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Dental manifestations of systemic disease
Anaesthesia and Analgesia in Dentistry. By RONALD A. GREEN and MICHAEL P. COPLANS. London: H. K. Lewis. Pp. Sgo. .rg73. Price E7.00 The Authors, who are Consulting Anaesthetists at London teaching hospitals, have been ambitious in their declared intent to cater for a wide spectrum of readership from dental undergraduate to consultant anaesthetist. The result has been inevitably a large volume which does not deal in any depth with either anaesthesia or dentistry but covers superficially most related parts of the two specialties. The first ten chapters deal with various aspects of dental anaesthesia from preoperative considerations, equipment, hazards and posture to inhalational and intravenous techniques. Other problems are highlighted in separate sections on general anaesthesia in children, conservative dentistry and the difficult case. The chapter on local anaesthesia in dental surgery by Mr Kenneth Ray is to be particularly recommended as is that on anaesthesia for maxillo-facial surgery by Dr Phillip Moore. The style is very readable and in places reminiscent of ‘anaesthetic chats’ behind the dental chair. There is a tendency to repetition and a frequent annoying referral to other pages where the promised ‘full discussion of. . .” is often disappointing. The techniques advocated are acceptable current practice and a tyro dental anaesthetist who follows the advice given should have few problems. However there are several points one would seriously question. The safety of the bent needle suggested for venepuncture (fig. 95) and the use of the medial aspect of the antecubital fossa for this procedure (fig. 96); the text does indicate the dangers of the latter. The authors do not favour particularly the recumbent position even for intravenous induction in the dental chair and it is surprising these days to see recovery in the sitting position not only described but illustrated (figs 71 and 117). This is an expensively produced, attractive and clearly illustrated book. There is an adequate index and a very limited bibliography. The book has little appeal to the professional anaesthetist, perhaps more to the dental student and the medical practitioner cum dental anaesthetist; they also may find it too long and costly. J. EDMONDS-SEAL
Dental Manifestations of Systemic Disease. By DAVID H. TRAPNELL and JOHN London: Butterworth. BOWERMAN. (Radiology in Clinical Diagnosis Series.) Pp. 175. Price E4.95. This book forms part of the ‘Radiology in Clinical Diagnosis Series’ and Dr Trapnell, the editor, in his general preface, states that ‘The purpose of the series is to give clinicians an up-to-date and comprehensive survey of the role of diagnostic radiology in different spheres of clinical practice and, to provide radiologists in training, with a handbook from which they can quickly learn, and to which they can readily refer’. The authors, a Consultant Radiologist and a Consultant Oral Surgeon, introduce the first chapter with the statement that-‘It seems to be the habit of some radiologists to show little interest in radiographs of the teeth. They are, or pretend to be, ignorant concerning “dental” radiology which they leave to dental surgeons. The latter, however, while expert in the changes occurring in the mouth, are not usually so familiar with the radiology of other parts of the body as their radiologist colleagues.’ One of the stated purposes of this book is to build a bridge between these two disciplines. 106
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Following an introductory chapter dealing briefly with anatomy, terminology, and radiography are seven chapters under the following general titles-Skeletal Disorders Present at Birth; Skeletal Disorders Appearing after Birth; Connective Tissue and Allied Disorders and Chromosomal Abnormalities; Diseases of the Endocrine System; Malignant Neoplastic Disease; Haemoglobinopathies and Infection; and Disorders of Diet and Metabolism. There are 109 illustrations in 168 pages of text, the vast majority of which are printed well and only two fail to show the intended detail: Fig. 3.26, p. 75 and Fig. 6.12, p. 137. There, is however, some inconsistency in the orientation of occlusal films which purists will find annoying and Fig. 4.3 on p. 85 is inverted. Each disease is introduced by a general description of its aetiology and clinical features followed by general skeletal radiographic abnormalities and concluding with the dental radiographic manifestations. The authors wished the book to be comprehensive without being exhaustive, but one wonders if exhaustion set in when a condition such as fibrogenesis imperfecta, for which It is possible there is yet no published description of teeth and jaw changes, was included. the authors hoped that the introduction of such a rare condition into a book directed at medical and dental clinicians and radiologists may stimulate them to look more closely at the teeth and jaws and thereby fill gaps in our knowledge. There are one or two small faults to be found. Occasionally descriptive words which have a specific clinical meaning such as opalescent and cyst, are used in a Radiological sense, and the inconsistent use of the word cystic in different forms, i.e. cystic, ‘cystic’, and pseudocystic is particularly confusing in the description of conditions such as hyperparathyroidism and neurofibromatosis. Although the authors wished to describe the teeth and jaw changes in detail they could, with benefit, have described the skull changes in more detail. In the description of the changes in Pyle’s Disease, Komins (BritishJournal of Radiology, 1954,28: 670-675) is only partly quoted and his interesting comment that the skull changes are similar to those of fibrous dysplasia is omitted, Despite these minor criticisms, the authors have managed to produce a book which collates information normally scattered through many journals and text books and includes some original observations of their own. They have succeeded in their stated intention of bridging the gap between the radiologist and the dental surgeon-both will find much of interest here. This neat paperback deserves a place on all dental hospital and radiology department shelves. Every oral surgery department should have one and, dare I suggest, even though Christmas has come and gone, that it might represent a useful present from a Consultant Dental Surgeon to a Consultant Radiologist! B. C. O’RIORDAN
Dentistry and the Allergic Patient. Edited by C. A. FRAZIER. Illinois: Thomas. L7.85 (818.75).
Price
The objective of this book is commendable, for as it is emphasised in the foreword approximately 15 per cent of the population is allergic to some substance and may therefore be placed at risk when receiving dental treatment. In addition to dealing at length with the hazards to which such a patient may be subjected, there is also a discussion of those diseases, occurring in the mouth, which may have an allergic basis. Thus the first part of the book is devoted to the detection of an allergic patient by means of a history and clinical examination and to the management of any allergic crises which may ensue. This section is subject to some repetition, for example, the treatment of anaphylactic collapse is described in detail on three occasions. There is an extensive review of allergic reactions to local anaesthetics and of contact
Dental Manifestations of Systemic Disease. By DAVID H. TRAPNELL and JOHN London: Butterworth. BOWERMAN. (Radiology in Clinical Diagnosis Series.) Pp. 175. Price E4.95. This book forms part of the ‘Radiology in Clinical Diagnosis Series’ and Dr Trapnell, the editor, in his general preface, states that ‘The purpose of the series is to give clinicians an up-to-date and comprehensive survey of the role of diagnostic radiology in different spheres of clinical practice and, to provide radiologists in training, with a handbook from which they can quickly learn, and to which they can readily refer’. The authors, a Consultant Radiologist and a Consultant Oral Surgeon, introduce the first chapter with the statement that-‘It seems to be the habit of some radiologists to show little interest in radiographs of the teeth. They are, or pretend to be, ignorant concerning “dental” radiology which they leave to dental surgeons. The latter, however, while expert in the changes occurring in the mouth, are not usually so familiar with the radiology of other parts of the body as their radiologist colleagues.’ One of the stated purposes of this book is to build a bridge between these two disciplines. 106
BOOK
REVIEWS
107
Following an introductory chapter dealing briefly with anatomy, terminology, and radiography are seven chapters under the following general titles-Skeletal Disorders Present at Birth; Skeletal Disorders Appearing after Birth; Connective Tissue and Allied Disorders and Chromosomal Abnormalities; Diseases of the Endocrine System; Malignant Neoplastic Disease; Haemoglobinopathies and Infection; and Disorders of Diet and Metabolism. There are 109 illustrations in 168 pages of text, the vast majority of which are printed well and only two fail to show the intended detail: Fig. 3.26, p. 75 and Fig. 6.12, p. 137. There, is however, some inconsistency in the orientation of occlusal films which purists will find annoying and Fig. 4.3 on p. 85 is inverted. Each disease is introduced by a general description of its aetiology and clinical features followed by general skeletal radiographic abnormalities and concluding with the dental radiographic manifestations. The authors wished the book to be comprehensive without being exhaustive, but one wonders if exhaustion set in when a condition such as fibrogenesis imperfecta, for which It is possible there is yet no published description of teeth and jaw changes, was included. the authors hoped that the introduction of such a rare condition into a book directed at medical and dental clinicians and radiologists may stimulate them to look more closely at the teeth and jaws and thereby fill gaps in our knowledge. There are one or two small faults to be found. Occasionally descriptive words which have a specific clinical meaning such as opalescent and cyst, are used in a Radiological sense, and the inconsistent use of the word cystic in different forms, i.e. cystic, ‘cystic’, and pseudocystic is particularly confusing in the description of conditions such as hyperparathyroidism and neurofibromatosis. Although the authors wished to describe the teeth and jaw changes in detail they could, with benefit, have described the skull changes in more detail. In the description of the changes in Pyle’s Disease, Komins (BritishJournal of Radiology, 1954,28: 670-675) is only partly quoted and his interesting comment that the skull changes are similar to those of fibrous dysplasia is omitted, Despite these minor criticisms, the authors have managed to produce a book which collates information normally scattered through many journals and text books and includes some original observations of their own. They have succeeded in their stated intention of bridging the gap between the radiologist and the dental surgeon-both will find much of interest here. This neat paperback deserves a place on all dental hospital and radiology department shelves. Every oral surgery department should have one and, dare I suggest, even though Christmas has come and gone, that it might represent a useful present from a Consultant Dental Surgeon to a Consultant Radiologist! B. C. O’RIORDAN
Dentistry and the Allergic Patient. Edited by C. A. FRAZIER. Illinois: Thomas. L7.85 (818.75).
Price
The objective of this book is commendable, for as it is emphasised in the foreword approximately 15 per cent of the population is allergic to some substance and may therefore be placed at risk when receiving dental treatment. In addition to dealing at length with the hazards to which such a patient may be subjected, there is also a discussion of those diseases, occurring in the mouth, which may have an allergic basis. Thus the first part of the book is devoted to the detection of an allergic patient by means of a history and clinical examination and to the management of any allergic crises which may ensue. This section is subject to some repetition, for example, the treatment of anaphylactic collapse is described in detail on three occasions. There is an extensive review of allergic reactions to local anaesthetics and of contact