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Elsevier

Publications in this journal

• The history of sleep medicine.

  Authors: Dennis R Bailey, Ronald Attanasio

  Dental clinics of North America. 56(2):313-7.

  Sleep medicine as it is known today actually started as research and scientific study, not as clinical medicine. When one considers that sleep medicine today is in its infancy, it is obvious thatSleep medicine as it is known today actually started as research and scientific study, not as clinical medicine. When one considers that sleep medicine today is in its infancy, it is obvious that there is much more to learn. The history of sleep dates back to the 1880s. However, the most significant developments that moved sleep forward into the practice of medicine, and eventually dentistry, occurred from the 1950s on. This article explores the highlights of the history of sleep and sleep medicine.

• Screening and comprehensive evaluation for sleep related breathing disorders.

  Authors: Dennis R Bailey, Ronald Attanasio

  Dental clinics of North America. 56(2):331-42.

  The dentist is well positioned to screen for patients at risk for a sleep disorders, most often a sleep related breathing disorder, and when adequately trained, can treat those diagnosed with sleepThe dentist is well positioned to screen for patients at risk for a sleep disorders, most often a sleep related breathing disorder, and when adequately trained, can treat those diagnosed with sleep apnea using an oral appliance. This treatment requires some degree of training to be able to recognize the symptoms related to the more common sleep disorders. The dentist must determine if the patient is at risk for a sleep disorder through the use of screening questionnaires, reviewing the health history, and additional questioning of the patient.

• Sleep study-what the dentist needs to know.

  Authors: John F Trapp, T Troy Stentz

  Dental clinics of North America. 56(2):359-71.

  The intent of this article is to familiarize dental professionals with the polysomnogram (PSG). The evaluation of patients presenting with sleep disorders is complex, requiring an investigativeThe intent of this article is to familiarize dental professionals with the polysomnogram (PSG). The evaluation of patients presenting with sleep disorders is complex, requiring an investigative approach that synthesizes information obtained through a detailed history, a focused physical examination, and appropriate confirmatory testing. The PSG is the only clinical tool that measures multiple physiologic variables to qualitatively and quantitatively evaluate sleep. A proper understanding of the role of the PSG and its measurements and interpretation allows for a proper diagnosis so as to provide an optimal range of treatments for individual patients.

• Sleep bruxism: a comprehensive overview for the dental clinician interested in sleep medicine.

  Authors: Maria Clotilde Carra, Nelly Huynh, Gilles Lavigne

  Dental clinics of North America. 56(2):387-413.

  Sleep bruxism (SB) is a common sleep-related motor disorder characterized by tooth grinding and clenching. SB diagnosis is made on history of tooth grinding and confirmed by polysomnographicSleep bruxism (SB) is a common sleep-related motor disorder characterized by tooth grinding and clenching. SB diagnosis is made on history of tooth grinding and confirmed by polysomnographic recording of electromyographic (EMG) episodes in the masseter and temporalis muscles. The typical EMG activity pattern in patients with SB is known as rhythmic masticatory muscle activity (RMMA). The authors observed that most RMMA episodes occur in association with sleep arousal and are preceded by physiologic activation of the central nervous and sympathetic cardiac systems. This article provides a comprehensive review of the cause, pathophysiology, assessment, and management of SB.

• Effectiveness and outcome of oral appliance therapy.

  Authors: Benjamin T Pliska, Fernanda Almeida

  Dental clinics of North America. 56(2):433-44.

  Oral appliances (OAs) are a primary treatment option for snoring and mild to moderate obstructive sleep apnea (OSA) and are implemented as a noninvasive alternative for patients with severe OSA whoOral appliances (OAs) are a primary treatment option for snoring and mild to moderate obstructive sleep apnea (OSA) and are implemented as a noninvasive alternative for patients with severe OSA who are unwilling or unable to tolerate continuous positive airway pressure for the management of their disease. Studies have demonstrated the ability of OAs to eliminate or significantly reduce the symptoms of OSA and produce a measurable influence on the long-term health effects of the disease. Most studies have evaluated one type of OAs, the mandibular advancement splints. This article describes the effectiveness and outcomes of mandibular advancement splints.

• Sleep medicine in dentistry.

  Authors: Ronald Attanasio, Dennis R Bailey

  Dental clinics of North America. 56(2):xi-xiii.

• Surgical reconstruction of the upper airway for obstructive sleep apnea.

  Authors: Ofer Jacobowitz

  Dental clinics of North America. 56(2):453-74.

  Positive airway pressure can be effective for OSA treatment but is not effectively used by many patients. Surgical reconstruction of the airway is appropriate for patients who are not otherwisePositive airway pressure can be effective for OSA treatment but is not effectively used by many patients. Surgical reconstruction of the airway is appropriate for patients who are not otherwise effectively treated or as first-line treatment for patients with focal airway lesions. For surgical planning, examination schemes of the awake patient, as well as sleep endoscopy may be used. Nasal surgery may facilitate treatment using positive airway pressure or oral appliances or to improve quality of life. Pharyngoplasty and tongue base techniques for therapeutic upper airway reconstruction may be performed staged or simultaneously. Current and future approaches are described.

• Basic biology of sleep.

  Authors: John Harrington, Teofilo Lee-Chiong

  Dental clinics of North America. 56(2):319-30.

  Sleep can be defined as a complex reversible state characterized by behavioral quiescence, diminished responsiveness to external stimuli, and a stereotypical species-specific posture. Both componentsSleep can be defined as a complex reversible state characterized by behavioral quiescence, diminished responsiveness to external stimuli, and a stereotypical species-specific posture. Both components of sleep, non-rapid eye movement and rapid eye movement, are generated and maintained by central nervous system networks that use specific neurotransmitters located in specific areas of the brain. Widespread changes in physiologic processes occur during sleep, and these changes may influence the presentation and severity of specific medical disorders.

• Cone beam computed tomography: craniofacial and airway analysis.

  Authors: David C Hatcher

  Dental clinics of North America. 56(2):343-57.

  Imaging plays a role in the anatomic assessment of the airway and adjacent structures. This article discusses the use of 3-dimensional (3D) imaging (cone beam computed tomography [CBCT]) to evaluateImaging plays a role in the anatomic assessment of the airway and adjacent structures. This article discusses the use of 3-dimensional (3D) imaging (cone beam computed tomography [CBCT]) to evaluate the airway and selected regional anatomic variables that may contribute to obstructive sleep-disordered breathing (OSDB) in patients. CBCT technology uses a cone-shaped x-ray beam with a special image intensifier and a solid-state sensor or an amorphous silicon plate for capturing the image. Incorporation of 3D imaging into daily practice will allow practitioners to readily evaluate and screen patients for phenotypes associated with OSDB.

• Medical disorders impacted by obstructive sleep apnea.

  Authors: Sabin R Bista, Teri J Barkoukis

  Dental clinics of North America. 56(2):373-86.

  Normal-sleeping individuals experience a lower metabolic rate and relative cardiovascular quiescent state with lower heart rate and blood pressure that naturally occurs during sleep compared with theNormal-sleeping individuals experience a lower metabolic rate and relative cardiovascular quiescent state with lower heart rate and blood pressure that naturally occurs during sleep compared with the waking state. In patients with obstructive sleep apnea (OSA), this quiescent state becomes disrupted. Research has shown a higher risk for several medical disorders, most ominous being a myocardial infarction or stroke. This article serves as an overview to the cardiovascular, cerebrovascular, metabolic, and gastroesophageal effects of OSA.

• Temporomandibular disorder pain and dental treatment of obstructive sleep apnea.

  Authors: Robert L Merrill

  Dental clinics of North America. 56(2):415-31.

  Treatment of sleep apnea with mandibular advancement devices (MADs) may be associated with the development of symptoms of temporomandibular disorder (TMD). This article discusses the different typesTreatment of sleep apnea with mandibular advancement devices (MADs) may be associated with the development of symptoms of temporomandibular disorder (TMD). This article discusses the different types of TMD and orofacial pain problems that may occur during treatment of obstructive sleep apnea (OSA) with a MAD. It is critical that the general dentist who is providing dental devices for OSA perform a thorough physical and neurologic assessment of the temporomandibular joint and associated structures before providing such a device so that preexisting problems are identified and discussed with the patient.

• Use of portable monitoring for sleep-disordered breathing treated with an oral appliance.

  Authors: Dennis R Bailey

  Dental clinics of North America. 56(2):445-52.

  The potential use of a portable monitor to assess the outcome of treatment with an oral appliance would ideally be performed by the dentist who is managing the patient's sleep-disordered breathing.The potential use of a portable monitor to assess the outcome of treatment with an oral appliance would ideally be performed by the dentist who is managing the patient's sleep-disordered breathing. Portable monitoring is one of the most cost-effective ways to assess the response to the oral appliance, to determine if further adjustment to the appliance is needed, and to retest to determine the current status following any adjustment. This article emphasizes the use of portable monitors primarily for follow-up care and assessment as opposed to diagnosis or, as it is sometimes referred to, screening.

• Medical insurance for dental sleep medicine.

  Authors: Marty R Lipsey

  Dental clinics of North America. 56(2):475-84.

  Over the last 5 to 7 years, dental teams have mastered the art and science of processing dental insurance for their patients but have major difficulties learning how to help their patients when itOver the last 5 to 7 years, dental teams have mastered the art and science of processing dental insurance for their patients but have major difficulties learning how to help their patients when it comes to medical insurance. This article attempts to provide a basic guide for the dental team in coding, billing, and processing of major medical insurance for dental sleep medicine. Although there is certainly a learning curve for the dental team in this endeavor, the "patient and physician friendly" dental sleep medicine practice is a model that will help to assure growth and success.

• Anxiety control in the dental patient.

  Authors: Orrett E Ogle, Marc B Hertz

  Dental clinics of North America. 56(1):1-16, vii.

  Oral sedation with benzodiazepines and anxiolysis with nitrous oxide are 2 effective methods to help alleviate anxiety and fear of dental procedures. Many patients would prefer to have theirOral sedation with benzodiazepines and anxiolysis with nitrous oxide are 2 effective methods to help alleviate anxiety and fear of dental procedures. Many patients would prefer to have their dentistry performed with sedation if it were offered to them. This article presents a detailed discussion on minimal sedation that should give the reader a good understanding of this valuable aspect of clinical care.

• Oral surgery for patients on anticoagulant therapy: current thoughts on patient management.

  Authors: Ladi Doonquah, Anika D Mitchell

  Dental clinics of North America. 56(1):25-41, vii.

  Minor oral surgical procedures make up a significant part of the daily practice of dentistry. With the increased sophistication of medical technology and medications there is increased likelihood ofMinor oral surgical procedures make up a significant part of the daily practice of dentistry. With the increased sophistication of medical technology and medications there is increased likelihood of performing surgery on patients who are being treated for conditions that require some type of anticoagulant therapy. These patients are at an increased risk for perioperative bleeding or thrombotic complications if anticoagulation is discontinued or the dosage is adjusted. Therefore, a fine balance needs to be obtained and adequate preparation of these patients is the key to establishing this balance. This article reviews suggested approaches to the management of such patients.

• Diagnosis and management of common postextraction complications.

  Authors: Joseph E Pierse, Harry Dym, Earl Clarkson

  Dental clinics of North America. 56(1):75-93, viii.

  Extraction of impacted teeth is one of the most common surgical procedures performed by oral and maxillofacial surgeons. Every surgical procedure results in some degree of postoperative bleeding andExtraction of impacted teeth is one of the most common surgical procedures performed by oral and maxillofacial surgeons. Every surgical procedure results in some degree of postoperative bleeding and inflammation, typically manifesting as pain and edema. Although the complex physiology of the human body is beyond the scope of this article, the educated clinician should have an understanding of the time line associated with these processes so as to determine whether a patient's complaint of postoperative bleeding, pain, or swelling represents a normal response to surgical trauma or an aberrant reaction.

• Risk management in the dental office.

  Authors: Harry Dym

  Dental clinics of North America. 56(1):113-20, viii.

  This article is devoted to risk-management strategies regarding oral surgical procedures in the general dental office. Lawsuits are more likely to be filed following poor outcomes related to oralThis article is devoted to risk-management strategies regarding oral surgical procedures in the general dental office. Lawsuits are more likely to be filed following poor outcomes related to oral surgical procedures rather than after operative or prosthetic dental procedures. The article is not meant to discourage practitioners from performing oral surgical procedures if they have the experience, training, and appropriate skill set to complete the planned procedure. Rather, it advises clinicians as to the steps one can take to limit the chances of litigation from occurring, and avoid the emotionally and painful time-consuming process associated with a malpractice lawsuit.

• Local anesthesia: agents, techniques, and complications.

  Authors: Orrett E Ogle, Ghazal Mahjoubi

  Dental clinics of North America. 56(1):133-48, ix.

  This article outlines the different classes of local anesthetics available for dental procedures. It also gives an overview of the mechanism of action and metabolism of each different class of localThis article outlines the different classes of local anesthetics available for dental procedures. It also gives an overview of the mechanism of action and metabolism of each different class of local anesthetic. Furthermore, it discusses indications and contraindications of each local anesthetic and the proper dosage of each. The techniques for the administration of local anesthetics with the relevant anatomy are explained. An overview is given of the possible complications that can occur because of local anesthetic use and their possible treatment options.

• Preoperative evaluation of the surgical patient.

  Authors: Stephen Petranker, Levon Nikoyan, Orrett E Ogle

  Dental clinics of North America. 56(1):163-81, ix.

  A thorough preoperative evaluation to identify correctable medical abnormalities and understand the residual risk is mandatory for all patients undergoing any surgical procedure, including oralA thorough preoperative evaluation to identify correctable medical abnormalities and understand the residual risk is mandatory for all patients undergoing any surgical procedure, including oral surgery. Routine preoperative evaluation will vary among patients, depending on age and general health. This article addresses the preoperative evaluation of surgical patients in general, and the evaluation for general anesthesia in the operating room.

• Review of antibiotics and indications for prophylaxis.

  Authors: Adam Weiss, Harry Dym

  Dental clinics of North America. 56(1):235-44, x.

  Antibiotic prophylaxis to prevent infective endocarditis has been controversial through the years, with various changes made to recommendations provided to treating physicians and dentists. TheAntibiotic prophylaxis to prevent infective endocarditis has been controversial through the years, with various changes made to recommendations provided to treating physicians and dentists. The dentist must always use his or her best judgment when applying any guideline. However, it is important to remember that the guidelines may be cited in any malpractice litigation as evidence of the standard of care. Early diagnosis with prompt treatment with effective antimicrobial therapy is the best way to lower the mortality and morbidity. When prescribing antibiotics, the clinician must realize that the overprescription of antibiotics has led to resistance to antibiotic regimens and the rise of antibiotic-resistant bacteria.

• Alveolar bone grafting and reconstruction procedures prior to implant placement.

  Authors: Harry Dym, David Huang, Avichai Stern

  Dental clinics of North America. 56(1):209-18, x.

  Before implant placement, adequate bone must be present; this is a fundamental step in treatment planning for implants. Understanding the basics of bone grafting and reconstruction techniques isBefore implant placement, adequate bone must be present; this is a fundamental step in treatment planning for implants. Understanding the basics of bone grafting and reconstruction techniques is critical for successful implant placement. Alveolar bone grafting can be very intimidating when first attempted. With careful instruction, education, and practice, grafting can be accomplished by many practitioners. Different methods incorporate similar surgical principles while leading to the development of more advanced grafting techniques.

• Surgical management of cosmetic mucogingival defects.

  Authors: Harry Dym, Jonathan M Tagliareni

  Dental clinics of North America. 56(1):267-79, xi.

  Mucogingival conditions are deviations from the normal anatomic relationship between the gingival margin and the mucogingival junction. Mucogingival surgery is plastic surgery designed to correctMucogingival conditions are deviations from the normal anatomic relationship between the gingival margin and the mucogingival junction. Mucogingival surgery is plastic surgery designed to correct defects in the gingiva surrounding the teeth. Common mucogingival conditions are recession, absence, or reduction of keratinized tissue, and probing depths extending beyond the mucogingival junction. Surgical techniques used to augment cosmetic mucogingival defects include the free gingival autograft, the subepithelial connective tissue graft, rotational flaps, lateral sliding flaps, coronally repositioned flaps, and the use of acellular dermal matrix grafts.

• Oral surgery for the general dentist. Preface.

  Authors: Harry Dym, Orrett E Ogle

  Dental clinics of North America. 56(1):xiii-xiv.

• Hemostasis in oral surgery.

  Authors: Amandip Kamoh, Jason Swantek

  Dental clinics of North America. 56(1):17-23, vii.

  The control of hemorrhage is a key component for the clinician to understand before performing oral surgical procedures. Hemostasis may be obtained primarily by local hemostatic measures. IfThe control of hemorrhage is a key component for the clinician to understand before performing oral surgical procedures. Hemostasis may be obtained primarily by local hemostatic measures. If hemostasis is not achieved with this modality, various hemostatic agents exist, which may be used as adjuncts to obtain hemostasis. Preoperative, perioperative, and postoperative methodologies toward hemostasis in oral surgery have been presented.

• Biopsy techniques and diagnoses & treatment of mucocutaneous lesions.

  Authors: Michael H Chan, Joshua C Wolf

  Dental clinics of North America. 56(1):43-73, vii-viii.

  Oral mucosal lesions are commonly encountered in clinical practice. One study reported that they occurred in approximately 27.9% of patients aged 17 years and older and in 10.3% of children aged 2 toOral mucosal lesions are commonly encountered in clinical practice. One study reported that they occurred in approximately 27.9% of patients aged 17 years and older and in 10.3% of children aged 2 to 17 years. The diagnosis and treatment of mucosal diseases should be an integral part of the general practitioner's practice. According to an American Dental Association survey conducted in 2007, 44% of biopsies were performed by a general practictioner. Understanding of the fundamentals of diagnosing mucocutaneous lesions requires a sound knowledge of their origin and clinical course, and of biopsy methods using contemporary diagnostic tools and techniques.

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