Risk Assessment and Oral Diagnostics in Clinical Dentistry

Title Page
......Page 2
Copyright
......Page 3
Contents......Page 4
Authors......Page 5
Preface......Page 6
Acknowledgements......Page 8
Part A: Guidelines for Risk Assessment of Systemic Conditions that may Complicate or be Complicated by Dental Treatment......Page 9
1.1.1 Chief complaint......Page 10
1.1.5 Review of systems......Page 11
1.1.6 Family and social history......Page 13
1.2.2 Intraoral examination......Page 14
1.3 Ordering and performing laboratory tests......Page 16
1.3.3 Microbiology studies......Page 18
1.3.4 Histopathology studies......Page 22
1.4 Radiology studies......Page 27
1.4.1 Plain film......Page 28
1.4.2 Computed tomography......Page 29
1.4.4 Other imaging studies......Page 30
1.5 Suggested literature......Page 33
2.1 Vital signs......Page 34
2.2.2 Saliva as a diagnostic fluid......Page 37
2.3 General blood tests......Page 38
2.3.2 Red blood cells......Page 39
2.3.3 White blood cells......Page 45
2.4.1 Liver function......Page 46
2.4.2 Kidney function......Page 49
2.4.3 Electrolytes......Page 50
2.5 Suggested literature......Page 52
3.0 Introduction......Page 53
3.1 Platelets......Page 56
3.1.2 Platelet abnormalities......Page 57
3.2.1 Tests of coagulation......Page 61
3.2.2 Coagulation abnormalities......Page 62
3.2.3 Guidelines for dental treatment 3.2.3.1......Page 64
3.3 Suggested literature......Page 68
4.1 Medical conditions associated with an increased risk of oral infection......Page 69
4.1.1 Hematologic malignancies......Page 70
4.1.2 Aplastic anemia......Page 71
4.1.3 HIV infection......Page 72
4.2.1 Chemotherapy......Page 74
4.3.1 Basic tests of white blood cells......Page 75
4.3.2 Adjunctive tests......Page 77
4.4 Implications of abnormal wbc tests on provision of oral care......Page 78
4.5.1 Cardiac complications......Page 79
4.5.3 Recommendations for antibiotic prophylaxis......Page 80
4.6 Suggested literature......Page 81
5.0 Introduction......Page 83
5.1 Diabetes mellitus......Page 84
5.1.1 Tests for diagnosis and monitoring of DM......Page 85
5.2 Adrenal disorders......Page 88
5.2.1 Tests of adrenal function......Page 89
5.2.2 Implications of abnormal tests on provision of oral care......Page 90
5.3 Bone metabolism......Page 91
5.3.1 Bone metabolism tests 5.3.1.1......Page 92
5.5 Suggested literature......Page 93
Part B: Guidelines for Diagnosis of Orofacial Conditions
......Page 94
6.1 Dental caries......Page 95
6.1.1 Caries risk assessment......Page 96
6.1.2 Diagnosis of dental caries......Page 98
6.2 Periodontal disease......Page 104
6.2.1 Risk factors for periodontal disease......Page 105
6.2.2 Diagnosis of periodontal disease......Page 106
6.3 Selected literature......Page 108
7.1.1 Tests of bacterial infection......Page 110
7.1.2 Antimicrobials and spectrum......Page 115
7.2 Fungal infection......Page 117
7.2.1 Tests of fungal infection......Page 118
7.3 Viral infection......Page 120
7.3.2 Viral culture......Page 121
7.3.5 Biopsy......Page 123
7.5 Selected literature......Page 124
8.0 Introduction......Page 125
8.1.3 Oral discomfort......Page 126
8.2.1 Measurement of xerostomia and salivary hypofunction......Page 127
8.2.3 Salivary pH and buffering capacity......Page 129
8.2.4 Imaging studies......Page 130
8.3.1 Sialolithiasis......Page 131
8.3.5 Necrotizing sialometaplasia......Page 133
8.4.1 Diagnostic criteria......Page 135
8.5 Suggested literature......Page 139
9.0 Introduction......Page 140
9.2 Oral potentially malignant lesions......Page 144
9.3 Oral squamous cell carcinoma......Page 145
9.4 Other cancers of the oral cavity......Page 146
9.5.1 Physical examination......Page 147
9.5.2 Tissue biopsy......Page 148
9.6 Adjunctive tests......Page 149
9.6.3 Toluidine blue/tolonium chloride......Page 150
9.7 Selected literature......Page 151
10.0 Introduction......Page 152
10.1 Cancer pre-treatment risk assessment......Page 153
10.1.1 Head and neck cancers......Page 155
10.1.3 Antiresorptive therapy......Page 156
10.2.2 Oral mucositis......Page 157
10.2.3 Oral infection......Page 159
10.3.1 Hyposalivation......Page 160
10.3.2 Chronic GVHD......Page 161
10.3.4 Nutrition, taste, and smell impairment......Page 162
10.4.2 Caries......Page 163
10.4.4 Medication-associated osteonecrosis of the jaw......Page 165
10.4.5 Trismus and other musculoskeletal presentations......Page 168
10.4.7 Recurrent disease, second primary cancers, and metastatic disease......Page 169
10.5 Selected literature......Page 170
11.1 Autoimmune conditions......Page 171
11.1.1 Autoimmune conditions that target epithelium 11.1.1.1......Page 172
11.1.2 Autoimmune conditions that target connective tissue 11.1.2.1......Page 173
11.2 Immune-mediated conditions......Page 181
11.2.1 Lichen planus......Page 182
11.2.3 Recurrent aphthous stomatitis......Page 183
11.2.4 Erythema multiforme......Page 184
11.2.5 Granulomatous conditions......Page 185
11.3 Allergic disorders......Page 188
11.3.2 Contact hypersensitivity......Page 189
11.3.3 Plasma cell gingivitis......Page 190
11.4 Suggested literature......Page 191
12.0 Introduction......Page 192
12.2 General classification of pain......Page 194
12.3.1 Pain history......Page 195
12.3.2 Clinical pain assessment......Page 196
12.3.4 Other diagnostic modalities......Page 197
12.3.5 Behavioral aspects of pain......Page 199
12.4.1 Temporomandibular disorders......Page 201
12.4.2 Neuropathic pain......Page 203
12.4.3 Other pain conditions
......Page 205
12.5 Selected literature......Page 207
Appendix......Page 209
Index......Page 212