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Medical problems in dentistry, 3rd edition
UTTERWORTH EINEMANN
Journal
@‘Dentistry Vol. 23. No. 1. p, 36. 1995 Copyright 0 1995 Elsevier Science Ltd Printed in Great Britain. All rights reserved 0300-5712/95 $10.00 + 0.00
Book Reviews Medical Problems in Dentistry, 3rd edition. C. Scully and R. A. Cawson. Pp. 601. 1993. Oxford, Butterworth-Heinemann. Hardback, f30.00. This is the third edition of this book to appear within the short space of 1 1 years which simply highlights the success of this text in providing a valuable source of reference for all dental practitioners when faced with medically compromised patients. Indeed it must now be regarded as the standard text on this subject. The book discusses a wide variety of systemic diseases, both common and uncommon, which may be seen in dental practice, in its widest sense. Appropriate emphasis is given to commoner conditions. Useful chapters are included on anaesthesia and management of emergencies within the dental surgery. The chapter on medical aspects of maxillofacial trauma will be of value to junior staff working in oral surgery units within district general hospitals. Each chapter is clearly written and an adequate list of references directs the reader to appropriate further reading, if so desired; however, since many of the common medical problems are discussed in such a comprehensive fashion, this is often unnecessary. The text is liberally supplemented with tables which highlight fundamental details. Once again the authors acknowledge the impact of HIV infection on dentistry but also highlight other blood-borne viral infections of relevance to dental practice, notably hepatitis C virus. As the authors point out, the ‘public has become increasingly concerned about medical problems in dentistry’ and this is likely to be a continuing issue. With the increasing age of the population and the continued rapid expansion of medical knowledge, this book undoubtedly has wide appeal to all branches of the dental profession at both undergraduate and postgraduate levels. Likewise, this text and future editions are guaranteed to remain a popular and wise investment. The authors are to be congratulated on producing a comprehensive and highly readable reference text which will surely enhance management of the medically compromised patient. D. H. Felix
Oral Pathology-Colour Guide. R. A. Cawson and J. W. Odell. Pp. 152. 1993. Edinburgh, Churchill Livingstone. Softback, f 1 1 .50. Pathology is said to be the study of disease. I try to instill into my students that the art of histopathology is to interpret the two-dimensional image of a microscope section in terms of four dimensions-the third of depth
and the fourth of time. For example, in Figure 176, labelled ‘Erythroplasia’, there is an island of epithelial cells apparently separated from the overlying surface epithelium which might easily be interpreted as malignant invasion; the true interpretation is that in the depth of the specimen from which the picture is taken, the apparently separated island is in fact joined to the surface. As far as the fourth dimension is concerned it is most important to realize that diseases are processes occurring in time, for the point of diagnostic pathology is to reach a diagnosis (decide what has been happening) and to give a prognosis (predict what will happen). Of course, there are still some histopathologists who believe that their task is one of pattern recognition-and in practice it does indeed sometimes work like that-but the great majority of those at whom this volume is aimed are not training to become histopathologists and it is understanding of the disease processes that is paramount for them. In short, this book does not to my mind teach oral pathology but how to pass examinations in oral pathology. In fairness, Cawson and Odell infer in their Preface that this is exactly their aim, and to that extent it exceeds in some degree. They infer too that illustrations in colour (262 of them), especially such a large number at such moderate cost, are one of the major advantages of their book, but unfortunately some of the pictures are worthless. For example Figures 31, 32, 97 and 1 18 add nothing because nothing can be discerned. Some of the pictures are much better, but the uninitiated student is not in a position to know which pictures are worth looking at and which should be ignored. The general organization of the book is good, though I would have arranged the sections on keratoses, dysplasia and squamous cell carcinoma somewhat differently. It is now generally recognized that the diagnosis of keratosis should be qualified with an estimate of the degree of associated dysplasia, rather than as ‘frictional keratosis’ or ‘smoker’s keratosis’. I also think that infrabony is better than intrabony pocket (p. 19), that Figure 64 does not show loss of typical structure, that dentine papilla should be dental papilla (p. 47), that many oral surgeons successfully treat solitary eosinophilic granuloma much less radically than with wide excision and chemotherapy (p. 59), that cherubism is no longer regarded as a form of fibrous dysplasia (p. 63), that PAS is a better stain for candidal hyphae than Gram even in smears (p. 89), and that giant cell granuloma is not only found at the sites of shedding deciduous teeth (p. 103). For examination revision this volume does have something to recommend it, but I would hate to think that my students studied oral pathology in this way. J. W. Rippin
Journal
@‘Dentistry Vol. 23. No. 1. p, 36. 1995 Copyright 0 1995 Elsevier Science Ltd Printed in Great Britain. All rights reserved 0300-5712/95 $10.00 + 0.00
Book Reviews Medical Problems in Dentistry, 3rd edition. C. Scully and R. A. Cawson. Pp. 601. 1993. Oxford, Butterworth-Heinemann. Hardback, f30.00. This is the third edition of this book to appear within the short space of 1 1 years which simply highlights the success of this text in providing a valuable source of reference for all dental practitioners when faced with medically compromised patients. Indeed it must now be regarded as the standard text on this subject. The book discusses a wide variety of systemic diseases, both common and uncommon, which may be seen in dental practice, in its widest sense. Appropriate emphasis is given to commoner conditions. Useful chapters are included on anaesthesia and management of emergencies within the dental surgery. The chapter on medical aspects of maxillofacial trauma will be of value to junior staff working in oral surgery units within district general hospitals. Each chapter is clearly written and an adequate list of references directs the reader to appropriate further reading, if so desired; however, since many of the common medical problems are discussed in such a comprehensive fashion, this is often unnecessary. The text is liberally supplemented with tables which highlight fundamental details. Once again the authors acknowledge the impact of HIV infection on dentistry but also highlight other blood-borne viral infections of relevance to dental practice, notably hepatitis C virus. As the authors point out, the ‘public has become increasingly concerned about medical problems in dentistry’ and this is likely to be a continuing issue. With the increasing age of the population and the continued rapid expansion of medical knowledge, this book undoubtedly has wide appeal to all branches of the dental profession at both undergraduate and postgraduate levels. Likewise, this text and future editions are guaranteed to remain a popular and wise investment. The authors are to be congratulated on producing a comprehensive and highly readable reference text which will surely enhance management of the medically compromised patient. D. H. Felix
Oral Pathology-Colour Guide. R. A. Cawson and J. W. Odell. Pp. 152. 1993. Edinburgh, Churchill Livingstone. Softback, f 1 1 .50. Pathology is said to be the study of disease. I try to instill into my students that the art of histopathology is to interpret the two-dimensional image of a microscope section in terms of four dimensions-the third of depth
and the fourth of time. For example, in Figure 176, labelled ‘Erythroplasia’, there is an island of epithelial cells apparently separated from the overlying surface epithelium which might easily be interpreted as malignant invasion; the true interpretation is that in the depth of the specimen from which the picture is taken, the apparently separated island is in fact joined to the surface. As far as the fourth dimension is concerned it is most important to realize that diseases are processes occurring in time, for the point of diagnostic pathology is to reach a diagnosis (decide what has been happening) and to give a prognosis (predict what will happen). Of course, there are still some histopathologists who believe that their task is one of pattern recognition-and in practice it does indeed sometimes work like that-but the great majority of those at whom this volume is aimed are not training to become histopathologists and it is understanding of the disease processes that is paramount for them. In short, this book does not to my mind teach oral pathology but how to pass examinations in oral pathology. In fairness, Cawson and Odell infer in their Preface that this is exactly their aim, and to that extent it exceeds in some degree. They infer too that illustrations in colour (262 of them), especially such a large number at such moderate cost, are one of the major advantages of their book, but unfortunately some of the pictures are worthless. For example Figures 31, 32, 97 and 1 18 add nothing because nothing can be discerned. Some of the pictures are much better, but the uninitiated student is not in a position to know which pictures are worth looking at and which should be ignored. The general organization of the book is good, though I would have arranged the sections on keratoses, dysplasia and squamous cell carcinoma somewhat differently. It is now generally recognized that the diagnosis of keratosis should be qualified with an estimate of the degree of associated dysplasia, rather than as ‘frictional keratosis’ or ‘smoker’s keratosis’. I also think that infrabony is better than intrabony pocket (p. 19), that Figure 64 does not show loss of typical structure, that dentine papilla should be dental papilla (p. 47), that many oral surgeons successfully treat solitary eosinophilic granuloma much less radically than with wide excision and chemotherapy (p. 59), that cherubism is no longer regarded as a form of fibrous dysplasia (p. 63), that PAS is a better stain for candidal hyphae than Gram even in smears (p. 89), and that giant cell granuloma is not only found at the sites of shedding deciduous teeth (p. 103). For examination revision this volume does have something to recommend it, but I would hate to think that my students studied oral pathology in this way. J. W. Rippin