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Cawson's Essentials of Oral Pathology and Oral Medicine E-Book

Cawson's Essentials of Oral Pathology and Oral Medicine E-Book

Edward W Odell

(2017)

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Book Details

Abstract

The new edition of this classic book continues to support a new generation of dental students in their understanding of the essential aspects of oral pathology and oral medicine as they relate to the day-to-day practice of dentistry. Fully updated throughout with the latest diagnostic tests, treatment protocols and international guidelines, the book now comes with Pageburst – an exciting product which provides readers with an eBook – giving them the printed book, plus access to the complete book content electronically. Histology slides within the e-book can be magnified by the reader simulating the use of the microscope and aiding learning by the addition of overlays.


Table of Contents

Section Title Page Action Price
Front Cover cover
Cawson's Essentials of Oral Pathology and Oral Medicine i
Copyright Page iv
Table Of Contents v
Preface xv
References xvii
1 Principles of investigation, diagnosis and treatment 1
Taking a history 1
Demographic details 2
History of the present complaint 2
Medical history 2
The dental history 5
The family and social history 5
Consent 5
Clinical examination 6
Extraoral 6
Oral examination 6
Soft tissues 6
Teeth 7
Medical examination 8
Clinical differential diagnosis 8
Investigations 9
Screening and diagnostic tests 9
Imaging 9
Histopathology 10
Value and limitations 10
Biopsy 11
Selecting the biopsy site 11
Surgical biopsy methods 11
Frozen sections 13
Fine needle aspiration biopsy 13
Brush biopsy and exfoliative cytology 13
Laboratory procedures 14
Fixation 14
Tissue processing 14
Some common stains used for microscopy 14
Decalcified and ground (undecalcified) sections 14
Immunofluorescent and immunohistochemical staining 14
Molecular biological tests 15
Polymerase chain reaction and quantitative polymerase chain reaction analysis 17
In situ hybridisation and fluorescent in situ hybridisation analysis 17
Haematology, clinical chemistry and serology 18
Microbiology 18
Other clinical tests 20
Interpreting investigations and making a diagnosis and treatment plan 20
1 Hard tissue pathology 23
2 Disorders of tooth development 23
Abnormalities in the number of teeth 23
Anodontia 23
Isolated oligodontia 23
Oligodontia or anodontia with systemic defects 23
Anhidrotic (hereditary) ectodermal dysplasia 23
Other conditions associated with oligodontia 24
Additional teeth: hyperdontia 24
Effects and treatment 25
Syndromes associated with hyperdontia 25
Defective enamel formation 25
Defects of deciduous teeth 25
Defects of permanent teeth 25
Amelogenesis imperfecta ➔ Summary chart 2.1 p. 26 25
Hypoplastic amelogenesis imperfecta 27
Hypomaturation amelogenesis imperfecta 27
Hypocalcified amelogenesis imperfecta 28
Chronological hypoplasia ➔ Summary chart 2.1 p. 26 29
Molar-incisor hypomineralisation ➔ Summary chart 2.1 p. 26 30
Defective dentine formation ➔ Summary chart 2.1 p. 26 30
Osteogenesis imperfecta with opalescent teeth ➔ Summary chart 2.1 p. 26 31
Dentinogenesis imperfecta ➔ Summary chart 2.1 p. 26 31
Clinical features 31
Tooth structure 32
Dentinal dysplasia (‘rootless’ teeth) ➔ Summary chart 2.1 p. 26 32
Dentinal dysplasia (previously type 1 but now the only type) 32
Dentinal dysplasia ‘type 2’ 33
Defects of enamel and dentine ➔ Summary chart 2.1 p. 26 33
Regional odontodysplasia (ghost teeth) ➔ Summary chart 2.2 p. 27 33
Segmental odontomaxillary dysplasia 34
Other systemic diseases affecting teeth 35
Other metabolic disturbances 35
Ehlers–Danlos syndromes 36
Gardner’s syndrome (familial adenomatous polyposis) 36
Epidermolysis bullosa 36
Congenital syphilis ➔ Summary chart 2.1 p. 26 36
Vitamin D-resistant rickets 37
Extrinsic agents affecting teeth ➔ Summary chart 2.1 p. 26 37
Drugs 37
Tetracycline pigmentation 37
Cytotoxic chemotherapy 38
Fluorosis ➔ Summary chart 2.1 p. 26 38
Clinical features 38
Pathology 39
Other acquired developmental anomalies 40
Dilaceration 40
Fetal alcohol syndrome 40
Rhesus incompatibility 40
Odontomes 41
Disorders of eruption 42
Normal eruption 42
Natal teeth 43
Delayed eruption 43
Changes affecting buried teeth 43
3 Disorders of development 45
Clefts of lip or palate 45
Cleft lip and cleft palate 45
Management 47
Dental defects 48
Isolated cleft palate 48
Submucous cleft palate 48
Management 48
Syndromic cleft lip and palate 48
Other facial clefts 48
Stafne’s idiopathic bone cavity 49
Hereditary prognathism 49
Ankyloglossia 49
Cowden’s syndrome 50
Other craniofacial malformations 50
4 Dental caries 53
Aetiology 53
Bacterial plaque 53
Stages of formation of bacterial plaque 54
Microbiology 54
The ecological plaque hypothesis 55
Bacterial polysaccharides 55
Acid production in plaque 56
Plaque minerals 57
Sucrose 57
Epidemiological studies 57
Experimental studies on humans 58
Susceptibility of teeth to caries 59
Effects of fluorides 60
Saliva and dental caries 60
Buffering power 60
Inorganic components and enamel maturation 60
Antibacterial activities 60
Immunological defences 60
Pathology of enamel caries 61
The early caries lesion 61
Cavitation: cavity formation 64
Pathology of dentine caries 65
Protective reactions of dentine and pulp under caries 67
Clinical aspects of caries pathology 68
Arrested caries and remineralisation 68
Caries in deciduous teeth 69
Hidden caries 70
Root surface caries 70
Clinical aspects of reactions to caries 70
5 Pulpitis and apical periodontitis 73
Pulpitis ➔ Summary charts 5.1 and 5.2, pp. 79, 80 73
Clinical features 73
Pathology 74
Management 76
Pulp calcifications 77
Periapical periodontitis, abscess and granuloma ➔ Summary chart 5.2, p. 80 77
Acute apical periodontitis ➔ Summary chart 5.1, p. 79 78
Clinical features 78
Pathology and sequelae 78
Acute apical (dentoalveolar) abscess 79
Chronic apical periodontitis and periapical granuloma ➔ Summary chart 5.1, p. 79 81
Clinical features 81
Pathology 81
Treatment and sequelae 81
6 Tooth wear, resorption, hypercementosis and osseointegration 85
Tooth wear 85
Attrition 85
Abrasion 85
Erosion 86
Abfraction 87
Bruxism 87
Management 87
Resorption of teeth 88
Resorption of deciduous teeth 88
Resorption of permanent teeth 88
Idiopathic resorption 89
Hypercementosis 91
Pathology of osseointegration 91
Implant failure and peri-implantitis 93
7 Gingival and periodontal diseases 95
The normal periodontal tissues 95
Gingival and periodontal fibres 96
Gingival crevicular fluid (exudate) 96
Classification of periodontal diseases 96
Chronic gingivitis 96
Clinical features 97
Pathology 97
Microbiology 97
Management 98
Systemic predisposing factors 99
Pregnancy 99
Other conditions 99
Chronic periodontitis 99
Clinical features 99
Radiography 99
Aetiology 99
Microbiology 100
Microbial virulence factors 101
Pathology 101
Systemic predisposing factors 103
Smoking 103
Diabetes mellitus 104
Osteoporosis 105
General principles of management of chronic periodontitis 105
Treatment of periodontal pockets 105
Role of antibiotics 106
Treatment of advanced periodontal disease 106
Prognosis in periodontal disease 106
Complications of chronic periodontitis 106
Gingival recession 107
Treatment of gingival recession 108
Aggressive periodontitis 108
Localised aggressive periodontitis 108
Generalised aggressive periodontitis 108
Treatment of aggressive periodontitis 108
‘Prepubertal’ periodontitis 109
Periodontitis as a manifestation of systemic disease 109
Down’s syndrome 109
Papillon–lefèvre syndrome 110
Periodontal (lateral) abscess 110
Clinical features 110
Pathology 110
Treatment 110
Acute pericoronitis 110
Clinical features 111
Management 111
Acute necrotising ulcerative gingivitis 112
Clinical features 112
Aetiology 112
Treatment 113
HIV-associated periodontitis 113
Management 113
Gingival enlargement 113
Hereditary gingival fibromatosis 113
Drug-induced gingival overgrowth 114
Localised juvenile spongiotic gingivitis 115
Plasminogen deficiency gingivitis 115
Other inflammatory gingival swellings 115
8 Infections of the jaws 117
Normal healing of an extraction socket 117
Alveolar osteitis 117
Aetiology 117
Clinical features 119
Pathology 119
Prevention 119
Treatment 120
Osteomyelitis of the jaws 120
Acute osteomyelitis ➔ Summary charts 5.1 and 13.1 pp. 79, 222 120
Clinical features 120
Pathology 121
Management 121
Complications and resolution 122
Chronic osteomyelitis ➔ Summary charts 5.1 and 13.1 pp. 79, 222 122
Clinical features 122
Pathology 123
Diffuse sclerosing osteomyelitis 123
Chronic low-grade focal osteomyelitis and sclerosing osteitis ➔ Summary charts 5.1, 13.1 and 12.2 pp. 79, 222, 203 124
Osteoradionecrosis 124
Proliferative periostitis 125
Medication-related osteonecrosis of the jaws (MRONJ) 125
Management 126
Traumatic sequestrum 127
Sclerotic bone islands 128
9 Major infections of the mouth and face 129
Periapical (dentoalveolar) abscess 129
Collateral oedema 129
‘Fascial’ or tissue space infections 129
Facial cellulitis ➔ Summary charts 5.1 and 34.1 pp. 79, 461 130
Pathology 131
Ludwig’s angina 131
Management 132
Facial abscess 132
Antibiotic abscess 133
Necrotising fasciitis ➔ Summary chart 5.1 p. 79 133
Cavernous sinus thrombosis ➔ Summary chart 5.1 p. 79 133
Noma (cancrum oris, necrotising stomatitis) 134
Management 134
Actinomycosis 135
Pathology 135
Management 136
Other ‘actinomycoses’ 136
The systemic mycoses 136
Mucormycosis 137
Systemic infections by oral bacteria 137
Infective endocarditis 138
Lung and brain abscesses 138
10 Cysts in and around the jaws 139
Classification of cysts 139
Common features of jaw cysts 140
Treatment of jaw cysts 141
Treatment of soft tissue cysts 142
Odontogenic cysts 142
Radicular cyst ➔ Summary chart 10.1 p. 163 142
Clinical features 142
Radiography 143
Pathogenesis 143
Histopathology 143
Differential diagnosis 144
Treatment 144
Lateral radicular cyst ➔ Summary chart 10.1 p. 163 146
Residual radicular cyst ➔ Summary chart 10.1 p. 163 146
Inflammatory collateral cysts 146
Dentigerous cysts ➔ Summary chart 10.1 p. 163 146
Clinical features 147
Radiography 147
Pathogenesis 147
Histopathology 147
Differential diagnosis 148
Treatment 148
Eruption cyst 148
Odontogenic keratocyst ➔ Summary charts 10.1 and 10.2 pp. 163, 164 149
Clinical features 149
Radiography 149
Pathogenesis 150
The possible neoplastic nature of odontogenic keratocysts 150
Histopathology 151
Differential diagnosis 151
Treatment and recurrence 151
Basal cell naevus syndrome 153
Orthokeratinised odontogenic cyst 154
Lateral periodontal cysts 155
Botryoid odontogenic cysts 155
Glandular odontogenic cyst 156
Calcifying odontogenic cyst 156
Carcinoma arising in odontogenic cysts 157
Gingival cyst of the newborn 157
Epstein’s pearls 158
Gingival cyst of adults 158
Non-odontogenic cysts 158
Nasopalatine duct or incisive canal cyst 158
Clinical features 158
Pathogenesis and pathology 159
Nasolabial cyst 160
Sublingual dermoid cyst 160
Thyroglossal duct cyst 161
Branchial cyst 161
Foregut cyst 162
Other cysts in other chapters 162
11 Odontogenic tumours and related jaw lesions 165
Benign epithelial tumours 165
Ameloblastomas ➔ Summary chart 10.2 p. 164 165
Solid/multicystic or ‘conventional’ ameloblastoma 165
Pathology 166
Behaviour and treatment 168
Desmoplastic ameloblastoma 168
Metastasising ameloblastoma 169
Unicystic ameloblastoma ➔ Summary chart 10.1 p. 163 169
Squamous odontogenic tumour 170
Calcifying epithelial odontogenic tumour ➔ Summary chart 11.1 p. 185 170
Pathology 171
Adenomatoid odontogenic tumour ➔ Summary charts 10.1 and 11.1 pp. 163, 185 172
Pathology 172
Benign epithelial and mesenchymal tumours 172
Ameloblastic fibroma ➔ Summary chart 10.1 p. 163 172
Pathology 173
Ameloblastic fibrodentinoma and fibro-odontome 173
Primordial odontogenic tumour 173
Odontomes (odontomas*) ➔ Summary charts 11.1 and 12.1 pp. 185, 202 173
Compound odontome 174
Complex odontome 174
Other types of odontome 175
Calcifying odontogenic cyst ➔ Summary chart 11.1 p. 185 176
Dentinogenic ghost cell tumour ➔ Summary charts 11.1 and 13.1 pp. 185, 222 176
Benign mesenchymal tumours 177
Odontogenic fibroma ➔ Summary chart 10.1 p. 163 177
2 Soft tissue disease 235
15 Diseases of the oral mucosa 235
Ulcers ➔ Summary charts 15.2, 16.2 and 16.3 pp. 253, 280, 281 235
Herpesvirus diseases 235
Primary herpetic stomatitis ➔ Summary chart 15.2 p. 253 235
Clinical features 235
Pathology 236
Diagnosis 236
Treatment 237
Latency 238
Herpes labialis ➔ Summary chart 15.2 p. 253 238
Treatment 238
Herpetic whitlow 239
Herpes zoster of the trigeminal nerve ➔ Summary chart 15.2 p. 253 239
Clinical features 239
Pathology 239
Management 240
Complications 240
Ramsay Hunt syndrome 240
Cytomegalovirus ulcers 240
Hand-foot-and-mouth disease ➔ Summary chart 15.2 p. 253 240
Clinical features 240
Herpangina 241
Measles 241
Chicken pox 241
Tuberculosis 242
Pathology 242
Management 242
Syphilis 242
Congenital syphilis 242
Primary syphilis 243
Secondary syphilis 243
Tertiary syphilis 243
Management 243
Candidosis 244
Thrush ➔ Summary chart 15.1 and 19.1 pp. 252, 314 244
Clinical features 244
Pathology 245
Management 245
Angular cheilitis ➔ Summary chart 15.1 p. 252 246
Management 246
Erythematous candidosis ➔ Summary charts 15.1 and 19.3 pp. 252, 316 246
Acute antibiotic stomatitis ➔ Summary chart 15.1 p. 252 246
Median rhomboid glossitis ➔ Summary charts 15.3 and 19.3 pp. 252, 316 247
3 Systemic disease in dentistry 391
27 Anaemias, leukaemias and lymphomas 391
Anaemia 391
Clinical features 391
Mucosal disease 391
Glossitis 391
Recurrent aphthae 392
Candidosis and angular stomatitis 392
Dangers of general anaesthesia 392
Lowered resistance to infection 392
Sickle cell disease and sickle cell trait 392
Sickle cell disease 392
Dental aspects 392
The thalassaemias 393
Leukaemia 393
Acute leukaemia ➔ Summary chart 24.2 p. 373 393
Management 393
Chronic leukaemia 394
Management 394
Lymphomas 394
Hodgkin’s lymphoma 395
Non-Hodgkin lymphomas 395
Burkitt’s lymphoma 395
MALT lymphoma 396
Management 396
Nasopharyngeal extranodal NK/T-cell lymphoma 396
Other types of lymphoma 397
Leucopenia and agranulocytosis 397
Aplastic anaemia 398
Agranulocytosis 398
Cyclic neutropenia 398
28 Haemorrhagic disorders 399
Preoperative investigation 399
Laboratory investigations 399
Management of prolonged dental bleeding 399
Blood vessel abnormalities 399
Hereditary haemorrhagic telangiectasia 399
Angina bullosa haemorrhagica 400
Ehlers–Danlos syndrome 401
Purpura and platelet disorders 401
General features of purpura 401
Management 401
Causes of purpura 401
Clotting disorders 402
Haemophilia A 402
Clinical features 402
Principles of management 402
Christmas disease (haemophilia B) 403
Acquired clotting defects 403
Coumarin anticoagulant treatment 403
Novel anticoagulants 404
Heparin 404
Liver disease 404
Vitamin Kdeficiency 404
Combined bleeding disorders 404
Von Willebrand’s disease 404
Disseminated intravascular coagulation 404
Plasminogen deficiency 404
29 Immunodeficiency 407
Oral manifestations of immunodeficiency 407
Selective iga deficiency 407
C1 esterase inhibitor deficiency 408
Leukopenia and agranulocytosis 408
Immunosuppressive treatment 408
Bone marrow transplantation 408
Graft-versus-host disease 408
Other organ transplants 408
HIV infection and AIDS 408
Aetiology 409
Life cycle 409
Diagnosis of HIV infection 409
HIV staging and diagnosis of AIDS 410
Clinical course 410
Treatment 411
Oral lesions in HIV infection 411
Candidosis 412
Viral mucosal infections 413
Bacterial infections 413
Systemic mycoses 413
Malignant neoplasms 413
Kaposi’s sarcoma ➔ Summary chart 26.1 p. 390 413
Lymphomas 414
Lymphadenopathy 414
Autoimmune disease 414
Gingivitis and periodontitis 414
Salivary gland disease 414
HIV-associated salivary gland disease ➔ Summary chart 22.2 p. 354 414
Miscellaneous oral lesions 415
Mucosal ulcers 415
Oral hyperpigmentation ➔ Summary chart 26.1 p. 390 416
Oral adverse effects of HAART 416
Risks of transmission of HIV infection to healthcare workers 416
General aspects of dental management 416
Post-exposure prophylaxis and sharps injury 416
Risks of transmission of HIV to patients 417
30 Allergy, autoimmune and autoinflammatory disease 419
Allergic or hypersensitivity reactions 419
Atopy 419
Contact dermatitis 419
Latex allergy 420
Allergy to local anaesthetic 421
Asthma 422
Other type 1 reactions 422
Mucosal allergic responses 422
Oral allergy ‘syndrome’ 422
Allergy to metals 422
Nickel and chromium 422
Mercury 422
Angio-oedema ➔ Summary chart 34.1 p. 459 423
Allergic angio-oedema 423
Hereditary angio-oedema 423
Autoimmune diseases 423
The connective tissue diseases 424
Rheumatoid arthritis 424
Sjögren’s syndrome 424
Systemic lupus erythematosus 424
Systemic sclerosis (scleroderma) 425
Autoinflammatory diseases 425
Sarcoidosis ➔ Summary charts 22.2, 24.2 and 34.1 pp. 354, 373, 459 425
Pathology 425
Lung and lymph node involvement 425
Oral involvement 426
Salivary gland involvement 426
Diagnosis and management 426
31 Cervical lymphadenopathy 429
Investigation 429
Tuberculous cervical lymphadenopathy 430
Pathology 430
Atypical mycobacterial infection 431
Sarcoidosis 431
Syphilis 432
Cat-scratch disease 432
Pathology 432
Lyme disease 432
Infectious mononucleosis 432
Management 433
The acquired immune deficiency syndrome 433
Toxoplasmosis 433
Mucocutaneous lymph node syndrome (Kawasaki’s disease) 433
Langerhans cell histiocytosis 434
Sinus histiocytosis with massive lymphadenopathy 434
Castleman’s disease 434
Unicentric Castleman’s disease 434
Multicentric Castleman’s disease 434
Pathology 435
Drug-associated lymphadenopathy 435
Virchow’s node 435
Delphian node 436
32 Cardiovascular disease 437
General aspects of management 437
Local analgesia 437
Infective endocarditis 438
Clinical features 439
Prevention of endocarditis 439
Principles of antibiotic prophylaxis 439
Current guidance on antibiotic prophylaxis 439
Prevention 440
Implanted cardiac devices 441
33 Respiratory tract disease 443
Acute sinusitis ➔ Summary chart 38.1, p. 486 443
Clinical features 443
Diagnosis and management 443
Chronic sinusitis ➔ Summary chart 38.1, p. 486 443
Management 443
Odontogenic sinusitis 444
Fungal sinusitis 444
Allergic fungal sinusitis 444
Invasive fungal sinusitis 445
Surgical damage to the maxillary antrum 445
Displacement of a root or tooth into the maxillary antrum 445
Management 445
Oroantral communication 445
Aspiration of a tooth, root or instrument 446
Tuberculosis 446
Chronic obstructive airways disease 447
Asthma 447
Midfacial destructive lesions 447
Wegener’s granulomatosis ➔ Summary chart 24.2, p. 373 447
Oral and nasal lesions 448
Management 448
Carcinoma of the antrum 448
Cystic fibrosis (mucoviscidosis) 449
Sleep apnoea syndrome 449
Management 449
Bronchogenic carcinoma 449
Dental aspects 450
34 Gastrointestinal and liver disease 451
Gastro-oesophageal reflux and gastric regurgitation 451
Coeliac disease 451
Dental aspects 451
Crohn’s disease ➔ Summary chart 34.1 and 24.2, p. 459, 373 451
Oral effects 451
Orofacial granulomatosis ➔ Summary chart 34.1 and 24.2, p. 459, 373 453
Malabsorption syndromes 453
Ulcerative colitis 453
Oral aspects 454
Intestinal polyposis syndromes 454
Antibiotic-associated colitis 454
Liver disease 454
Impaired drug metabolism 454
Viral hepatitis 455
Hepatitis A 455
Hepatitis E 455
Hepatitis B 455
Clinical aspects 455
Serological markers of hepatitis B 455
The carrier state and complications 455
Risks to dental staff 456
Transmission of hepatitis B 456
Prevention and management of hepatitis B 457
Hepatitis D: the delta agent 457
Hepatitis C 457
Management 458
Control of transmission of viral hepatitis 458
35 Nutritional deficiencies 461
Vitamin deficiencies 461
Vitamin A deficiency 461
Riboflavin (B2) deficiency 461
Nicotinamide deficiency (pellagra) 461
Vitamin B12 deficiency 461
Folic acid deficiency 461
Vitamin C deficiency 461
Vitamin D deficiency 462
36 Endocrine disorders and pregnancy 463
Pituitary gigantism and acromegaly 463
Dental considerations 463
Thyroid disease 464
Hyperthyroidism 464
Dental considerations 464
Hypothyroidism 464
Cretinism 464
Adult hypothyroidism 464
Lingual thyroid 464
Parathyroid disease ➔ Summary chart 12.2 p. 203 465
Hyperparathyroidism 465
Hypoparathyroidism 466
Tetany 466
Pseudohypoparathyroidism 466
Adrenocortical diseases 466
Adrenocortical hypofunction or Addison’s disease 466
Adrenocortical hyperfunction 467
Autoimmune polyendocrine syndromes 467
Diseases of the adrenal medulla 467
Phaeochromocytoma 467
Multiple endocrine neoplasia syndromes 468
Diabetes mellitus 468
Dental aspects 469
Pregnancy 469
Fetal considerations 469
Maternal considerations 470
37 Renal disease 471
Chronic renal failure and dialysis 471
Renal transplantation 471
38 Pain and neurological disorders 473
Dental and periodontal pain 473
Pulpitis 473
Apical periodontitis ➔ Summary chart 38.1 p. 486 473
Periodontal abscess and pericoronitis 474
Cracked teeth 474
Acute necrotising ulcerative gingivitis 474
Pain in edentulous patients 474
Painful mucosal lesions 475
Pain in the jaws 475
Postsurgical pain and nerve damage 475
Iatrogenic nerve injury 475
Pain induced by mastication 475
Non-dental causes 476
Pain from salivary glands 476
Neuralgia and neuropathy 476
Trigeminal neuralgia ➔ Summary chart 38.1 p. 486 476
Diagnosis 477
Treatment 477
Trigeminal neuralgia in multiple sclerosis 477
Trigeminal neuropathy 477
Glossopharyngeal neuralgia 477
Postherpetic neuralgia ➔ Summary chart 38.1 p. 486 478
Bell’s palsy 478
Burning mouth ‘syndrome’ 478
Atypical facial pain (persistent idiopathic facial pain) 479
Atypical odontalgia 479
Paraesthesia and anaesthesia of the lower lip 479
Facial palsy 480
Upper and lower motor neuron lesions 480
Bell’s palsy 480
Dental aspects 481
Melkersson–Rosenthal syndrome ➔ Summary chart 34.1 p. 459 481
Other causes of facial palsy 482
Headache 482
Migraine 482
Migrainous neuralgia (cluster headache) ➔ Summary chart 38.1 p. 486 482
Management 483
Intracranial tumours 483
Disturbances of taste and smell 483
Loss of smell 483
Loss of taste 483
Epilepsy 484
Management 484
Dental aspects 484
39 Physical and learning disability 487
UK discrimination legislation 488
Learning disability 488
Down’s syndrome 489
General features 489
Management 490
Fragile X syndrome 490
Other chromosomal abnormalities 490
Behavioural disorders 491
Autism 491
Attention deficit hyperactivity disorder 491
Physical impairments 491
Cerebral palsy 491
Neuromuscular dysfunction 492
Dental aspects 492
Multiple sclerosis 492
Dental aspects 493
Hydrocephalus 493
Spina bifida 493
The muscular dystrophies 493
Myasthenia gravis 493
Dental aspects 494
40 Mental health disorders 495
Pain without medical cause 495
Anxiety disorders 496
Fear of dentistry 496
Depression 496
Dental aspects of depression 496
Obsessive-compulsive disorder 497
Factitious ulceration 497
Anorexia nervosa and bulimia nervosa 497
Psychoses 497
Schizophrenia 497
Dental aspects 498
41 Dentistry and elderly patients 499
Dementia 499
Other systemic diseases 500
Parkinson’s disease 500
Oral disease in the elderly 501
Factors affecting dental care of the elderly 501
The teeth 501
The alveolar bone and dentures 501
The temporomandibular joints 502
Salivary function 502
Mucosal diseases in the elderly 502
Malignant neoplasms and irradiation 502
Cardiovascular disease 502
42 Complications of systemic drug treatment 503
Local analgesics with vasoconstrictors 505
Chemical dependence 505
43 Medical emergencies 507
Sudden loss of consciousness 507
Common themes 507
Fainting 507
Prevention 508
Acute hypoglycaemia 508
Anaphylactic reactions 508
Signs and symptoms 508
Management 509
Myocardial infarction 509
Cardiac arrest 509
Strokes 510
Circulatory collapse in patients on corticosteroid treatment 510
Chest pain 511
Angina pectoris 511
Myocardial infarction 511
Respiratory difficulty 512
Severe asthma and status asthmaticus 512
Causes 512
Left ventricular failure 512
Convulsions 512
Epilepsy 512
Status epilepticus 512
Other emergencies 513
Haemorrhage 513
Violence 513
4 Learning guide and self-assessment questions 515
44 Learning guide 515
Self-assessment questions 521
Chapter 1 521
Section 1 521
Chapter 2 521
Chapter 3 521
Chapter 4 521
Chapter 5 522
Chapter 6 522
Chapter 7 522
Chapter 8 522
Chapter 9 522
Chapter 10 523
Chapter 11 523
Chapter 12 523
Chapter 13 523
Chapter 14 523
Section 2 524
Chapter 15 524
Chapter 16 524
Chapter 17 524
Chapter 18 524
Chapter 19 524
Chapter 20 524
Chapter 21 525
Chapter 22 525
Chapter 23 525
Chapter 24 525
Chapter 25 525
Chapter 26 525
Section 3 525
Chapter 27 525
Chapter 28 525
Chapter 29 526
Chapter 30 526
Chapter 31 526
Chapter 32 526
Chapter 33 526
Chapter 34 526
Chapters 35, 36 and 37 526
Chapter 38 526
Chapter 39 526
Chapter 40 527
Chapter 41 527
Chapter 42 527
Chapter 43 527
Index 529
A 529
B 530
C 531
D 532
E 533
F 534
G 534
H 535
I 536
J 537
K 537
L 537
M 538
N 539
O 539
P 540
Q 541
R 541
S 542
T 543
U 544
V 545
W 545
X 545
Z 545