Dentists are obligated to document and report suspected cases of abuse in all states, and dental hygienists are similarly obligated in some, but not all, states. The obligation is not to prove abuse or neglect, just to report what is suspected. Each state has different regulations on mandatory reporting for healthcare and other professionals, as well as specific reporting requirements for private citizens. It is essential that dental professionals know the potential signs and symptoms of the various types of abuse, are able to identify these, and understand the mandatory requirements for reporting in the state(s) in which they live and practice. It is by identifying, documenting and reporting abuse that victims can be protected and perpetrators prevented from continuing abusive practices and patterns.

The local anesthetic drugs presently available and used in dentistry represent the safest and most effective drugs in all of medicine for the prevention and management of pain. The dental profession purchased in excess of 300 million local anesthetic cartridges in the United States in 2006, making local anesthetics the most-used drugs in the dental profession. One drawback associated with intraoral local anesthesia is patients’ fear of injections and the perception that these are painful. Recent advances have resulted in the use of computer-controlled local anesthetic delivery vehicles to regulate the delivery and rate of flow of local anesthetics at the injection site, lessening potential discomfort associated with injections. New injection techniques that provide reliable anesthesia have also been introduced, and depending on the technique used and area of anesthesia necessary, they do not result in undesired extraoral soft tissue anesthesia. These new injection techniques have been aided by the use of computercontrolled local anesthetic delivery systems.

Modern general anesthesia and conscious sedation procedures are predictable, effective, and safe with appropriate patient selection, drugs and techniques. The use of conscious sedation in dentistry in office-based settings continues to increase. Nitrous oxide is the most commonly used inhalation anesthetic (sedative) used in dentistry, and has withstood the test of time with an excellent safety record. It reduces anxiety, pain, and memory of the treatment experienced, and is a valuable component of the armamentarium available to clinicians.

The overall goal of this article is to provide dental professionals with information on autism spectrum disorders and to ensure that they attain the comfort level and appropriate knowledge to treat and help afflicted patients.

Three out of four dental professionals experience chronic neck and shoulder pain that can affect quality of life, productivity, or career longevity. Proper movement in the neck and shoulder is essential to the delivery of dental care and in performing everyday activities. Keys to success in preventing neck and shoulder injuries and pain include maintaining a neutral head posture, maintaining a neutral shoulder posture with the patient positioned at an appropriate height, using chairs with armrests, developing muscle endurance for specific neck and shoulder muscles, using indirect vision, using loupes or procedural microscopes, as well as taking frequent breaks and stretches.

Methamphetamines were originally derived from amphetamine. Meth can be illegally and easily synthesized, and is known by many names, including speed, crystal meth and ice. In the United States, more than 10 million people report having tried meth. Its use results in immediate effects that can be pleasurable but medically dangerous. Longer-term use results in serious and devastating medical, psychological and oral conditions, and in extreme cases can result in death. Dental professionals are in a position to help with the early identification of meth abuse and to refer patients to medical professionals for counseling and treatment. Palliative and preventive oral care and treatment, as well as counseling, should be provided, along with monitoring of the patient, and definitive care should be provided when appropriate for the individual patient.

Twenty-six million people in the United States are living with chronic kidney disease (CKD). As the baby boomer generation continues to mature, medical procedures extending life improve,and with pharmacology advances, this number will increase. With an increased number of patients living with CKD seeking dental treatment, will the dental healthcare provider be prepared to provide treatment to patients living with renal disease-induced anemia, and with secondary hyperparathyroidism and its effects on bone metabolism and the cardiovascular system? Many providers are familiar with providing palliative treatment for xerostomia, but how do you recommend palliative treatment for someone who is on strict fluid and dietary restrictions, such as patients living with end stage renal disease? Diabetes and hypertension are the two greatest causes of kidney disease. Dental providers should be knowledgeable about the different stages of renal disease and different treatments associated with this condition, and be prepared to address oral complications of renal disease. The dental healthcare provider must become more familiar with the impact of periodontal disease on renal disease, specific medical challenges and become proficient in collaborating with medical healthcare providers to provide dental treatment to these patients.

Dental professionals commonly review health histories listing medications that identify patients with a diagnosis of acid reflux. Most often, a specialized physician known as a gastroenterologist treats this condition. However, there are dental manifestations, so it is important that dental professionals identify these patients and recommend appropriate dental therapies to protect the long-term health of the dentition. Furthermore, dental professionals have the opportunity to recognize this condition in untreated patients and may need to refer those patients to a physician for further evaluation.