Dental business management

Business models and systems do not exist for their own sake. Rather, they are designed to help your practice achieve its goals. Before you adopt any new system for any aspect of your practice, define the goals and write down the specific objectives you expect the system to achieve. Bear in mind that systems need to be easily understood by team members and by those who join the practice later on. It is important to understand that economic changes, governmental mandates and other factors beyond your control may make it necessary to reassess the way each system operates on a regular basis.     

Transplant patients. Dental management

Transplanted patients could be a source of fear and anxiety for dentist. In the present paper the personal experience on seven patients with transplanted organ undergoing odontoiatric treatment has been referred.     

Dental management of chemoradiation patients

The utilization of combined chemoradiation therapy has recently increased in the treatment of head and neck cancers. This patient population is significantly more prone to various oral complications during and after medical therapy. Oral complications and long-term effects include mucositis, xerostomia, alterations in taste, vascular compromise, mucosal thinning and increased risk of rampant caries and periodontal disease. The most serious oral complication that can arise is osteoradionecrosis. Managing patients properly prior to medical treatment can help decrease these potential complications during and after treatment. This purpose of this article is to review the different radiation and chemotherapy regimens used to treat patients with head and neck cancers, as well as protocols in the dental management of these patients before, during, and after medical treatment.     

Dental arch analysis system

The purpose of our research is to describe a computerized method, which enables orthodontists and researchers to analyze variation of dental arch form and dimension. The analysis system is composed of two independent parts: the database, where the images of scanned dental casts are stored, and the software. The operator uses the software to identify some landmarks on dental cast images. Corresponding distances are calculated (interincisive, intercanine and intermolar widths and the curve axis). Then the software algorithms calculate and draw the curves passing trough the selected landmarks (conics, catenary, cubic spline and polynomial curves). In the chosen curves the arch length is measured. The dental cast data, recorded at different times of the subject's life or in different steps of orthodontic treatment, are compared in order to evaluate the change in dimension (arch length and width) and form (shape). The statistical analysis of the data evaluates the variation in form and in dimension separately. The shape change is defined by Euclidean Distance Matrix Analysis (EDMA) and Bootstrap analysis. The computerized method allows orthodontists and researches to evaluate the variation in dimension and form of the dental arch in un-treated subjects and-or orthodontic patients over time. After the analysis of a large sample of patients or subjects, information concerning changes in dental arch dimension and form can be added to previous studies of other authors, distinguishing variation during and after orthodontic treatment, during growth or aging.     

Dental postoperative pain management in children

Misconceptions about the need for pain management in pediatric patients have been shown to be wrong. We now understand that children feel pain and respond to pain medication in much the same way as adults. With this new understanding, practitioners must recognize all the factors that affect the feeling of pain. Pain can be variable and each patient brings a unique set of characteristics to be evaluated. The first objective should be to assess the patient's previous treatment history, medical condition, extent of treatment needed, and age. An effective pain management protocol begins with preoperative pain and anxiety control, with the use of agents such as nitrous oxide and local anesthetics. Postoperative pain medication should be given at the correct dosage and time intervals for the appropriate duration. With our commitment to pain management in children, these protocols should easily translate into improved clinical practice.     

Dental management of the myasthenic patient

Myasthenia gravis (MG) is an auto-immune disorder of neuromuscular transmission which results in weakness and fatigue of skeletal muscles. The defect in neuromuscular transmission is most commonly seen in the muscles of the eyes, face, neck and shoulders but, in some patients, the respiratory muscles are involved. Patients with this condition may present with problems that necessitate special consideration when managing their dental treatment. Patients who are only mildly affected by MG can be treated in general dental practice for routine care. There are no contra-indications to the use of local anaesthetic agents and the presence of a vasoconstrictor is desirable. More severely affected patients and those who are very anxious about dental treatment should be cared for within the hospital environment. In these patients, respiratory muscles may be affected and, as a result, a myasthenic crisis may arise which requires assisted ventilation and, in some cases, intubation. Those patients who are fearful of the dental environment are likely to be emotionally stressed during such times and this increases the risk of a myasthenic crisis; sedation techniques can be beneficial in this group of patients.     

Dental management of the elderly patient

The dental management of the elderly individual is becoming more of an issue in both general dental practice and specialist prosthodontic practice. This is because, in general, the population is living longer and often elderly patients are retaining their natural teeth into their old age. In addition, there are often related significant medical, social and oro-dental issues that require consideration. CLINICAL RELEVANCE: The dental management of the elderly patient is an increasing problem. This paper seeks to consider the main relevant issues pertaining to this important subject area.