General medicine and surgery for dental practitioners Part 8: Musculoskeletal system

Orthodontics in patients with significant medical co-morbidities

“…It is essential to assess the TMJ when examining the patient and to repeat reviews at regular intervals throughout treatment (Müller et al, 2009). Modified toothbrush handles and electric toothbrushes can be recommended to patients with rheumatology in the case of significant destructive joint pathology (Greenwood and Meechan, 2003; Treister and Glick, 1999); however, current approaches appear successful in significantly limiting the degree of erosive arthropathy in children with JIA. A bite splint can be provided to unload the joint during any acute periods of inflammation, but the use of functional appliances in these patients is a controversial area.…”

Allgemeinmedizinische Erkrankungen und Kieferorthopädie

“…Es wird empfohlen, die ausgeübten kieferorthopädischen Kräfte zu verringern und in kürzeren Abständen nachzujustieren [85]. [95]. " Während der akuten Entzündungsphasen können die Kiefergelenke mithilfe einer Aufbissschiene entlastet werden.…”

Access to special care dentistry, part 7. Special care dentistry services: seamless care for people in their middle years – part 1

“…Rheumatoid arthritis (RA) is a chronic, progressive, multi-system disorder which is thought to be auto-immune in nature. 17 Some people are genetically susceptible to rheumatoid arthritis and in these cases stress, infection or trauma may trigger its development. 18 RA is characterised by periods of fl ares and remissions.…”

“…RA can occur at any age but commonly affects women between the ages of 20 and 50, with a mean age of onset between 30 and 40. 17 There is currently no cure and the treatment goal is to reduce joint inflammation and pain, maximise joint function and prevent joint destruction and deformity. 18 Optimally, treatment involves patient education, rest and exer cise, joint protection, medications and occasionally surgery.…”