A Practical Approach to Special Care in Dentistry

61 Chapter 16-6Table 16.6.1 Dental management considerations.

1 Chapter 1-1 Figure 1.1.1 Patient with spastic cerebral palsy and preserved intellectual ... Figure 1.1.2 Extensive caries upper central incisors. Figure 1.1.3 (a) Severe malocclusion with anterior open bite. (b) Sialorrhoe... Figure 1.1.4 Patients who present in wheelchairs may have treatment provided... Figure 1.1.5 (a) Spastic cerebral palsy. (b) Hand deformity calls for adapti...

2 Chapter 1-2 Figure 1.2.1 Patient with uncontrolled epilepsy wearing a protective headgea... Figure 1.2.2 Severe displacement of the maxillary central incisors following... Figure 1.2.3 (a) Tooth extraction and removal of maxillary bone fragments. (... Figure 1.2.4 (a) Sequelae of repeated facial injuries secondary to epileptic... Figure 1.2.5 Severe gingival hyperplasia in a patient on phenytoin. Figure 1.2.6 Electroencephalogram (EEG) showing epileptiform activity. Figure 1.2.7 Magnetic resonance imaging (MRI) can identify structural change...

3 Chapter 1-3 Figure 1.3.1 Facial myopathy with severe open mouth. Figure 1.3.2 Anterior open bite. Figure 1.3.3 Lateral cephalogram showing a dolichocephalic growth pattern (r... Figure 1.3.4 (a) Facial myopathy (hypotonia, dolichocephaly and open mouth).... Figure 1.3.5 Diagnostic muscle biopsy showing random variation in fibre size... Figure 1.3.6 Orthopaedic surgery to improve scoliosis.

4 Chapter 2-1 Figure 2.1.1 Dentition: generalised plaque, calculus and gingival inflammati... Figure 2.1.2 Maxilla: caries in teeth #54, #53, #65, stained fissures in #16... Figure 2.1.3 Mandible: caries in teeth #75, #84 and #85; calculus on the lin... Figure 2.1.4 Right and left bitewing radiographs: mixed dentition; caries in...

5 Chapter 2-2 Figure 2.2.1 Oral examination was carried out with the help of pictograms. Figure 2.2.2 (a) Fracture of the incisal edge of the crown of tooth #11. (b)... Figure 2.2.3 Desensitisation with visual support may be helpful. Figure 2.2.4 A visual timer may improve co‐operation. Figure 2.2.5 (a) Fascination by an inanimate object. (b) Ritualistic behavio...

6 Chapter 2-3 Figure 2.3.1 (a) Irregular palate, with erythema of the denture bearing muco... Figure 2.3.2 Cone beam computed tomography showing a bone defect in the uppe... Figure 2.3.3 (a–d) Prosthodontic rehabilitation with a new upper dental pros... Figure 2.3.4 (a) Lip fissures. (b) Dental agenesis, microdontia and macroglo... Figure 2.3.5 Orthodontic therapy can be successfully performed in selected p...

7 Chapter 3-1 Figure 3.1.1 Thickened upper labial frenulum. Figure 3.1.2 Cone beam computed tomography showing a considerable isolated c... Figure 3.1.3 Orthodontic treatment for a patient with visual impairment. Figure 3.1.4 Braille is a useful communication tool mainly for complete blin... Figure 3.1.5 When the blind patient uses a guide dog, avoid interfering with...

8 Chapter 3-2 Figure 3.2.1 Bimaxillary compression resulting in a narrow, pointed/ogival a... Figure 3.2.2 Sign language can be used to enhance communication. Figure 3.2.3 Orthodontic treatment for a patient with craniofacial dysostosi... Figure 3.2.4 An audiogram shows the quietest sounds a patient can just hear.... Figure 3.2.5 Cochlear implants in a child with congenital deafness.

9 Chapter 4-1 Figure 4.1.1 Orthopantomogram showing multiple caries and alveolar bone loss... Figure 4.1.2 Primary tuberculosis manifesting as a non‐healing, tender ulcer... Figure 4.1.3 Positive Mantoux test (also known as tuberculin PPD test for pu... Figure 4.1.4 Chest x‐ray showing cavitary lesions typically associated with ...

10 Chapter 4-2 Figure 4.2.1 Oral HPV‐associated papillomatosis in AIDS. Figure 4.2.2 (a–c) Lesions closely associated with HIV infection: oral candi... Figure 4.2.3 Exfoliative cheilitis as an adverse oral effect of proteinase i... Figure 4.2.4 Infection control in the dental clinic. Figure 4.2.5 Pneumonia by Pneumocystis carinii as an AIDS‐defining condition...

11 Chapter 4-3 Figure 4.3.1 Orthopantomogram demonstrating unrestorable caries in #26. Figure 4.3.2 Erosive lichen planus in an HCV‐infected patient. Figure 4.3.3 Jaundice related to liver dysfunction.

12 Chapter 5-1 Figure 5.1.1 Panoramic radiography showing caries and a prior filling in too... Figure 5.1.2 (a–c) Severe periodontal disease in a 37‐year‐old male with dia... Figure 5.1.3 Xerostomia – depapillated, smooth dry dorsum of the tongue. Figure 5.1.4 Continuous glucose monitoring system.

13 Chapter 5-2 Figure 5.2.1 Orthopantomogram: neglected mouth with unrestorable caries in t... Figure 5.2.2 Macroglossia in a patient with hypothyroidism. Figure 5.2.3 Goitre (enlarged thyroid gland). Figure 5.2.4 Grey‐scale ultrasound and colour Doppler sonogram showing multi...

14 Chapter 5-3 Figure 5.3.1 Mild goitre (anterior and lateral view). Figure 5.3.2 Pitted hypoplastic enamel and staining present on buccal surfac... Figure 5.3.3 Generalised moderate to severe tooth surface loss on the palata... Figure 5.3.4 Orthopantomogram demonstrating patchy medullary radiolucency su... Figure 5.3.5 Long cone periapical radiograph demonstrating periapical radiol...

15 Chapter 6-1 Figure 6.1.1 Orthopantomogram demonstrating a neglected mouth with multiple ... Figure 6.1.2 Postoperative bleeding after dental extraction in liver cirrhos...Figure 6.1.3 Grey‐scale ultrasound and colour Doppler sonogram showing a liv...

16 Chapter 6-2Figure 6.2.1 Orthopantomogram demonstrating multiple carious teeth, missing ...Figure 6.2.2 Brown tumour associated with secondary hyperparathyroidism in a...Figure 6.2.3 Autosomal‐dominant polycystic kidney disease (ADPKD) may lead t...Figure 6.2.4 A haemodialysis system including a blood circuit (with the vasc...

17 Chapter 7-1Figure 7.1.1 Orthopantomogram findings suggestive of osteoporosis as well as...Figure 7.1.2 Granular jawbone and severe cortex erosion in a female patient ...Figure 7.1.3 Right‐sided femoral neck fracture (most are due to osteoporosis...Figure 7.1.4 The gold‐standard method to assess bone mineral density (BMD) i...

18 Chapter 7-2Figure 7.2.1 Enlargement of the left maxillary area.Figure 7.2.2 Hypercementosis associated with Paget disease.

19 Chapter 7-3Figure 7.3.1 Orthopantomogram showing conserved structure of the condylar pr...Figure 7.3.2 Condylar process of a rheumatoid arthritis patient showing flat...Figure 7.3.3 Methotrexate‐induced oral ulcer.Figure 7.3.4 Stiff fingers and swollen joints in rheumatoid arthritis.

20 Chapter 8-1Figure 8.1.1 Orthopantomogram demonstrating severe vertical bone loss in mes...Figure 8.1.2 Angiotensin‐converting enzyme inhibitor (enalapril)‐induced fac...Figure 8.1.3 (a,b) Calcium channel blocker (nifedipine)‐induced gingival hyp...Figure 8.1.4 Ambulatory blood pressure monitoring record over a 24‐hour peri...

21 Chapter 8-2Figure 8.2.1 Periapical dental radiograph showing chronic periapical periodo...Figure 8.2.2 Gingival hyperplasia caused by nifedipine (a calcium channel bl...Figure 8.2.3 Nicorandil (a potassium channel opener)‐induced oral ulcer.Figure 8.2.4 Patient with unstable angina treated in a hospital setting with...Figure 8.2.5 Stress echocardiography and Doppler echocardiography are establ...

22 Chapter 8-3Figure 8.3.1 Orthopantomogram demonstrating loss of multiple teeth and deter...Figure 8.3.2 Oral lichenoid drug reaction triggered by a beta‐blocker (nevib...Figure 8.3.3 Myocardial perfusion single‐photon emission computed tomography...

23 Chapter 8-4Figure 8.4.1 Orthopantomogram showing severe maxillary atrophy and radiograp...Figure 8.4.2 Heart pacemaker (VVI) on chest x‐ray.Figure 8.4.3 Implantable cardioverter‐defibrillator with 1 lead and 2 shock ...

24 Chapter 8-5Figure 8.5.1 Periapical radiograph showing radiolucent lesion related to #36...Figure 8.5.2 Exploratory surgery confirmed the radiological suggestion of ra...Figure 8.5.3 Mechanical mitral valve prostheses.Figure 8.5.4 Biological aortic valve prostheses.