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Advances in medical science and in preventive dentistry have changed the context of oral health. The American population is living longer with numerous complex chronic diseases. This paper is to raise awareness about the impact of multiple chronic diseases and their associations with oral diseases. Comorbidities can worsen the course of dental treatment. Inflammation has been the connecting factor in the bidirectional pattern of oral and systemic diseases. High occurrences of chronic diseases generally occur in aging as well as disadvantaged populations. Serious infections, slow healing, prolonged bleeding, and hospitalizations can escalate in patients with uncontrolled chronic diseases. A multidisciplinary team-based approach to patient management can minimize complications and unexpected challenges.

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Sickle Cell Disease (SCD) is genetically described as an autosomal blood disorder resulting from the presence of a mutated form of hemoglobin. Morbidity, frequency of crisis, degree of anemia, and organ systems involved vary considerably per patient. Dental health professionals and other specialists commonly request comprehensive medical consultations prior to performing complex periodontal, endodontic, and surgical procedures. In order to have successful dental outcomes and minimize posttreatment dental complications, relevant disease indicators are noted. This review is to raise awareness of the impact of oral diseases in patients with sickle cell disease and to emphasize the importance of full medical disclosure, radiographic interpretation, and a well-documented medical history, and a well-written consultation which can guide treatment planning and greatly improve the course of dental treatment.

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BACKGROUND: Sodium lauryl sulfate (SLS), a popular surface active agent ingredient within toothpastes, is known for its foaming action. Surface active agents increase the effectiveness of toothpastes with respect to dental plaque removal. SLS is a known irritant and also has allergenic potential. The authors report 3 patients with oral pain secondary to inflammation of the dorsal anterior tongue. These patients were all using toothpastes with SLS as an ingredient. RESULTS: The dorsal tongue lesions and oral pain resolved upon switching to toothpastes without SLS as an ingredient. CONCLUSIONS: Clinicians should be aware of the potential of SLS within toothpastes to cause oral mucosal inflammatory reactions of the anterior dorsal tongue. To our knowledge, these are the first case reports of oral mucosal inflammatory reactions of the anterior dorsal tongue associated with SLS containing toothpastes.

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BACKGROUND: The authors report a case of a 42-year-old woman with End Stage Renal Disease (ESRD) undergoing dialysis therapy with the relative loss of tooth root lamina dura and several mandibular radiolucencies. Secondary hyperparathyroidism related to End Stage Renal Disease may result in the loss of bone density and radiolucent lesions, which has been previously described as Brown tumor. Findings significant for hyperparathyroidism may befound on routine dental imaging. RESULTS: The patient was evaluated, and treatment was initiated for her dental conditions. She is at present still on the kidney transplant waiting list. CONCLUSION: Patients with End Stage Renal Disease and hyperparathyroidism require communication and cooperation between dentists and physicians. PRACTICAL IMPLICATIONS: It is important for dentists to consider Brown tumor as a possible diagnosis of radiolucent jaw lesions.

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An expected accident can happen at any time during a routine practice in the dental office due to the types of instruments used. One of the instruments used in routine dental practice is a high speed drill and a bur. If Personal Protective Equipment (PPE) is not practiced at any time in the dental office, very serious injuries could easily happen to the clinician, staff or to the patient.

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This Point/Counterpoint considers whether a general dentistry postgraduate year one (PGY-1) residency should be required for all new graduates who do not pursue specialty training. Currently, New York and Delaware require PGY-1 for dental licensure, while other states offer it as an alternative to a clinical examination for obtaining licensure. Viewpoint 1 supports the position that PGY-1 should be mandatory by presenting evidence that PGY-1 residencies fulfill new graduates' need for additional clinical training, enhance their professionalism and practice management skills, and improve access to care. The authors also discuss two barriers-the limited number of postdoctoral positions and the high cost-and suggest ways to overcome them. In contrast, Viewpoint 2 opposes mandatory PGY-1 training. While these authors consider the same core concepts as Viewpoint 1 (education and access to care), they present alternative methods for addressing perceived educational shortcomings in predoctoral curricula. They also examine the competing needs of underserved populations and residents and the resulting impact on access to care, and they discuss the potential conflict of interest associated with asking PGY-1 program directors to assess their residents' competence for licensure.

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The oral cavity is a part of the body. The health of the oral cavity affects the health of the entire body. This relationship is reciprocal, as the overall health of an individual will also affect the health of that individual's oral cavity. Periodontal disease is a common, chronic inflammatory disease affecting the supporting structures of the teeth. It has been proposed that periodontal disease is a risk factor for systemic diseases such as diabetes.

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In most cases, FCOD is diagnosed by reviewing clinical and radiographic information and data. Multiple quadrants and a mixture of sclerotic radiopaque lesions with radiolucent borders facilitate radiographic interpretation. FCOD is a self-limiting condition that requires no further treatment once a diagnosis has been made. Prognosis is excellent. Follow-up is needed to assess for progression and any possible complications. This should include periodic radiographic evaluation. If endodontic therapy is required, it should not be initiated until a thorough clinical and radiographic evaluation has been completed.

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The panoramic radiographs of six Papillon-Lefèvre affected siblings from one family are evaluated and compared. These six affected siblings range in age from seven to twenty-four years of age. Tooth loss and periodontal disease progression are radiographically documented as these affected siblings age and eventually become endentulous with evident ridge resorption.

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