Essentials of Human Disease in Dentistry (eBook)

Mark Greenwood (Autor)

eBook Download: EPUB

2018 | 2. Auflage
John Wiley & Sons (Verlag)
978-1-119-25185-9 (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

Contributors viii

Preface to the First Edition xi

Preface to the Second Edition xii

Acknowledgements xiii

About the companion website xiv

1 Clinical examination and history taking 1
M Greenwood

2 Inflammation and anti-inflammatory drugs 11
CM Robinson and RA Seymour

3 Principles of infection and infection control 21
S Waugh, E Ong, S Hogg, K Orr, JG Meechan, RA Seymour, M Greenwood, C Taylor and G Toms

3A Sterilisation, disinfection and antiseptics 22

3b Principles of infection and infection control, diagnosis and treatment of bacterial infections 27

3C Viruses and antiviral agents relevant to dentistry 38

3d Infection with immunodeficiency virus and implications for the oral cavity: Infection with HIV46 3E Fungi and antifungal agents 53

4 Immunological disease 55
C Stroud and H Bourne

5 Cardiovascular disorders 67
RH Jay, G Stansby, T Barakat, RA Seymour, JG Meechan, CM Robinson, m Greenwood, S Hogg and A Balakrishnan

5A Introduction to cardiovascular disease (CVD) 68

5B Heart failure 78

5C Cardiac arrhythmias 81

5D Valvular heart disease 84

5E Hypertension 87

5F Anticoagulants, drugs affecting blood clotting 92

5G Dental implications of CVD 95

5H Peripheral vascular and cardiac surgical disorders 97

6 Respiratory disorders 107
SJ Bourke and M Greenwood

7 Gastrointestinal disorders 120
M Greenwood, JG meechan and JR Adams

8 Renal disorders 131
EK Montgomery, JA Sayer, AL Brown and M Greenwood

9 Neurology and special senses 145
M Greenwood, RI macleod, RH Jay, JG meechan, P Griffiths, N Ali and RJ Banks

9A Neurology 146

9b Ent 152

9C Neurological disorders and dental practice 155

9D Stroke, speech and swallowing 161

9E Ophthalmology 165

9 F Anticonvulsant and anti-Parkinsonian drugs 170

10 Shock 173
S Clark

11 Musculoskeletal disorders 179
F Birrell, M Greenwood and RH Jay

12 Dermatology and mucosal lesions 194
K Staines

13 Endocrinology and diabetes 208
RH Jay, M Greenwood and JG Meechan

14 Pain and anxiety control 222
CC Currie, J Durham and JG Meechan

15 Adverse drug reactions and interactions 234
RA Seymour and M Greenwood

16 General oncology 251
CM Robinson and PJ Thomson

17 Child health 265
FE Hogg and RR Welbury

18 Medicine for the elderly 277
RH Jay

19 Psychiatric disorders 283
SJ Brown, M Greenwood and JG Meechan

19A General psychiatry 284

19B Drug abuse 304

19C Anxiolytic and hypnotic drugs 307

20 Haematology 309
J Hanley, A Lennard and S Mathia

20A General haematology, haemato-oncology 310

20B Haemostasis 322

20C Transfusion medicine 329

21 Medical emergencies 334
M Greenwood

Appendix: normal reference ranges 346

Index 347

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"

Textauszug

CHAPTER 1
Clinical examination and history taking

M Greenwood

Key topics

• Essential components of a medical history
• Key issues that may arise from the medical history

Learning objectives

• To be familiar with the main components of a medical history.
• To be aware of the medical terms used in taking a medical history, and their meaning.
• To be aware of the normal vital signs.

Components of a medical history

The medical history aims to:

• Enable the formulation of a differential diagnosis or diagnosis
• Put the patient’s disease process into the correct medical and social context.
• Establish a rapport with the patient.

Clinicians engaged in obtaining medical histories should introduce themselves to the patients and give their designations. The taking of the history may then commence and should follow a scheme similar to that shown in Table 1.1.

Table 1.1 Areas to be covered in a medical history.

Presenting complaint

History of presenting complaint

Past medical history

Allergies

Past dental history

Drugs

Social history

Family history

Psychiatric history

Presenting complaint

The presenting complaint can be recorded in medical terms, but often is better expressed in the patient’s own words. When recording the history in writing, quotation marks should be placed around the patient’s words. In a verbal case presentation, it should be stated that the patient’s own words are being used. It is important to avoid presumptive diagnoses in the presenting complaint. For example, patients do not present with iron deficiency anaemia; they may present with symptoms that arise from it. It should be remembered that symptoms are the features of the illness that the patient describes; signs are physical findings obtained by the clinician.

History of the presenting complaint

The history of the presenting complaint should be a chronological but succinct account of the patient’s problem. It is important to start at the onset of the problem and describe its progression. Symptoms should be similarly described.

Points to include when asking patients about pain are as follows:

• Site
• Character – for example, tight/band-like (in the chest, suggestive of cardiac origin)
• Does the pain radiate anywhere?
• Onset – sudden or gradual
• Severity (ask the patient to rate on a scale of 1–10, with 10 being the most severe)
• Duration
• Exacerbating/relieving factors (including the use and efficacy of medication)
• Preceding events or associated features
• Has the pain occurred before? / Is it getting better or worse?

Past medical history

It is worth asking a generic set of opening questions – for example, ‘Do you have any heart or chest problems?’ Questioning should then focus on specific disorders – for example, asthma, diabetes, epilepsy, hypertension, hepatitis, jaundice or tuberculosis. It is also worth specifically asking about any previous problems with the arrest of haemorrhage. Past problems with intravenous sedation or general anaesthesia should be noted. It is worth asking about any previous history of rheumatic fever, which may have led to cardiac valve damage. In 2008, the National Institute for Health and Care Excellence (NICE) discontinued the regular use of antibiotic prophylaxis for bacteraemia-producing dental procedures in patients with cardiac damage. There were some concerns about this, however, such as the lack of an evidence base for prophylaxis and the fact that Europe and the USA differed in their practices.

Before 2008, a consistent upward trend was apparent in the population-corrected incidence of infective endocarditis in England. Soon after the implementation of the NICE guidelines, the slope of the trend line increased further, although there is no direct evidence that this was due to the discontinuation of antibiotic prophylaxis in dentistry. In 2016, NICE modified the guidance slightly to state that: ‘Antibiotic prophylaxis against infective endocarditis is not recommended routinely [my emphasis] for people undergoing dental procedures’. This addition emphasises NICE’s standard advice on healthcare professionals’ responsibilities. Doctors and dentists should offer the most appropriate treatment options, in consultation with their patients and/or their carers or guardians. In doing so, they should take into account the recommendations of NICE guidance and the values and preferences of patients, and also apply their clinical judgement.

To guide decision-making, NICE has provided information regarding which might be considered high-risk and moderate-risk groups for the development of infective endocarditis – see Table 1.2.

Table 1.2 Stratification of the risk of infective endocarditis.

High-risk categories

Patients with a previous history of infective endocarditis

Patients with any form of prosthetic heart valves (including a transcatheter valves)

Those in whom prosthetic material was used for cardiac valve repair

Patients with any type of cyanotic congenital heart disease

Patients with any type of congenital heart disease repaired with prosthetic material, whether placed surgically or by percutaneous techniques, for the first 6 months after the procedure or lifelong if a residual shunt or valvular regurgitation remains

Moderate-risk categories

Patients with a previous history of rheumatic fever

Patients with any other form of native valve disease (including the most commonly identified conditions: bicuspid aortic valve, mitral valve prolapse or calcific aortic stenosis)

Patients with unrepaired congenital anomalies of the heart valves

It is clearly important that positive findings be recorded. Some important negative findings too are worth recording.

Allergies

Any known allergies should be recorded. This is one aspect of the medical history that should be recorded even if there are no known allergies. Any allergies that are identified should be highlighted in the clinical record.

Past dental history

In a general history, the dental history should be relatively brief. It can include details of the regularity or otherwise of dental attendance and the use of local anaesthesia or sedation. Any adverse events, including post-extraction haemorrhage, could also be included here.

Drugs

Any medication taken by the patient should be recorded. The use of recreational drugs can be included in this section or in the social history.

‘Recreational’ drugs

Dentists should have a working knowledge about the implications of patients using recreational drugs, as the use of such drugs is relatively common. Cannabis has a sympathomimetic action that could potentially exacerbate the systemic effects of adrenaline in dental local anaesthetics. Heroin and methadone are both opioid drugs, with methadone being used in drug rehabilitation programmes. Oral methadone has a high sugar content and can lead to rampant caries. Heroin can lead to addicts having a low threshold for pain and can cause thrombocytopaenia, in addition to interfering with drugs that dentists may prescribe. Other details regarding recreational drugs are given in Chapter 19 (titled ‘Psychiatric disorders’).

Complementary therapies

Complementary therapies are often used by patients. Many patients do not deem it important to tell dental practitioners that they are using such preparations, as they do not feel that it may be of any relevance. It is important to remember, however, that some of the drugs that dental practitioners prescribe can be affected by some complementary therapies. A summary of some of the more common potential interactions is given in Table 1.3.

Table 1.3 Complementary medicines and their interactions with conventional medicines with potential consequences.

Herb

Conventional drug

Potential problem

St. John’s wort

Monoamine oxidase inhibitors and serotonin reuptake inhibitors Antidepressants Iron

Mechanism of herbal effect uncertain Insufficient evidence of safety with concomitant use – therefore...

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: 1-119-25185-0 / 1119251850
• ISBN-13: 978-1-119-25185-9 / 9781119251859