Tag Archives: dentistry

Anbesol for babies: why worry?

23 Jun

Dapsone and topical anesthetic agents (benzocaine, the active ingredient in anbesol) are the most common causes of acquired methemoglobinemia

Acquired methemoglobinemia is a result of certain ingested drugs leading to a state of oxidized (ferric state Fe+++) of hemoglobin, which are unable to bind oxygen. The remaining hemoglobin groups have an increased oxygen affinity causing a left shift.

The overall result is a functional anemia.

There are two ways for methemoglobin to be reduced back to hemoglobin:

  1. NADH-dependent catalyzed by cytochrome b5 reductase (b5R)
  2. NADPH generated by glucose-6 phosphate dehydrogenase (G6PD), but in order for this pathway to be activated, an extrinsically administered electron acceptor is required (methylene blue and riboflavin)

Infants are more susceptible to the development of methemoglobinemia because their erythrocyte cytochrome b5 reductase activity is 50-60% of adult activity

Treatment includes administration of intravenous methylene blue, 1 to 2 mg/kg, given over five minutes

Source: uptodate.com

Submitted by K Estes.


common dental diagnoses

29 Jul


inflammation of the operculum (overlying tissues over an erupting tooth) when food gets stuck under it and inflammation gets bad.


Dental Caries

breakdown of the enamel to expose the dentin which can cause pain



two kinds – reversible and irreversible.

Occurs when the enamel and dentin are breached.

Usually heat or cold, or sweet sensitivity like with caries.

If pain is spontaneous, it usually means irreversible pulpitis with pulpal death or necrosis.

Penicillin VK or Clindamycin are treatment with dental referral for definitive root canal therapy or dental extraction.


Periapical abscess or periradicular periodontitis

The disease extends beyond the pulp to the root and apex of the tooth and surrounding tissues

may have formed a track for infection to drain (periapical abscess with sinus/fistula) or not (periapical abscess without sinus/fistula).

pain with percussion of the tooth is characteristic.


Submitted by J. Stone.


References: (Tintinalli’s Emergency Medicine Chapter 240); picture

dental anatomy: quick review

28 Jul

QUICK Anatomy:

there is the dentin, which is most of the tooth, which surrounds the pulp.

The pulp is the neurovascular supply of the tooth in the core of the tooth.

The Crown is the visible portion of the tooth consists of a thick layer of enamel overlying the dentin.

The Root extends into the alveolar bone and is covered by a thin layer called Cementum.

Beyond the cementum wrapping the tooth is the periodontal ligament, which abuts the bone.

At the apex of the tooth is a feeding neurovascular bundle that gives to the pulp.






Submitted by J. Stone.


References: (Tintinalli’s Emergency Medicine Chapter 240); picture 1, picture 2.

Help, I need a dentist!

3 Jul

4 slides. quick read. go forth.


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Submitted by F. DiFranco.