Medical emergencies in the dental school setting.

PURPOSE/OBJECTIVES: An aging population with an increasing chronic disease burden may make management of medical emergencies in dental practice more common. Previous research has differed significantly in the reported frequency of medical emergencies in a dental setting, often relying on survey-based protocols. This study examines the incidence and type of emergencies encountered in a dental school setting. Additional examination of contributing medical co-morbidities is provided. METHODS: A retrospective study was designed to review 121 incident reports at the Ohio State University College of Dentistry (OSU CoD) from July 1, 2013 to January 24, 2019. Sixty-five of the recorded events were classified as medical emergencies and were further analyzed. RESULTS: The most common emergency encountered was syncope, followed by cardiac events, seizures, and diabetic complications. Emergencies most commonly occurred in the pre-doctoral general dentistry clinics. Many of the affected patients had no significant medical history. CONCLUSION: Identifying emergencies most encountered by dentists is critical for process improvement, awareness, and targeted educational initiatives. This may reduce the frequency of medical emergencies in dental practices and allow for more efficient management should they occur.

Oral Findings of Erdheim-Chester Disease: A Case Report and Review of the Literature.

Erdheim-Chester Disease (ECD) is a rare non-Langerhans cell histiocytosis characterized by histiocytic infiltration of multiple organ systems, including the bony skeleton, central nervous system, cardiovascular system, lungs, and kidneys. Manifestations of the disease are highly variable, ranging from focal disease to multisystem involvement. Oral manifestations are exceedingly rare, with only 10 known reports of ECD involving the jaws. The objective of this case report is to highlight the radiographic, clinical, and histological features of ECD involving the maxillofacial complex. A 35-year-old male admitted for sepsis secondary to pyelonephritis and suspected diabetes insipidus received an extensive workup for ECD versus IgG4 disease versus lymphoma. The oral-maxillofacial surgery service was consulted for biopsy of maxillary lesions noted to have increased activity on positron emission tomography. Intraoral biopsy yielded the characteristic histopathological features of ECD, confirming the diagnosis. We compare the clinical, radiographic, and microscopic features of ECD with past findings, contributing to the profile of this rare disease.