Posts for Clinical Care Concerns
Missives from Ms Peg Lateral (MJ Fehrenbach, RDH, MS)
or Counsels from Ms Carabelli (J Young-Scholes, (ret.) RDH, ASc)
November 1, 2022
Patient Care Concerns from Ms Peg Lateral
Considerations maintaining our scientific viewpoint.
Saw this posted recently when taking a friend to her weekly hospital visit; one may want to consider its use in clinical areas since a having oral cancer, periodontal disease, endodontics, and caries can be overwhelming for patients... not to mention other health concerns they may have a history with. It helps remind us all!!!
These considerations bring up other related topics that always need a special consideration; see associated CURRENT links to check out below:
BEST HANDOFF TIPS for dental setting (RDH MAG)
ABUSE AND NEGLECT (NIH) REDUCE STRESS (ADA)
PATIENT COMMUNICATION TOOLS (RDH MAG)
MANAGEMENT OF DENTAL PATIENTS WITH SPECIAL NEEDS (AAPD)
LINK BETWEEN DENTAL AND MENTAL HEALTH (CLEVELAND CLINIC)
November 21, 2022
Computer Aided Diagnosis from Ms Peg Lateral
We are zooming in on CAD and how it is aiding in diagnosing periodontitis over time!
Can you imagine sitting in your dental chair and the computer nearby is aiding you in the diagnosis of the patient's periodontal case using latest classification system? Well, welcome to the future. The figure here has been taken from the research article below (#3). Until then, check out Automated staging and grading app for periodontal records!
From recent study noted below:
"Computer-aided diagnosis (CAD) has been used to identify cavities and periodontitis lesions, as well as maxillary sinusitis, osteoporosis, and other pathologies in the oral and maxillofacial field. It can provide dental professionals with a valuable second opinion by automatically detecting and classifying pathological changes. Recently, CAD based on deep learning have been used extensively for solving complex problems in radiology. However, studies of deep learning applications have been limited in the field of oral and maxillofacial imaging. The deep learning method has been applied to: detect landmarks in cephalograms; detect teeth and classification; diagnose cavities; and detect maxillary sinusitis."
These considerations bring up other related topics that always need a special consideration; see associated CURRENT links to check out below:
See Link #3
December 10, 202
Dementia and Oral Health? from Ms Carabelli
Poor oral health is one of the risk factors for dementia!
As an oral health professional, one of our most important roles is to educate the patient that what manifests in the oral cavity can affect one’s overall health and state of being. There are several microorganisms in the oral cavity that are capable of degrading host tissue. Assessment of soft and hard deposits, removal, and appropriate oral health care measures, particular for that patient, are factors that help maintain one’s overall health.
Dementia (including Alzheimer Disease) result from the death of nerve cells and the ability to communicate between these cells then begins to diminish. Genes do play a role, but no specific abnormal gene has not yet to be associated with any type of this condition. However, major risk factors are being studied that may contribute to the onset of this disease. Poor oral health is one risk factor that is now being considered as a catalyst to dementia or Alzheimer Disease. Thus our role as that a Dental Hygienist can be vital to keeping one’s mental health.
Links to several recent studies:
https://www.sciencealert.com/the-cause-of-alzheimers-could-be-coming-from-inside-your-mouth
https://www.medscape.com/viewarticle/980703 (need to register and there is no downside!!!)
March 25, 2023
Integrated Research Biopsies from Ms Peg Lateral
We need more data such as with integrated research autopsies!
As we start the new year, we need to address a topic that is sometimes hard due to certain factors (see discussion next paragraph). But it is always been that autopies and research go hand and hand in medicine. But not as yet in oral medicine, the new specialty assigned by the ADA. There needs to be collection of craniofacial tissue ASAP as part of biobanking. The new technologies that allow for high-resolution, multimodal phenotyping of human samples, using optimized sampling procedures (possibly of whole jaws with teeth) will then allow for unprecedented understanding of common and rare dental, oral, and craniofacial diseases NOW!
It is true that conventional autopsies are becoming less common due to many factors such as cultural or religious objections, high costs for time and limited personnel, and growing opinions about the lack of an autopsy’s usefulness compared with other diagnostic techniques. But even so conventional autopsy is till used for research purposes, sometimes called the “research autopsy,” that has proven useful for understanding cardiovascular diseases, diabetes, cancer biology, chemotherapeutic failures, and viral pandemics such as COVID-19. Interestingly, all these have also major focuses within orofacial regions and infections related to them. This tendency is highlighted in the linked article as the bidirectional relationship of the orofacial region in the context of extraoral diseases.
Link to opinion article: https://jada.ada.org/action/showPdf?pii=S0002-8177%2822%2900731-0 (can download as needed to share!)