid
Treatment Guide to Common Skin Conditions Prepared by Loren Regier, BSP, BA, Sharon Downey -www.RxFiles.ca Revised: Jan 2004 Dermatitis, Atopic Dry Skin Psoriasis Step 1 - General Treatment Measures Step 1 - General Treatment Measures Step 1 • Avoid contact with irritants or trigger factors • Use cool air humidifiers • Non-pharmacologic measures (general health issues) • Avoid wool or nylon clothing. • Lower house temperature (minimize perspiration) • Moisturizers (will not clear skin, but will ↓ itching) • Wash clothing in soap vs detergent; double rinse/vinegar • Limit use of soap to axillae, feet, and groin • Avoid frequent or prolonged bathing; twice weekly • Topical Steroids Step 2 recommended but daily bathing permitted with • Coal Tar • Colloidal oatmeal bath products adequate skin hydration therapy (apply moisturizer • Anthralin • Lanolin-free water miscible bath oil immediately afterwards) • Vitamin D3 • Intensive skin hydration therapy • Limit use of soap to axillae, feet, and groin • Topical Retinoid Therapy • “Soapless” cleansers for sensitive skin • Apply lubricating emollients such as petrolatum to • Sunshine Step 3 damp skin (e.g. after bathing) • Oral antihistamines (1st generation)for sedation & relief of • Salicylic acid itching give at bedtime +/- a daytime regimen as required Step 2 • Bath additives (tar solns, oils, oatmeal, Epsom salts) • Topical hydrocortisone (0.5%) for inflammation • Colloidal oatmeal bath products Step 2 apply od-tid; ointments more effective than creams • Water miscible bath oil • Phototherapy (UVB) may use cream during day & ointment at night • Humectants: urea, lactic acid, phospholipid • Photochemotherapy (Psoralen + UVA) Step 4 Step 3 • Combination Therapies (from Step 1 & 2 treatments) • Prescription topical corticosteroids: use lowest potency • Oral antihistamines for sedation & relief of itching steroid that is effective and wean to twice weekly. -
Dermatological Effects of Different Keratolytic Agents on Acne Vulgaris
Clin l of ica a l T n r r i u a l o s J Alodeani, J Clin Trials 2016, 6:2 Journal of Clinical Trials DOI: 10.4172/2167-0870.1000262 ISSN: 2167-0870 Research Article Open Access Dermatological Effects of Different Keratolytic Agents on Acne Vulgaris Essa Ajmi Alodeani* College of Medicine at AD-Dwadmi, Shaqra University, Saudi Arabia *Corresponding author: Essa Ajmi Alodeani, College of Medicine at AD-Dwadmi, Shaqra University, Saudi Arabia, Tel: +966 55 075 9042; E-mail: [email protected] Received date: March 24, 2016; Accepted date: April 18, 2016; Published date: April 25, 2016 Copyright: © 2016 Alodeani EA. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Acne vulgaris is a chronic inflammatory skin disease; it's one of the most common skin disorders and affects mainly adolescents and young adults. Keratolytic agents are widely used in treatment of acne from several years. In this study we aimed to evaluate and compare the cutaneous response of different keratolytic agents in management of acne vulgaris. Ninety patients were selected among those attending the outpatient dermatology clinic in AD- Dwadmi hospital during the period from October 2015 to February 2016. The selected patients had different forms of acne vulgaris, papulo-pustular, comedonal and post acne scar. Three types of keratolytic agents were used, glycolic acid 50%, salicylic acid 20% and jessner solution. In papulopustular lesions, the three agents were effective with non-significant difference between them; however, there was more excellent results with jessner solution (70 % of patients) then glycolic acid (50%) and lastly salicylic acid (40%). -
Addisonian Pigmentation of the Oral Mucosa
PEDIATRIC DERMATOLOGY Series Editor: Camila K. Janniger, MD Addisonian Pigmentation of the Oral Mucosa Samir S. Shah, MD; Catherine H. Oh, MD; Susan E. Coffin, MD, MPH; Albert C. Yan, MD Cutaneous pigmentation is a hallmark of Addison Free thyroxine and thyrotropin levels were within disease. When present, the hyperpigmentation reference range. generally localizes to sun-exposed surfaces. This case highlights a less well-recognized Comment cutaneous feature that is pathognomonic for the Addison disease, a chronic primary insufficiency of disease: oral mucous membrane hyperpigmenta- the adrenal glands, results in both glucocorticoid and tion. We describe this unique type of discolor- mineralocorticoid deficiency. Historically, tuberculo- ation in detail and contrast it with other forms of sis accounted for most cases of Addison disease.1 oral pigmentation. Autoimmune destruction of the adrenal glands, also Cutis. 2005;76:97-99. known as autoimmune adrenalitis, is now the most common cause of Addison disease in both children and adults.2,3 Autoimmune destruction of other Case Report endocrine tissues can occur concurrently. These A 9-year-old girl presented with a 4-month history polyglandular autoimmune syndromes are associated of painless black patches on the tongue and gingiva. with hypoparathyroidism, pernicious anemia, and The patches had persisted despite treatment with chronic mucocutaneous candidiasis (type 1); diabetes oral fluconazole, which had been prescribed empiri- mellitus (type 2); or thyroiditis (type 3).4 Type 3, cally for presumed oral candidiasis. Results of a phys- however, consists of an autoimmune thyroiditis ical examination revealed scattered, asymptomatic, syndrome in the absence of Addison disease.5 bluish-black macules on the dorsal surface of the Although most children (75%) presenting with isolated tongue, the mucosal surface of the lower lip, and the Addison disease are boys,6 type 1 autoimmune poly- hard palate (Figure). -
The OHNEP Interprofessional Oral Health Faculty Toolkit
The OHNEP Interprofessional Oral Health Faculty Toolkit Adult-Gerontology Nurse Practitioner Program CURRICULUM INTEGRATION OF INTERPROFESSIONAL ORAL HEALTH CORE COMPETENCIES: • Adult-Gerontology Health Assessment • Adult-Gerontology Health Promotion • Adult-GerontologyPrimary Care • Resources © Oral Health Nursing Education and Practice (OHNEP) INTRODUCTION The Oral Health Nursing Education and Practice (OHNEP) program has developed an Interprofessional Oral Health Faculty Tool Kit to S! provide you with user friendly curriculum templates and teaching-learning resources to use when integrating oral health and its links to ! overall health in your Adult-Gerontology Nurse Practitioner program. ! Oral health and its relation to overall health has been identified as an important population health issue. Healthy People 2020 (2011), the IOM Reports, Advancing Oral Health in America (2011) and Building Workforce Capacity in Oral Health (2011), as well as the IPEC Competencies ! (2011), challenged HRSA to develop interprofessional oral health core competencies for primary care providers. Publication of the report, ! Integrating Oral Health in Primary Care Practice (2014), reflects those interprofessional oral health competencies that can be used by Adult- Gerontology Nurse Practitioners for faculty development, curriculum integration and establishment of “best practices” in clinical settings. ! The HRSA interprofessional oral health core competencies, the IPEC competencies and the NONPF core competencies provide the framework for the curriculum templates and resources. Exciting teaching-learning strategies that take students from Exposure to Immersion to Competence can begin in the classroom, link to simulated or live clinical experiences and involve community-based service learning, advocacy and policy initiatives as venues you can readily use to integrate oral health into your existing primary care curriculum.