Credentialing and privileging for the oral and maxillofacial surgeon

Understanding the credentialing and privileging process is important for all practitioners. Whether applying to a medical staff for the first time, participating in the reappointment process, applying for new privileges, or challenging a clinical privilege denial, the practitioner needs to understand the process and know his or her rights. This article should assist the oral and maxillofacial surgeon and the organizations providing credentials and privileges to make the process less difficult and more efficient.     

The PDA and the oral maxillofacial surgeon

The personal digital assistant (PDA) offers clinicians the ability to enter and manage clinical information at the point of care. The first part of this series examined the oral medicine and surgery resources available on the Internet. This article discusses the possibilities of PDA technology, in conjunction with the Internet, for oral maxillofacial surgeons to enhance their clinical practice.     

Common contractual concerns for the oral and maxillofacial surgeon

Whether new to private practice or a seasoned practitioner, an oral and maxillofacial surgeon (OMS) needs to understand how to handle complicated and often stressful negotiations of contracts for which he or she usually is untrained. This article is designed to give a general understanding of certain common contractual language. It is not comprehensive in scope, but it attempts to cover contracts that are most often seen by an OMS in practice. It is a general discussion of common legal concepts that could face an OMS, but it is not, nor is it intended to be, legal advice.     

Eating disorders and the oral and maxillofacial surgeon

Perhaps the most challenging of all patients seeking treatment with the oral and maxillofacial surgeon (OMS) are those with eating disorders (EDs). Complex psychiatric illnesses, with their associated and significant medical sequelae, make a thorough knowledge of these disorders critical in the approach, evaluation, treatment planning, and surgical outcome in this expanding population of patients. Whether surgery for patients with EDs is elective in nature or unplanned, challenges are faced in all aspects of their care, from diagnosis to preoperative preparation, surgery, and treatment. This article identifies and outlines issues of importance for the OMS when encountering patients with known or suspected EDs and provides guidance in the management of their outpatient or inpatient treatment.     

Improvised explosive devices and the oral and maxillofacial surgeon

Improvised explosive devices have created a new class of casualties that presents a unique surgical challenge for oral and maxillofacial surgeons. The injury pattern and severity are different from those seen in conventional trauma patients. Because of battlefield circumstances, patients are sometimes delayed significantly in their transport to a trauma center, and they frequently arrive at a trauma center with hypotension, hypothermia, and acidosis. Definitive care is delayed while the hemodynamic status and life-threatening injuries are stabilized. Hospital triage protocols must be well established in advance to prepare a timely response to the mass casualty event. Proper resource use is an ever-evolving challenge for hospital staff during these times.     

Obstructive sleep apnoea: The role of the oral and maxillofacial surgeon

Obstructive sleep apnoea is a relatively common sleep disorder that is popularly associated with snoring and excessive daytime sleepiness. It is a disorder with serious implications that has only in the last two decades received the attention of clinical specialists. The aim of this article is to review the role of the dental profession in the recognition and management of this disorder.     

Training of the oral and maxillofacial surgeon in implantology.

This article reports the results of a survey of oral and maxillofacial surgery residency programs regarding the teaching of implantology. The findings show that although oral and maxillofacial surgery residents receive as much or more didactic training than most trainees in other dental specialties, and much more extensive surgical experience, the teaching is not uniform and there is still need for improvement in some areas.     

HIV and AIDS in the adolescent and adult: an update for the oral and maxillofacial surgeon

HIV and AIDS are among the most complex disease states affecting the worldwide population. OMS and other care providers should have a good understanding of the myriad of systemic effects of this disease and its treatment. This disease affects every system in the body, and in order to provide the best care to these patients, a basic knowledge of this disease process is mandatory. The OMS has the potential to assist in the initial diagnosis of HIV and in recognition of worsening disease. Research continues to examine new treatment modalities, and the search for a vaccine continues. Until a cure is found, the stark statistic seen on bumper stickers remains: 40,000,000 infected. 0 cured.     

Referral of patients with non-odontogenic oral diseases to an oral and maxillofacial surgeon

Patients with non-odontogenic oral diseases may be referred to an oral and maxillofacial surgeon by a dentist, a general medical practitioner or a medical specialist. At the department of Oral and Maxillofacial Surgery of a medical centre, a survey involving 96 referred patients with a non-odontogenic oral disease addressed the clinician who was responsible for the referral, the patient characteristics, and the nature and location of the oral disease. From the patients who regularly visited a dentist, 53% were referred by a dentist. From the patients who visited a dentist irregularly, 73% were referred by a general medical practitioner. No significant correlation was found between the nature and location of the non-odontogenic oral disease and the profession of the clinician who was responsible for the referral, with an exception for the tongue, for which a medical specialist was more often responsible for the referral.     

Joint Commission of Accreditation of Healthcare Organization accreditation for the office-based oral and maxillofacial surgeon

Office-based surgery has become a vital component of the practice of oral and maxillofacial surgeons and periodontists. It has enabled these specialties to provide needed service to patients in an outpatient setting, including the option of intravenous sedation. It is the stance of this article to promote professional oversight and quality assurance through accreditation by the Joint Commission to maintain a standard in the delivery of office-based surgical services, thus upholding the integrity of the profession in the clinical setting.     

Comparison of patient and surgeon assessments of pain in oral and maxillofacial surgery

Pain perception is a physical sensation interpreted in the light of experience and is influenced by a great number of interacting factors. Clinicians are constantly required to combine subjective and objective information to determine optimal treatment of pain. In this study, the authors prospectively compare patients' subjective complaints of pain using the visual analog scale to the surgeons' assessment of pain using standard history and physical examination findings.     

Role of the oral and maxillofacial surgeon in the diagnosis and treatment of patients with osteoporosis

Because of the increasing prevalence of osteoporosis in the aging population, it is important for oral surgeons to be aware of this condition. Oral health frequently reflects systemic diseases, and calcium loss in the teeth may mirror systemic mineral losses in the skeleton. Chronic health conditions, such as osteoporosis, also may affect surgical outcomes. In the past, therapies of osteoporosis were limited to hormonal replacement therapy and fluoride. Recently, there has been a proliferation of new therapies for osteoporosis that may affect dental health. The association between bisphosphonate use and osteonecrosis of the jaw is of concern. It is important that oral surgeons be aware of the medications a patient is using for the treatment of osteoporosis before initiating any procedure.