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Using dental anesthetics on a person addicted to cocaine may lead to serious complications. Chronic cocaine abuse can lead to agitation, paranoia, hypertension and heart failure. A 20-year-old male experiencing jaw pain had two molars extracted. He was given an injection of three cartridges of two percent lidocaine with epinephrine 1:50,000 as an anesthetic. The patient's extraction sites kept bleeding despite the use of an ice pack. He was observed snorting cocaine when he thought he was alone. The epinephrine may have prevented severe bleeding in the patient. Using vasoconstrictors, drugs which tighten blood vessels, may help prevent local anesthetics from causing heart problems leading to cardiotoxicity. Dental treatment is not recommended for patients who are chronic cocaine abusers. Dentists should inform patients of the hazards of cocaine abuse before using local anesthesia.

Chronic suppurative osteomyelitis still constitutes a significant oral health burden in developing countries. However, it is a relatively rare complication of odontogenic infections in the United States. This case report serves to heighten awareness of suppurative osteomyelitis as an important, albeit uncommon, sequela of long-standing infection of the jaw in a healthy U.S. adult with no known predisposing factors. We describe a case of chronic suppurative osteomyelitis that presented in a healthy, young, adult female with no predisposing factors besides smoking 11 years post-endodontic therapy. [ABSTRACT FROM AUTHOR]

This survey recorded utilization levels of stock and custom mouthguards among middle and high school athletes in a US metropolitan area and gathered data on the prevalence of traumatic injuries that have occurred as a consequence of school-based athletic competition. The data also included reasons for the athletes' noncompliance. A 23-question, online survey form was developed. A geographically diverse list of public and private schools in the Houston metropolitan area was identified and included 30 public middle schools, 32 public high schools, 8 private middle schools, and 10 private high schools. The sports surveyed were baseball, basketball, field hockey, football, lacrosse, soccer, softball, volleyball, and wrestling. Only 1 private middle school participated. Only 5 of 32 public high schools and 1 private high school participated, representing response rates of 16% and 10%, respectively. Overall, there were 503 responses, and 56% of the respondents did not have a mouthguard. Among athletes who owned a mouthguard, most (70%) had stock versions purchased in a retail store, while 11% had a custom mouthguard fabricated by a dentist, and 19% had both types. The most frequent reasons cited for not wearing a mouthguard were forgetting to use it and a lack of comfort. The injury rates reported by respondents in the stock and custom mouthguard groups were 26% and 9%, respectively. A consistent, concerted effort by local dental societies should be aimed at school administrators and coaches to encourage enforcement or reinforcement of mouthguard usage policies among high school athletes, but, ultimately, parents need to step up to protect their children. [ABSTRACT FROM AUTHOR]

A 56-year-old white man presented at our dental clinic for routine care. The intraoral examination revealed an asymptomatic red lesion with white vesicle-like areas on the right side of the soft palate. The extraoral examination was normal, and regional lymph nodes were nonpalpable. The patient's medical history included liver cirrhosis and pancreatitis. He also had a 30-year history of alcohol misuse (1-5 drinks per day) and a 30-pack-year smoking history. (The patient had stopped drinking at the time of presentation, and had quit smoking 2 years earlier.) We instructed him to gargle with warm salt water at home and return in 2 weeks. At follow-up, the lesion was unresolved, so a biopsy was performed. [ABSTRACT FROM AUTHOR]

The article discusses the case history of a 56-year-old man with asymptomatic red lesion with white vesicle-like areas on the right side of the soft palate, who was diagnosed with erythroplakia. He had a 30-year history of alcohol misuse and smokong and had liver cirrhosis and pancreatitis. A diagnosis of squamous cell carcinoma (SCC) in situ was confirmed in pathological investigation.

Tooth structure loss is a normal part of the aging process, with generalized predictable patterns. However, when a dentist is faced with an atypical pattern of extensive structural damage, identifying the etiology responsible for the catastrophic collapse of a patient's anterior incisal guidance can be a diagnostic challenge. Clinicians who are presented with plausible medical histories juxtaposed with socially and culturally accepted eating behaviors may clarify an otherwise nebulous clinical presentation. This article presents an unusual case report involving both synergistic and synchronous habitual and culturally adopted eating practices and pica, which resulted in severe tooth abrasion, abfraction, and erosion.

This article reviews the clinical issues regarding adverse drug reactions in geriatric dental patients. Accurate clinical observations and diagnosis are complicated in geriatric patients because they are predisposed to chronic illnesses, various prescribing physicians, and a decreased ability to metabolize and detoxify multiple medications. The authors have further reviewed neurological motor reactions with a detailed review of the physical presentations of Parkinson's disease. As such, the dental professional has a unique opportunity to provide observational feedback to other healthcare providers concerning the health status of their geriatric patients. In this case report, the changes in the patient's physical status and mental well-being were not a result or associated with a catastrophic event (eg, stroke, cardiovascular event, or head injury). The patient's rapid degeneration was anecdotally associated with a recently prescribed group of medications, which shows the need for healthcare professionals to be aware of changes in medications when assessing patients' health.

Pica is a compulsive eating disorder involving non-nutritive substances. The etiology of this eating disorder is unknown but it often is associated with subclinical mineral deficiencies. This article focuses on the simultaneous occurrence of two types of eating disorders, the co-existence of depression during four pregnancies, and the resulting dental clinical implications. The literature is substantial enough to support a possible etiological association between these eating disorders and depression during pregnancy. Associations between eating psychopathology, depression, and anxiety have been described consistently. The diagnosis of pica and the dental treatment related to it are not a common part of most dental practices; knowing the clinical features and detecting the condition depend on careful questioning and diligence. At present, no one has described the physiologic or psychological basis for pica. This article reviews the published literature pertaining to pica, specifically pagophagia.