Trismus as a first presenting complaint in a case of myasthenia gravis.

The initial presentation of myasthenia gravis as trismus is very rare and no previous reports have been found in the literature. A 35-year-old male presented to the outpatient unit of our department with inability to clench well and to open his mouth. Physical examination revealed that he had clinical findings consistent with the signs and symptoms of myasthenia gravis. He was immediately referred to a neurologist, who confirmed that he was in an advanced stage of myasthenia gravis with severe deficit to his respiratory muscles and he was promptly treated. He is presently on a maintenance drug therapy. To our knowledge, this is the first reported case of myasthenia gravis whose initial presentation was trismus. This case presents a rare but important diagnosis that should be added to the differential diagnosis of trismus.

Primary oral tuberculosis: report of two cases.

Oral lesions of tuberculosis though uncommon, are seen in both the primary and secondary stages of the disease. In secondary tuberculosis, the oral manifestations may be accompanied by lesions in the lungs, lymph nodes, or in any other part of the body and can be detected by a systemic examination. Primary oral tuberculosis may present as a diagnostic challenge for the clinician. Here we report two patients with primary tuberculosis in the oral cavity who presented to the dental department, were diagnosed and referred for medical management.

Guidelines for management of impacted canines.

Though the management of impacted canine is considered a multi-disciplinary entity requiring the expertise of a number of specialists, the general practitioner needs to coordinate care and must know about the diagnosis and management of canine impaction. The management of canine impactions can be simplified by following a logical and systematic approach. The schematic treatment plan for impacted canines and the factors influencing and determining the plan are discussed in this article.