Treatment of Oral Diseases
A Concise Textbook
George Laskaris, M.D., D.D.S., Ph.D.
Head of Oral Medicine, Department of
Dermatology, A. Sygros Hospital
Associate Professor of Oral Medicine
Medical School, University of Athens
Athens, Greece
Visiting Professor
University of London, UK
Thieme
Stuttgart • New York
Library of Congress Cataloging-in-Publication Data
Laskaris. George.
Treatment of oral diseases : a concise textbook / Georg
Laskaris : with contributions by P. Angelakis … |et al.]. p. ; cm.
Companion v. to: Color atlas of oral diseases / George Laskaris. 3rd ed.. rev. and expanded. c2003.
Includes bibliographical references.
ISBN 3-13-130111-2 (GTV : alk. paper) -
ISBN 1-58890-176-9 (TNY : alk. paper)
1. Mouth-Diseases.
[DNLM: 1. Mouth Diseases-diagnosis. 2. Mouth Diseases-drug therapy. 3. Mouth Diseases-therapy. WU 166 L344t 2005] I. Angelakis. Philip. II. Laskaris. George. Enchromos atlas stomatologias. English. III. Title.
RC815.L3733 2005
616.3′106-dc22
2004018493
© 2005 Georg Thieme Verlag,
Riidigerstrasse 14, 70469 Stuttgart, Germany
Thieme New York, 333 Seventh Avenue.
New York, NY 10001 USA
Cover design: Martina Berge, Erbach
Typesetting by Satzpunkt Ewert GmbH, Bayreuth
Printed in Germany by Druckhaus Gotz, Ludwigsburg
ISBN 3-13-130111-2 (GTV)
ISBN 1-58890-176-9 (TNY) 1 2 3 4 5
Important note: Medicine is an ever-changing science undergoing continual development. Research and clinical experience are continually expanding our knowledge, in particular our knowledge of proper treatment and drug therapy. Insofar as this book mentions any dosage or application, readers may rest assured that the authors, editors, and publishers have made every effort to ensure that such references are in accordance with the state of knowledge at the time of production of the book.
Nevertheless, this does not involve, imply, or express any guarantee or responsibility on the part of the publishers in respect to any dosage instructions and forms of applications stated in the book. Every user is requested to examine carefully the manufacturers’ leaflets accompanying each drug and to check, if necessary in consultation with a physician or specialist, whether the dosage schedules mentioned therein or the contraindications stated by the manufacturers differ from the statements made in the present book. Such examination is particularly important with drugs that are either rarely used or have been newly released on the market. Every dosage schedule or every form of application used is entirely at the user’s own risk and responsibility. The authors and publishers request every user to report to the publishers any discrepancies or inaccuracies noticed.
Some of the product names, patents, and registered designs referred to in this book are in fact registered trademarks or proprietary names even though specific reference to this fact is not always made in the text. Therefore, the appearance of a name without designation as proprietary is not to be construed as a representation by the publisher that it is in the public domain.
This book, including all parts thereof, is legally protected by copyright. Any use, exploitation, or commercialization out-side the narrow limits set by copyright legislation, without the publisher’s consent, is illegal and liable to prosecution. This applies in particular to photostat reproduction, copying, mimeographing, preparation of microfilms, and electronic data processing and storage.
Dedication
This book is dedicated to the brightest star. my son Christos G. Laskaris, whose memory leads my mind and life
Preface
Oral medicine is an important discipline and the diagnostic and therapeutic challenges faced by the stomatologist range from trivial, isolated, innocuous oral lesions to the oral manifestations of life-threatening systemic diseases. It requires a thorough understanding of and a firm knowledge base in dentistry, oral pathology, otorhinolaryn-gology, dermatology, and internal medicine.
The diagnostic part of the practice of oral medicine is addressed in many excellent texts including the Color Arias of Oral Diseases by the author of this volume.
This book aims to provide a concise, practical, and reliable guide to the management of oral diseases. The field of therapeutics of oral diseases is progressing rapidly and every effort has been made to include evidence-based multimodality therapeutic regimens-drugs, surgery, and other therapeutic means-where appropriate. However, I ask the reader to keep in mind that this book is not meant to be a substitute for a thorough knowledge base or the comprehensive literature on each and every therapeutic component used in clinical practice. Nor is it aiming to present details of surgical techniques.
The emphasis is on formulating and implementing a sound therapeutic plan, following an initial clinical evaluation, a comprehensive differential diagnosis, and an accurate final diagnosis. Three universal principles of therapeutics are high-lighted. The first principle of management of oral disease is comprehensive and addresses the patient as a whole, not just a particular lesion. The time devoted to establishing a healthy and trusting relationship with the patient and his patient’s family, alleviating anxiety, fear and other concerns, explaining the pros and cons of various therapeutic strategies in simple terms, is time well spent for both the patient and the physician. Secondly, in complex problems, cooperation and consultation among the various subspecialties involved in the care of a patient, with clearly defined roles and goals for all involved, are mandatory. Lastly, since the time of Hippocrates, therapeutic excess leading to harm is to be avoided–in modern terms, the choice of a particular therapeutic approach should be based on the available scientific evidence.
The book is divided into three parts: Part 1 presents the definition and a brief summary of each disease–etiology, main clinical features, diagnosis and differential diagnosis, and a detailed multimodality treatment plan. For practical purposes. disease entities appear in alphabetical order in the contents. Part II provides information regarding the main categories of drugs and the commonly used individual drugs within these categories, which have proved useful in the treatment of a particular disease. Part III provides a synopsis of the basic principles and oral applications of lasers, which are making significant inroads in the field of oral therapeutics.
It is my hope that stomatologists, oral surgeons, dentists, dermatologists, otorhinolaryngologists, pediatricians, and internists alike will find the information in the book useful for the treatment of oral diseases.
Sincere thanks are due to the contributors of this volume for sharing their experience and knowledge of the treatment of specific oral diseases. I would also like to express my gratitude and thanks to Dr Stathis S Papavasiliou, Associate