Dentistry's Role in Assessing and Managing Controlled Substance Risk: Historical Overview, Current Barriers, and Working Toward Best Practices.

Dentistry is in a unique position among the health care professions to assess and manage the patient with controlled substance risk. The concern over opioid risk is not new, and historically dentists have had to balance the critical need for adequate pain care with the importance of recognizing the consequences of using controlled substances for their patients. Barriers for providing adequate patient assessment and management may be greater in dentistry than other health care fields, although these barriers can be recognized and overcome. Collaboration with cotreating providers will improve patient outcomes and reduce patient risk.

Development, implementation, and evaluation of a novel multidisciplinary one health course for university undergraduates.

Today's collaborations across fields of health and wellness are insufficient to meet societies' challenges in combating disease and maintaining the ecosystem and public health. In this article, we present a One Health curriculum model designed to encourage undergraduate students of varying disciplines to value the connectedness of animals, humans, and the environment and to think innovatively about solutions to priority global health issues. We present the design and implementation of a course that brought together multiple faculty from different fields of study, including the dental, medical, nutrition, and veterinary schools, in a curriculum designed for undergraduates primarily from Arts & Sciences fields. The curriculum was collaboratively designed around four key One Health categories: 1) Infectious zoonotic diseases and global health, 2) Naturally occurring shared disease in companion animals that can serve as models for human disease, 3) Human-animal interactions, and 4) Impact of environmental health on human and animal health. We show this course successfully deepened students' understandings of One Health, its role in addressing high priority health issues and the overall benefits of a One Health approach to tackling societal problems. We also report a positive experience by the faculty working in collaboration to implement the curriculum model and the overall enthusiasm of students for the course, all of whom would recommend it to their peers. We conclude by proposing the potential of the curriculum model underlying this course to fill the need for One Health Curricula in programs preparing future health professionals.

Primary Headaches.

The primary headaches are composed of multiple entities that cause episodic and chronic head pain in the absence of an underlying pathologic process, disease, or traumatic injury. The most common of these are migraine, tension-type headache, and the trigeminal autonomic cephalalgias. This article reviews the clinical presentation, pathophysiology, and treatment of each to help in differential diagnosis. These headache types share many common signs and symptoms, thus a clear understanding of each helps prevent a delay in diagnosis and inappropriate or ineffective treatment. Many of these patients seek dental care because orofacial pain is a common presenting symptom.

A Model for Opioid Risk Stratification: Assessing the Psychosocial Components of Orofacial Pain.

This article describes a model of opiate risk stratification with a special focus on dentistry and oral surgery. A brief overview covers the scope of the US opioid abuse and misuse epidemic, and the role of the dentist in mitigating the problems of diversion and misuse of controlled substances. The expanding role of dentistry is summarized. An assessment outlines gathering critical risk information, screening questionnaires, access to state prescription monitoring programs, and communication with cotreating providers. Special populations are discussed. Barriers and possible solutions for effective implementation of these strategies are summarized.

Orofacial pain after invasive dental procedures: neuropathic pain in perspective.

BACKGROUND: The neurologist is very familiar with the painful neuropathies of the trunk and extremities but, generally, to a lesser extent with those of the head and face. Of the latter, the neurologist is particularly familiar with ophthalmic zoster and trigeminal neuralgia. REVIEW SUMMARY: This review deals with neuropathic orofacial pain: (1) to highlight its presentation; and (2) to contrast it with that of neuropathic pain elsewhere in the body, including the head, from which it seems to differ significantly. The reason for the difference is also discussed as well as its implications for the diagnosis of orofacial pain as neuropathic. In the cases of neuropathic orofacial pain presented, the pain followed invasive dental procedures, making it relatively homogenous in terms of its etiology. The cases are contrasted with those of cranial nonorofacial and of noncranial painful neuropathy. CONCLUSIONS: It is suggested that the presence of abnormal sensory responses to touch, in the sense of paresthesia, dysesthesia, or allodynia, is a prerequisite for the diagnosis of neuropathic pain, when other, motor or sensory, signs of nerve injury ordinarily guiding the diagnosis are lacking, as is often the case in the face.

Orofacial pain following an invasive dental procedure.

Like headache, the etiology of orofacial pain is often an enigma. Orofacial pain resulting from invasive dental procedure may cause a patient to present to a neurologist for diagnosis and treatment. The cases presented here were personally seen by the first author, a consulting neurologist; they illustrate the diversity in clinical presentation and the differences between a musculoskeletal and neuropathic origin of pain. Treatment is touched upon, but is neither exhaustive nor evidence based.