Essentials of Human Disease in Dentistry (eBook)

Mark Greenwood (Autor)

eBook Download: PDF

2018 | 2. Auflage
John Wiley & Sons (Verlag)
978-1-119-25182-8 (ISBN)

Infos

A comprehensive guide to providing effective dental treatment and care to patients affected by diseases

Essentials of Human Disease in Dentistry, Second Edition takes an integrated approach to dentistry and how it relates to general medicine, surgery, pharmacology, therapeutics, pathology and microbiology.  Building on the success of the Textbook of Human Disease in Dentistry, this new edition has been updated with a new layout, featuring key topics, learning objectives and practical clinical advice in each chapter.

This accessible guide is structured around the systems of the body and covers all major diseases and conditions with their aetiology, symptoms, and treatments. The focus is on the relevance of particular diseases and their drug treatment in relation to dentistry and patient dental management.

This vital resource:

• Promotes a better understanding of how to provide effective dental treatment to patients affected by diseases
• Presents illustrative examples and helpful clinical photographs throughout
• Includes a new chapter on the importance of understanding shock
• Features self-assessment questions at the end of each chapter, and a companion website hosting downloadable images from the book

Essentials of Human Disease in Dentistry, Second Edition is an invaluable resource for undergraduate dentistry students as well as newly qualified dentists preparing for the MFDS exam. 

About the Author
Mark Greenwood is an NHS Consultant in Oral and Maxillofacial Surgery as well as Honorary Clinical Professor of Medical Education in Dentistry at the School of Dental Sciences, Newcastle University, UK. Qualified in both medicine and dentistry, he has been published in many peer reviewed journals and has co-authored two books on general medicine and surgery for dental practitioners.

Inhalt

Title Page 5
Copyright Page 6
Contents 7
Contributors 10
Preface to the first edition 13
Preface to the second edition 14
Acknowledgements 15
About the companion website 16
Chapter 1 Clinical examination and history taking 17
Components of a medical history 18
Presenting complaint 18
History of the presenting complaint 18
Past medical history 18
Allergies 18
Past dental history 19
Drugs 19
‘Recreational’ drugs 19
Complementary therapies 19
Implanted cardiac devices 20
Social history 20
Family history 20
Psychiatric history 20
General questions 20
Cardiovascular system 20
Respiratory system 20
Gastrointestinal system 20
Neurological system 20
Musculoskeletal system 20
Genitourinary system 20
Clinical observations in the clothed patient 21
Overall view of the patient 21
Examination of the hands 21
The face 22
Examination of the cardiovascular system in the clothed patient 23
Jugular venous pressure 23
Respiratory system 23
Gastrointestinal system 23
Vital signs 24
Specific lesions 24
Summary 25
Further Reading 25
Multiple Choice Questions 26
Chapter 2 Inflammation and anti-inflammatory drugs 27
Cell and tissue injury – Introduction 28
Necrosis 28
Coagulative necrosis 28
Colliquative necrosis 28
Caseous necrosis 28
Fibrinoid necrosis 28
Fat necrosis 28
Gangrene 28
Apoptosis 28
Wound healing 29
Inflammation – Introduction 30
Pathogenesis of acute inflammation 31
Sequelae of acute inflammation 31
Organisation 32
Suppuration 32
Fibrinous inflammation 32
Serous inflammation 32
Ulceration 32
Pathogenesis of chronic inflammation 32
Primary chronic inflammation 33
Persistent infection 33
Foreign body reactions 33
Autoimmune disease 33
Granulomatous inflammation 33
Systemic effects of inflammation 33
Anti-inflammatory drugs 34
Antihistamines 35
H1 receptor antagonists 35
Uses 35
Unwanted effects 35
Dental uses of antihistamines 35
Corticosteroids 35
Anti-inflammatory action of corticosteroids 35
Anti-inflammatory actions of corticosteroids applicable to dentistry 35
Further Reading 36
Multiple Choice Questions 36
Chapter 3 Principles of infection and infection control 37
Chapter 3A Sterilisation, disinfection and antiseptics 38
Sterilisation and disinfection 38
General principles 38
What should be sterilised? 38
Decontamination and pre?cleaning 38
Sterilisation and disinfection methods 38
Monitoring efficacy 39
Heat 39
Dry heat 39
Moist heat 39
Irradiation 40
Filtration 40
Chemicals 40
Gases 40
Antiseptics 40
Terminology 40
Skin preparations 40
Antiseptic mouthwashes (antiplaque agents, plaque-inhibitory agents) 40
Chlorhexidine 40
Phenols 42
Quaternary ammonium compounds (QACs) 42
Chapter 3B Principles of infection and infection control, diagnosis and treatment of bacterial infections 43
Introduction 43
Use of the laboratory in the diagnosis of bacterial infections 43
Microscopy 43
Light microscopy 43
Phase contrast microscopy 44
Dark ground microscopy 44
Fluorescent microscopy 44
Electron microscopy 44
Staining techniques 44
Gram stain 44
Bacterial morphology 45
Culture and identification 46
Bacterial typing 47
Antimicrobial susceptibility testing 47
Disc sensitivity testing 47
Minimum inhibitory concentration (MIC) 47
Non-cultural diagnostic techniques 48
Latex agglutination testing 48
Enzyme-linked immunosorbent assay (ELISA) 48
Serology 48
Molecular methods 48
Gene probes 49
Polymerase chain reaction (PCR) 49
Restriction enzyme analysis 49
Pulsed-field gel electrophoresis 50
DNA sequencing 50
General principles of specimen collection 50
Antibacterial drugs 50
Antibacterials that interfere with the bacterial cell wall 50
Penicillins and cephalosporins 51
Antibacterials that interfere with bacterial protein synthesis 51
Tetracyclines 51
Erythromycin 51
Clindamycin 51
Antibacterials that interfere with bacterial nucleic acid 52
Metronidazole 52
Antimetabolic antibiotics 52
Sulphonamides and trimethoprim 52
Antibacterial use in dentistry 52
Therapeutics 52
Prophylaxis 52
Unwanted effects of antibacterial drugs 53
Chapter 3C Viruses and antiviral agents relevant to dentistry 54
Viruses relevant to dentistry 54
What is a virus? 54
Virus classification 54
The major groups of animal viruses 54
The DNA viruses 54
The RNA viruses 55
Diagnosis of virus infections 55
Hepatitis 55
Hepatitis A and E 55
Hepatitis B virus (HBV) 55
Hepatitis C (HCV) 56
Hepatitis D 56
Chronic hepatitis 56
Blood-borne virus infections: prevention 56
Herpes simplex virus (HSV) 57
Biology and epidemiology 57
Clinical presentation 57
Specimen collection and laboratory diagnosis 57
Treatment 57
Varicella zoster virus (VZV) 57
Biology and epidemiology 57
Clinical presentation 57
Sample collection and laboratory diagnosis 58
Treatment 58
Prevention 58
Cytomegalovirus (CMV) 58
Biology and epidemiology 58
Clinical presentation 58
Specimen collection and laboratory diagnosis 59
Treatment 59
Epstein–Barr virus (EBV) 59
Biology and epidemiology 59
Clinical presentation 59
Specimen collection and laboratory diagnosis 59
Treatment 59
Enteroviruses 59
Biology and clinical presentation 59
Herpangina 59
HFMD 59
Diagnosis 59
Treatment 59
Mumps 60
Biology and epidemiology 60
Clinical presentation 60
Diagnosis 60
Treatment 60
Adenovirus 60
Biology and epidemiology 60
Clinical presentation 60
Laboratory diagnosis 60
Treatment 60
Other respiratory infections 60
Antiviral agents 60
Mechanism of action of antiviral medications 61
Unwanted effects of antiviral agents 61
Drug interactions with antiviral agents 61
Chapter 3D Infection with immunodeficiency virus and implications for the oral cavity:: Infection with HIV 62
Introduction 62
Epidemiology 62
Clinical presentations 62
Oral manifestations of HIV disease 63
Fungal infections 63
Candidiasis 63
Clinical features 64
Differential diagnosis 64
Diagnosis 64
Treatment 65
Topical treatment 65
Systemic treatment 65
Prognostic significance 65
Histoplasmosis 65
Cryptococcus neoformans 65
Human papillomavirus lesions 65
Clinical features 65
Differential diagnosis 65
Prognosis 65
Treatment 65
Hairy leukoplakia and EBV 65
Hairy leukoplakia and the progression of HIV disease 66
Clinical appearance and manifestations 66
Differential diagnosis 66
Diagnosis 66
Treatment 66
Bacterial lesions 66
Periodontal disease 66
Differential diagnosis 66
Different course in HIV infection 66
Neoplastic lesions 66
Kaposi’s sarcoma (KS) 66
Clinical features 66
Differential diagnosis 67
Treatment 67
Lymphoma 67
Clinical features 67
Differential diagnosis 67
Treatment 67
Other oral lesions associated with HIV disease 67
Oral ulceration 67
Diagnosis 67
Treatment 67
Idiopathic thrombocytopaenic purpura (ITP) 68
Clinical features 68
Differential diagnosis 68
Salivary gland disease and xerostomia 68
Management 68
Diagnosis of HIV infection 68
Principles of treatment 68
Chapter 3E Fungi and antifungal agents 69
Fungi 69
Antifungal agents 69
Unwanted effects of antifungal medication 69
Further Reading 69
Multiple Choice Questions 69
Chapter 4 Immunological disease 71
Introduction 72
Overview of a normal immune response 72
What is immunodeficiency? 72
What are the consequences of immunodeficiency? 73
Infection 73
Autoimmunity and malignancy 73
What are the symptoms and signs of immunodeficiency? 73
Examples of specific primary immunodeficiencies seen in dental practice 73
Common variable immunodeficiency (CVID) 73
Wiskott–Aldrich syndrome (WAS) 73
Chronic mucocutaneous candidiasis (CMC) 73
Chronic granulomatous disease (CGD) 73
Deficiency of C1 esterase inhibitor (hereditary angioedema) 73
Implications of immunodeficiency in dental practice 74
Common conditions can be features of immunodeficiency 74
Allergy in dental practice 74
Introduction 74
Incidence of allergic diseases 74
Allergens and irritants in dental practice 74
Type I hypersensitivity (allergy) 74
Pathogenesis 74
Clinical features of allergic reactions 75
Diagnosis of type I hypersensitivity reactions 75
Laboratory investigations 75
Skin prick tests 76
Challenge tests 76
Causes of type I hypersensitivity reactions in dental practice 76
Latex allergy 76
Other agents associated with type I hypersensitivity reactions in dental practice 77
Chlorhexidine 77
Local anaesthetics 77
Treatment of type I hypersensitivity reactions 77
Minor reactions 77
Major reactions/anaphylaxis 77
Other reactions 77
Stomatitis 77
Oral erythema 77
Cheilitis 78
Autoimmune disease 78
Examples of autoimmune disease seen in dental practice 78
Organ specific 78
Systemic autoimmunity 79
IgG4-related disease 80
Immunosuppressants 80
Dental problems of immunosuppressed patients 80
Fungal infections 80
Viral infections 81
Malignancy 81
Ciclosporin-induced gingival overgrowth 81
Further Reading 82
Multiple Choice Questions 82
Chapter 5 Cardiovascular disorders 83
Chapter 5A Introduction to cardiovascular disease (CVD) 84
The heart and circulation 84
Electrical control 85
Cardiac circulation 85
Cardiovascular pathology 85
Atherosclerosis 85
Definitions 86
Risk factors 86
Pathogenesis of atherosclerosis 86
Drugs used in the prevention of atherosclerosis 87
Consequences of atherosclerosis 87
Aneurysms 87
Thrombosis, embolism, ischaemia and infarction 88
Definitions 88
Thrombosis 88
Arterial thrombosis 88
Venous thrombosis 89
Cardiac thrombosis 89
Embolism 89
Pulmonary embolism 89
Systemic embolism 90
Ischaemia and infarction 90
Clinical features of CVD 90
Symptoms 90
Signs detectable in the clothed patient 91
Cardiac investigations 92
Clinical aspects of MI 92
Angina 93
Chapter 5B Heart failure 94
Introduction 94
Pathophysiology 94
Cardiac causes of heart failure 94
Neurohormonal adaptive responses 94
Exacerbating conditions 95
Clinical aspects of heart failure 95
Treatment of heart failure 95
Drugs used to manage heart failure 95
Chapter 5C Cardiac arrhythmias 97
Pathophysiology 97
Tachycardias 97
Bradycardias 97
Clinical aspects of arrhythmias 97
Drugs used to manage cardiac arrhythmias 98
Class I: membrane-stabilising drugs 98
Mechanism of action 98
Impact on oral structures and dental management 98
Drug interactions relevant to dental practice 98
Class II: ?-adrenoreceptor antagonists 98
Mechanism of action 98
Class III: agents influencing potassium channels 98
Mechanism of action 98
Impact on oral structures and denta lmanagement 98
Drug interactions relevant to dental practice 99
Class IV: calcium channel blockers 99
Mechanism of action 99
Cardiac glycosides 99
Mechanism of action 99
Impact on oral structures and dental management 99
Drug interactions relevant to dental practice 99
Chapter 5D Valvular heart disease 100
Introduction 100
Pathology of valvular heart disease 100
Rheumatic fever 100
Infective endocarditis 100
Prophylaxis against infective endocarditis 101
Chapter 5E Hypertension 103
Measurement of blood pressure 103
Drugs used to treat hypertension 104
Diuretics and aldosterone antagonists 104
Mechanism of action 104
Impact on oral structures and dental management 104
Drug interactions relevant to dental practice 104
ACE inhibitors 104
Mechanism of action 105
Impact on oral structures and dental management 105
Drug interactions relevant to dental practice 105
Angiotensin II receptor antagonists 105
Mechanism of action 105
Impact on oral structures and dental management 105
Drug interactions relevant to dental practice 105
Calcium channel blockers 105
Mechanism of action 105
Impact on oral structures and dental management 105
Drug interactions relevant to dental practice 105
?-Adrenoreceptor antagonists 105
Mechanism of action 106
Impact on oral structures and dental management 106
Drug interactions relevant to dental practice 106
?-Adrenoreceptor blockers 106
Mechanism of action 106
Impact on oral structures and dental management 106
Vasodilators 106
Mechanism of action 106
Impact on oral structures and dental management 106
Centrally acting drugs 106
Mechanism of action 106
Impact on oral structures and dental management 106
Treatment of hypertension 106
Chapter 5F Anticoagulants, drugs affecting blood clotting 108
Heparin 108
Pharmacodynamics 108
Pharmacological properties 108
Unwanted effects 108
Oral anticoagulants 108
Pharmacological properties 108
Monitoring patients on oral anticoagulants 109
Unwanted effects 109
Dental management of patients on warfarin 109
Uses of anticoagulants 109
Antiplatelet drugs 110
Aspirin 110
Use of aspirin as an antiplatelet drug 110
Clopidogrel 110
Prasugrel 110
Dipyridamole 110
Fibrinolytic and antifibrinolytic drugs 110
Fibrinolytic drugs 110
Antifibrinolytic drugs 110
Chapter 5G Dental implications of CVD 111
Hypertensive patients 111
Patients post-MI 111
Other aspects of management 111
Smoking and the cardiovascular system 112
Chapter 5H Peripheral vascular and cardiac surgical disorders 113
Peripheral vascular disorders 113
The chronically ischaemic leg 113
Management: claudication 113
Management: critical ischaemia 114
The acutely ischaemic leg 114
Peripheral arterial aneurysms 114
Complications of aneurysms 114
AAAs 114
Carotid disease 115
Venous disease and leg ulcers 116
Varicose veins 116
DVT and pulmonary embolism 116
DVT 116
Pulmonary embolism 116
Prophylaxis against DVT 116
Leg ulceration 117
Treatment of leg ulceration 117
Swollen legs/lymphoedema 117
Causes of secondary lymphoedema 118
Cardiac surgical disorders 118
Coronary artery bypass surgery 118
Diagnosis 118
Management 118
Percutaneous coronary intervention (PCI) 118
Coronary artery bypass grafting (CABG) 118
Valvular heart disease 118
Symptoms 118
Aetiology and individual valve lesions 118
Diagnosis 119
Treatment 119
Cardiac transplantation 119
Congenital heart disease 119
Classification 119
PDA 120
ASDs 120
VSDs 120
Coarctation of the aorta 120
Truncus arteriosus 120
Transposition of great vessels 120
Tetralogy of Fallot 120
Aetiology 120
Management 120
Further Reading 121
Multiple Choice Questions 121
Chapter 6 Respiratory disorders 123
Introduction 124
Clinical assessment 124
Symptoms 124
Examination 124
General medical history 125
Investigating respiratory disease 125
Asthma 126
Drugs used to treat asthma 126
Bronchodilators (‘relievers’) 126
Anti-inflammatory drugs (‘preventers’) 127
COPD 127
Lung cancer 128
Obstructive sleep apnoea syndrome (OSAS) 129
Respiratory tract infections 130
Cystic fibrosis and bronchiectasis 130
Pulmonary embolism 131
Fibrotic lung disease 131
Management of inhaled foreign body 131
What happens in the accident and emergency department? 132
Respiratory disorders and dentistry 132
Examination of the clothed patient 133
Specific disorders 133
Asthma 133
Infections 133
Chronic suppurative respiratory disorders 133
TB 133
Lung abscess 133
Legionnaire’s disease 134
Lung cancer 134
Sarcoidosis 134
OSAS 134
Acute respiratory distress syndrome (ARDS) 134
Further Reading 134
Multiple Choice Questions 134
Chapter 7 Gastrointestinal disorders 136
Introduction 137
Relevant points in the history 137
Examination 139
Liver disease 139
Liver failure 139
Cirrhosis 140
Haemochromatosis 141
Wilson’s disease 141
Alpha 1-antitrypsin deficiency 141
Budd–Chiari syndrome 141
Primary biliary cirrhosis (primary biliary cholangitis) – PBC 141
Gilbert’s syndrome 141
Jaundice 141
Liver tumours 142
Coagulation and liver disease 142
Prescribing in liver disease 142
Nutritional disorders 142
Vitamin B deficiencies 143
Iron deficiency anaemia 143
Vitamin A deficiency 143
Vitamin D deficiency 143
Vitamin E deficiency 144
Vitamin K deficiency 144
Vitamin C deficiency 144
Dental aspects of GI system disorders 144
Ulcer-healing drugs and antacids 144
Unwanted effects of antiulcer drugs in the mouth and perioral structures 145
Drug interactions 145
Further Reading 145
Multiple Choice Questions 145
Chapter 8 Renal disorders 147
Introduction 148
Structure of the kidneys 148
The glomerulus 148
The tubule 148
The loop of Henle 148
Measurement of renal function 148
Glomerular filtration rate (GFR) 148
Creatinine 148
Creatinine clearance (CrCl) 149
Formal assessment of GFR by inulin 149
Estimating GFR from serum creatinine measurements 149
Control of acid–base balance 150
Regulation of body fluid volume and composition 150
Excretion (waste, drugs) 150
Endocrine activity 150
Blood pressure control: renin–angiotensin–aldosterone system 150
Clinical presentation of abnormal renal function 150
Asymptomatic patient with abnormal urinalysis or blood tests 150
Proteinuria 150
Haematuria 151
Nephritic syndrome 151
Nephrotic syndrome 151
AKI 152
Pre-renal AKI 152
Intrinsic renal AKI 152
Post-renal AKI 152
CKD 152
Classification of CKD 153
Complications of CKD 153
Management of patients with CKD 153
Management of renal anaemia 153
Management of mineral and bone disorders 153
Approach to managing patients with impaired renal function 153
Investigation 154
Urine analysis 154
Imaging of the kidneys 154
Renal biopsy 154
The kidneys and systemic disease 154
Diabetes mellitus 154
Microscopic vasculitis (microscopic angiitis) 154
Anti-GBM disease 155
Amyloid 155
IgA nephropathy and Henoch–Schönlein purpura 155
Sarcoid 155
Systemic lupus erythematosus (SLE) 155
Systemic sclerosis 156
Abnormalities secondary to infections 156
HIV-related nephropathy (HIVAN) 156
Inherited renal disease 156
Reflux nephropathy (chronic pyelonephritis) 156
Renal stone disease 156
Hypertensive nephrosclerosis and atheromatous renovascular disease 156
CKD–Mineral and Bone Disorders (CKD?MBD) 156
ESRD and RRT 157
CAPD 158
APD 158
Dental aspects relating to renal patients 159
Prescribing in renal disease 159
Further Reading 159
Multiple Choice Questions 160
Chapter 9 Neurology and special senses 161
Chapter 9A Neurology 162
Head injury 162
Signs of skull fracture 162
Types of brain injury 163
Concussion 163
Contusion 164
Diffuse axonal injury 164
Cerebral oedema 164
Intracranial haemorrhage 164
Extradural haemorrhage 164
Subdural haemorrhage 164
Intracerebral haemorrhage 164
Assessment 165
General signs and symptoms of brain injury 166
Spinal injury 166
Complications 166
Brain abscess 166
Space-occupying lesions 167
Meningitis 167
Chapter 9B ENT 168
Deafness 168
Conductive deafness 168
Sensorineural deafness 168
Clinical testing 168
Rinne’s test 168
Weber’s test 168
Tinnitus 168
Vertigo 168
Dizziness 168
Infections and inflammatory disorders of the ear, nose, sinuses and tonsils 168
Ear infections 168
Nasal obstruction 169
Paranasal sinuses 169
Carcinoma of the pharyngeal tonsil 170
Stridor 170
Chapter 9C Neurological disorders and dental practice 171
Relevant points in the history 171
Facial pain 172
Other disorders 172
General examination 175
Cranial nerves 175
Neurological disorders: management considerations in dental practice 176
Chapter 9D Stroke, speech and swallowing 177
Stroke 177
Pathology of stroke 177
Risk factors and prevention 177
Clinical features of stroke or TIA 178
Management of acute stroke 178
Stroke rehabilitation 179
Dental aspects of stroke 179
Speech 179
Swallowing 179
Elements of swallowing 179
Swallowing disorders 179
Assessment and treatment of swallowing problems 180
Chapter 9E Ophthalmology 181
Measurement of vision 181
Common causes of visual loss 181
Age-related macular degeneration 181
Cataract 182
Open-angle glaucoma 182
Diabetic retinopathy 182
The acute red eye 183
Conjunctivitis (very common, no pain, no loss of vision) 183
Subconjunctival haemorrhage (very common, no pain, no loss of vision) 183
Episcleritis (common, mild pain, no loss of vision) 183
Corneal ulceration (severe pain, possible loss of vision) 183
Acute uveitis (uncommon, pain, loss of vision) 183
Acute glaucoma (very uncommon, severe pain, marked loss of vision) 183
Conditions of common interest 184
Giant cell arteritis 184
Sjögren syndrome 184
Behçet’s disease 184
Ophthalmic complications of dental anaesthesia 184
Transmission of infections through the ocular surface 185
Facial trauma and the eye 185
Chapter 9F Anticonvulsant and anti-Parkinsonian drugs 186
Anticonvulsant drugs 186
Drug classification 186
Mechanism of action 186
Unwanted effects of anticonvulsant medication 186
Anti-Parkinsonian drugs 187
Drug classification 187
Mechanism of action 187
Unwanted effects 188
Further Reading 188
Multiple Choice Questions 188
Chapter 10 Shock 189
Introduction 190
Pathophysiology 190
Aetiology of shock 191
Hypovolemic shock 191
Cardiogenic shock 191
Obstructive shock 191
Apparent hypovolemia 191
Clinical features 192
Principles of management 192
Monitoring 193
Refractory shock 193
Summary 193
References 193
Multiple Choice Questions 194
Chapter 11 Musculoskeletal disorders 195
Introduction 196
Classifying musculoskeletal problems 196
Osteoarthritis 196
Clinical features 196
Symptoms 196
Signs 196
Risk factors for osteoarthritis 196
Demographic changes 197
Management 197
Rheumatoid arthritis 198
Clinical features 198
Symptoms 198
Signs 198
Radiographic signs of rheumatoid arthritis 198
Burden of rheumatoid arthritis 198
Management of rheumatoid arthritis 198
Reactive arthritis 198
Clinical features 199
Signs and symptoms 199
Radiographic signs of reactive arthritis 199
Management of reactive arthritis 200
Other joint disorders 200
Disorders mainly involving soft tissues 200
Management of fractures and joint replacements 201
Joint replacements 201
Metabolic bone disease and calcium 202
Physiology of calcium metabolism 202
Investigations of bone disease 202
Biochemical tests 202
Imaging tests 202
Drugs used in bone disease 203
Parathyroid disorders 204
Hypoparathyroidism 204
Hyperparathyroidism 204
Important bone conditions 205
Osteomalacia and rickets 205
Osteoporosis 205
Bone metastases 205
Paget’s disease of bone 206
Other bone disorders 206
Dental treatment in patients with musculoskeletal disorders 207
Patients with syndromes 207
Patients with joint disorders 207
Other disorders 208
Summary 208
References 208
Multiple Choice Questions 208
Chapter 12 Dermatology and mucosal lesions 210
Introduction 211
Assessment of a patient presenting with skin lesions 211
Nail changes 211
Finger clubbing 211
Diseases of the skin 211
Eczema and dermatitis 211
Atopic dermatitis (eczema) 211
Urticaria 212
Contact dermatitis 212
Disorders of keratinization 212
Psoriasis 212
Infections and skin manifestations 212
Superficial bacterial skin infections 212
Deep bacterial skin infections 212
Bacterial exanthemata 213
Fungal infections (mycoses) 213
Tinea 213
Candidal infections 213
Chronic mucocutaneous candidiasis 214
Oral lesions secondary to fungal infections 214
Viral infections of the skin 214
Shingles 214
Herpetic whitlow 214
Herpes labialis ‘cold sore’ 214
Oral lesions secondary to viral infections 214
Dermatological manifestations of systemic disease 214
Deficiency states 214
Dermatological manifestations of GI disease 215
Dermatological manifestations of endocrine disease 215
Hyperthyroidism 215
Hypothyroidism 215
Diabetes mellitus 215
Cushing’s syndrome 215
Actinic disorders of the skin 215
Actinic keratoses 215
Actinic cheilitis 215
Squamous cell carcinoma of the skin (SCC) 216
Basal cell carcinoma (BCC) 216
Referral of patients with suspected skin malignancy 216
Keratoacanthoma 216
Disorders of skin and oral pigmentation 216
External causes of pigmentation of skin 217
Internal causes of pigmentation of skin and oral mucosa 217
Generalised/multiple areas of pigmentation 217
Localised pigmented skin lesions secondary to melanin accumulation in the skin cells (no melanocytic proliferation 217
Melanocytic pigmented lesions of the skin 217
Pigmentation of the oral mucosa 218
Clinical management of intra-oral pigmentation 218
Autoimmune dermatological disease 218
LP 218
Pemphigoid 219
Mucous membrane pemphigoid (MMP) 219
Bullous pemphigoid 220
Erythema multiforme (EM), Stevens–Johnson syndrome and toxic epidermal necrolysis 220
Stevens–Johnson syndrome and toxic epidermal necrolysis 221
Pemphigus 221
Pemphigus vulgaris 221
Dermatitis herpetiformis 221
Lupus erythematosus (LE) 222
Systemic lupus erythematosus (SLE) 222
Discoid lupus erythematosus (DLE) 222
Behçet’s syndrome (BS) 222
Graft versus host disease (GVHD) 222
Drug-induced causes of oral/dermatological lesions 222
Lichenoid lesions 222
Fixed drug eruption 222
Drug-induced bullous disease 222
Further Reading 222
Multiple Choice Questions 223
Chapter 13 Endocrinology and diabetes 224
Introduction 225
Regulation and feedback 225
Mechanisms of endocrine disease 226
Important endocrine syndromes 226
The adrenal glands 226
The thyroid gland 227
The pituitary gland 229
The parathyroid glands 230
Diabetes mellitus 230
Terminology and classification 230
Types of diabetes 231
Clinical features and diagnosis 231
Management 231
Complications of diabetes 233
Long-term complications of diabetes mellitus 234
Diabetes during surgery 234
Oral contraceptives 235
Impact on dental management 235
Drug interactions 235
Pregnancy 235
Other endocrine conditions of relevance 236
Dental aspects in endocrine patients 236
Further Reading 237
Multiple Choice Questions 237
Chapter 14 Pain and anxiety control 238
Introduction 239
Local anaesthetics 239
Introduction 239
Pharmacology of local anaesthetics 239
Mechanism of action 239
Physicochemical properties influencing local anaesthetic action 240
Metabolism of local anaesthetics 241
Vasoconstrictors 241
Adverse effects of dental local anaesthesia 241
Allergy 242
Toxicity 242
Drug interactions 242
Analgesia in dentistry 243
Peripherally acting analgesics 243
Centrally acting analgesics 244
Drugs used in conscious sedation 245
Introduction 245
Intravenous sedation 246
Benzodiazepines 246
Inhalational sedation 246
N2O 247
Oral sedation 247
Transmucosal sedation 247
Further Reading 247
Multiple Choice Questions 248
Chapter 15 Adverse drug reactions and interactions 250
Adverse drug reactions 251
Salivary glands 251
Drug-induced xerostomia 251
Management of drug-induced xerostomia 251
Drug-induced sialorrhoea 252
Drug-induced pain and swelling of the salivary glands 252
Drug-induced taste disturbances 252
Oral mucosa and tongue 252
Drug-induced vesiculobullous lesions 252
Lichen planus 252
Other drug-related white lesions of the oral mucosa 253
Drug-induced discoloration of the oral mucosa 253
Drug-induced oral ulceration 253
Local irritants 253
Drug-related aphthous-type ulceration 253
Fixed drug eruptions 254
Dental structures 255
Tooth development 255
Drug-induced staining of the dental structures 255
Sugar-based medicines 255
Periodontal tissues 255
Drug-induced gingival overgrowth 255
Risk factors for drug-induced gingival overgrowth 255
Pathogenesis of drug-induced gingival overgrowth 256
Treatment of drug-induced gingival overgrowth 256
Drug-induced desquamative gingivitis 257
Drugs that can increase the expression of periodontal disease 257
Alveolar bone 257
Bisphosphonate-induced osteonecrosis 257
Prevention of bisphosphonate-induced osteonecrosis 257
Treatment of bisphosphonate-induced osteonecrosis 258
Dry socket (alveolar osteitis) 258
Cleft lip and palate 258
Miscellaneous oral adverse drug reactions 258
Angioedema and ACE inhibitors 258
Drug-induced dyskinesias 258
Summary 258
Drug interactions 258
Mechanisms of drug interactions 259
Pharmacokinetic interactions 259
Pharmacodynamic interactions 259
Relevance of drug interactions in dental practice 259
Agents that interfere with local anaesthetics and vasoconstrictors 259
Interactions with local anaesthetics 259
Interactions with vasoconstrictors 261
Drugs acting on the CNS 261
Drugs of abuse 261
Drugs that interact with oral and intravenous sedation 261
Drugs that act on the CNS 261
Drugs acting on the gastrointestinal tract 262
Local anaesthetics 262
Muscle relaxants 262
Drugs that interfere with analgesics prescribed by dentists 262
Aspirin 262
Ibuprofen 262
Paracetamol 262
Drugs that interfere with antimicrobials prescribed by dentists 263
Drugs used in the treatment of gout 263
Oral contraceptives 263
Erythromycin 263
Metronidazole 264
Tetracyclines 264
Antifungals 265
Summary 265
Further Reading 265
Multiple Choice Questions 265
Chapter 16 General oncology 267
Introduction 268
Disorders of growth and differentiation 268
Introduction 268
Disorders of growth 268
Disorders of differentiation 269
Neoplasia 270
Definitions and terminology 270
General features of neoplasia 271
Metabolic effects of neoplasia 272
Classification of neoplasms 272
Biological characteristics of cancer 272
Clinical oncology 273
Tumour identification and diagnosis 273
Management of malignant disease 273
Surgery 273
Radiotherapy 274
Chemotherapy 274
Hormonal manipulation 274
Prognosis 275
Type of cancer 275
Stage 275
Introduction to head and neck oncology 276
Oral complications of malignancy 276
Management of head and neck radiotherapy patients 278
Management of patients on chemotherapy 278
Palliative care 279
The future 279
Further Reading 279
Multiple Choice Questions 279
Chapter 17 Child health 281
Development 282
Specific areas of development 282
Range of normality and individual variation 282
Rate of development 282
Pattern of development 282
Eventual level of attainment 282
Key milestones 282
Child health surveillance 282
Language and speech 283
Language and speech delay 283
Language and speech disorders 283
Hearing 283
Hearing loss 283
Vision 283
Respiratory infections in childhood 284
URTIs 284
Otitis media (OM) 284
Tonsillitis 284
Acute lower respiratory tract infection 284
Bacterial pneumonia 284
Measles 284
Croup 284
Bronchiolitis 284
Pertussis 284
Cystic fibrosis (CF) 284
Asthma 285
Oral infections 285
Viral 285
Primary herpes simplex infection 285
Secondary herpes simplex infection 286
Varicella zoster 286
Mumps 286
Measles 286
Herpangina 286
Hand, foot and mouth disease 286
Infectious mononucleosis 286
Human papillomavirus 286
Bacterial 286
Staphylococcal infections 286
Streptococcal infection 286
Congenital syphilis 286
Tuberculosis 286
Cat-scratch disease 287
Fungal 287
Candida 287
Actinomycosis 287
Protozoal 287
Clefts of the lip and palate 287
Aetiology of clefts 287
Genetic factors 287
Environmental factors 288
Child physical abuse 288
Introduction 288
Prevalence 288
Aetiology 288
Identification 288
Types of orofacial injuries in child physical abuse 289
Conclusions 290
Further Reading 291
Multiple Choice Questions 291
Chapter 18 Medicine for the elderly 293
Introduction 294
Ageing 294
Features of illness in old age 294
Non-specific presentations 294
Multiple pathology, and consequent polypharmacy 294
Impaired homeostasis, resistance to disease and recovery 295
Loss of functional independence 295
Care settings for older people 295
Assessment and rehabilitation 295
Long-term care 295
History taking 296
Examination 296
General principles of management 296
Mental capacity 297
Prescribing for older dental patients 297
Practical tips on prescribing 298
Further Reading 298
Multiple Choice Questions 298
Chapter 19 Psychiatric disorders 299
Chapter 19A General psychiatry 300
Introduction – what is psychiatry? 300
Relevance to dental practitioners 300
The nature and diagnosis of psychiatric disorders 300
Psychiatric presentations encountered by dentists 300
Anxiety disorders 301
Dental anxiety – anxiety related to visiting the dentist 302
Dental phobia 302
Anxiety and avoidance 302
Management of dental anxiety 303
Preventative measures 303
Treatment 303
Obsessive compulsive disorder (OCD) 303
Management of OCD 303
Hypochondriasis 304
Management of hypochondriasis 304
Psychogenic pain 304
Management of psychogenic pain – general principles 304
Atypical facial pain 305
TMJ dysfunction syndrome 305
Atypical odontalgia 305
Oral dysaesthesia 305
Eating disorders 305
Anorexia nervosa 305
Bulimia nervosa 306
Substance misuse 307
Alcohol abuse 307
Management of drug and alcohol misuse 307
Schizophrenia 308
Positive symptoms of schizophrenia 308
Negative symptoms of schizophrenia 308
Antipsychotics 308
Other treatments 309
Schizophrenia and the dentist 309
Mood disorders 309
Depression 309
Management of depression 310
Antidepressants 310
Augmentation 310
Electroconvulsive therapy (ECT) 310
Psychological therapies 310
Dental aspects of depression 310
Bipolar affective disorder (mania) 311
Management of bipolar affective disorder 311
Lithium 311
Relapse prevention and rehabilitation 312
Dental aspects of bipolar affective disorder 312
Specific groups for special consideration: children 312
Autistic spectrum disorders 312
Aetiology 312
Management 313
Hyperkinetic disorder (or ‘attention-deficit hyperactivity disorder’, ADHD) 313
Management 313
Anxiety disorders and phobias 313
Specific groups for special consideration: the elderly 313
Dementia 313
Delirium 315
Management of delirium 315
Specific groups for special consideration: people with learning disabilities 315
Presentation 315
Aetiology 316
Dental aspects 316
Down syndrome (trisomy 21) 316
Dental aspects 316
Capacity and consent 316
Assessment of capacity 317
Referral to psychiatric services 317
Indications and routes of referral 317
Basic psychiatric assessment 319
Chapter 19B Drug abuse 320
Alcohol 320
Effects on orodental structures 320
Effect on management 320
Drug interactions 320
Smoking 320
Effects on orodental structures 320
Effect on management 321
Drug interactions 321
Cannabis 321
Effects on orodental structures 321
Effect on management 321
Heroin and methadone 321
Effects on orodental structures 321
Effect on management 321
Drug interactions 321
Cocaine 321
Effects on orodental structures 321
Effect on management 321
Drug interactions 321
Amphetamines and ecstasy 321
Effects on orodental structures 321
Effect on management 321
Drug interactions 321
Hallucinogens 321
Effects on orodental structures 321
Effect on management 321
Drug interactions 322
Solvent abuse 322
Effects on orodental structures 322
Effect on management 322
Anabolic steroids and performance enhancers 322
Effects on orodental structures 322
Effect on management 322
Chapter 19C Anxiolytic and hypnotic drugs 323
Anxiolytic drugs 323
Hypnotic drugs 323
Further Reading 324
Multiple Choice Questions 324
Chapter Chapter 20 Haematology 325
Chapter 20A General haematology, haemato-oncology 326
Normal haemopoiesis 326
The bone marrow stroma 326
Erythropoiesis 326
Haemoglobin 327
Red cell metabolism 327
Anaemia 327
General features of anaemia 327
Iron deficiency anaemia 328
Iron absorption and distribution 328
Causes of iron deficiency 328
Clinical features of iron deficiency anaemia 328
Laboratory investigation of suspected iron deficiency 328
Treatment 328
Megaloblastic anaemias 329
Absorption of vitamin B12 329
Folate deficiency 329
Clinical features of megaloblastic anaemia 329
Laboratory investigations 329
Treatment 329
Anaemia of chronic disease 329
Haemolytic anaemias 330
Classification of haemolytic anaemias 330
Laboratory investigation of haemolysis 330
Red cell membrane defects 330
Hereditary spherocytosis (HS) 330
Haemoglobinopathies 331
Sickle cell disease (SCD) 331
Clinical features of SCD 331
Acute management of a painful crisis 332
?-Thalassaemia 332
Pathophysiology 332
?-Thalassaemia 332
Pathophysiology 332
Red cell fragmentation syndromes 332
Multiple myeloma 333
Clinical presentation 333
Investigations 333
Prognosis 333
Treatment 333
Osteonecrosis of the jaw 334
Bone marrow failure syndromes 334
Acute leukaemias 334
Chronic myeloproliferative disorders (MPDs) 336
Lymphomas 336
Hodgkin lymphoma 336
NLPHL 336
CHL 336
Treatment 337
NHL 337
Chapter 20B Haemostasis 338
Overview of normal haemostasis 338
Inherited bleeding disorders 338
Haemophilia A 338
Haemophilia B 339
Laboratory diagnosis 339
Treatment 339
The development of recombinant products 340
Management of haemophilia patients undergoing dental surgery 340
von Willebrand disease 340
Clinical features 341
Laboratory diagnosis 341
Treatment 341
Acquired vWD 341
Rare inherited coagulation disorders 341
Inherited platelet disorders 342
Acquired disorders of haemostasis 342
Acquired platelet disorders 342
Warfarin and dental surgery 343
Mechanism of action of warfarin 343
Warfarin and bleeding risk 344
The risk of bleeding following dental surgery 344
The risk of discontinuing anticoagulation prior to surgery 344
Direct Oral Anticoagulants (DOACs) 344
DOACs and dental surgery 344
Chapter 20C Transfusion medicine 345
Introduction 345
Blood group systems 345
The ABO blood group system 345
The Rhesus (Rh) blood group system 345
Red cell antibodies 345
Alloantibody production 345
Alloantibodies in pregnancy 346
Blood components 346
High-titre testing 346
Hospital pre-transfusion testing 346
Selecting ABO-compatible blood 346
Haemovigilance in the UK 346
Minimising errors in blood transfusion 347
‘Right blood, right patient’ 347
Platelets 347
Fresh frozen plasma 347
Indications for FFP 347
Cryoprecipitate 347
Risks of transfusion 348
Preventing transfusion reactions 348
Alternatives to blood transfusion 348
Further Reading 348
Multiple Choice Questions 348
Chapter 21 Medical emergencies 350
Introduction 351
The ABCDE approach to the sick patient 351
The collapsed patient 352
Fainting (vasovagal syncope) 352
Signs and symptoms 353
Management 353
Chest pain 353
Signs and symptoms 353
Management 353
The diabetic patient 353
Diabetic emergencies 354
Signs and symptoms 354
Management 354
Hypersensitivity reactions – anaphylaxis 354
Signs and symptoms 354
Management 354
‘Second-line’ drugs – not required to be administered by dental practitioners 354
Angioedema 355
Fits 355
Signs and symptoms 355
Management 355
Cardiac arrest 355
Possible causes of cardiac arrest 355
Signs and symptoms 355
Management 355
Use of defibrillation 356
Pacemakers 356
Asthma 357
Signs and symptoms 357
Management 357
Hyperventilation 357
Signs and symptoms 357
Management 357
Choking 357
Adrenal crisis 358
Signs and symptoms 359
Management 359
Local anaesthetics emergencies 359
Cardiovascular problems in association with local anaesthetics 359
Temporary facial palsy or diplopia 359
Stroke 359
Needle breakage 359
Sedation emergencies 360
Management 360
Emergencies arising from impaired haemostasis 360
Summary 360
Further Reading 360
Multiple Choice Questions 360
Appendix: normal reference ranges 362
Index 363
EULA 378

Rezensionen

"This second edition of Essentials of Human Disease in Dentistry is an invaluable resource for undergraduate dentistry students, for dentists preparing for the MFDS exam, and for all dental practitioners"

Produkt-Details

• Erscheint lt. Verlag: 1.2.2018
• Reihe/Serie: Essentials (Dentistry)
• Reihe/Serie: Essentials (Dentistry)
• Reihe/Serie: Essentials (Dentistry)
• Sprache: englisch
• Themenwelt: Medizin / Pharmazie ► Allgemeines / Lexika
• Themenwelt: Medizin / Pharmazie ► Zahnmedizin
• Schlagworte: Adverse Drug Reactions and Interactions • Cardiovascular disorders • care of the elderly • Child Health • Clinical Examination and History Taking • dentistry • Einführung i. d. Zahnmedizin • Endocrinology and Diabetes • Essentials of Human Disease in Dentistry 2nd Edition • Gastrointestinal disorders • General Oncology • Haematology • Immunological Disease • Inflammation and Anti-inflammatory Drugs • Introductions to Dentistry • <p>Guide to Human Disease in Dentistry • Mark Greenwood</p> • medical emergencies • Musculoskeletal disorders • Neurology and Special Senses • Oralpathologie • Oral Pathology • Oral Sciences & Technology • Pain and Anxiety Control • Principles of Infection and Infection Control • psychiatric disorders • renal disorders • respiratory disorders • shock • skin disorders • Textbook of Human Disease in Dentistry • Understanding Human Disease in Dentistry • Wissenschaft u. Technologie der Mundheilkunde • Zahnmedizin
• ISBN-10: 1-119-25182-6 / 1119251826
• ISBN-13: 978-1-119-25182-8 / 9781119251828