What Is Web Hosting?

 

Web hosting companies are the connection between an individual or company and World Wide Web readers. To put a webpage online, one must go through a web host.

The webpage developer will upload his or her design to the web host according to the company's guidelines and policies, and based on the type of software the webpage designer has used. That upload submits the files to the web host, and then the webpage is published for all to see on the Internet.

Many web hosts, such as popular HostMonster, offer a number of tools to help their clients not only to simplify the process of uploading files to a webpage, but even offer programs to help build webpages quickly and easily. Virtually anyone can build a webpage with these simple, yet effective, tools. Knowing html code is not important with aids such as HostMonster "Website Builder" or software like Dreamweaver.

When choosing a web host, it's important to keep your personal or corporate goals in mind. If it's your own personal website, you might not mind if the web host puts banner ads on it. However, if it's a corporate site you're preparing, do you want your web host to advertise similar businesses on your page? Many web hosts offer free web hosting services if the company is allowed to place advertising on it or charge a small fee to keep it clear of outside sponsors. If you are looking to host with a provider that does not display any ads you may want to consider reading our web hosting reviews to find the perfect fit for your needs.

Why does my website need SEO?

The majority of web traffic is driven by the major commercial search engines - Google, Bing and Yahoo!. Although social media and other types of traffic can generate visits to your website, search engines are the primary method of navigation for most Internet users. This is true whether your site provides content, services, products, information or just about anything else.

Search engines are unique in that they provided targeted traffic - people looking for what you offer. Search engines are the roadways that makes this happen. If your site cannot be found by search engines or your content cannot be put into their databases, you miss out on incredible opportunities available to websites provided via search.

Search queries, the words that users type into the search box, carry extraordinary value. Experience has shown that search engine traffic can make (or break) an organization's success. Targeted visitors to a website can provide publicity, revenue, and exposure like no other channel of marketing. Investing in SEO, whether through time or finances, can have an exceptional rate of return compared to other types of marketing and promotion.
Why can't the search engines figure out my site without SEO?

Search engines are smart, but they still need help. The major engines are always working towards improving their technology to crawl the web more deeply and return better results to users. However, there is a limit to how search engines can operate. Whereas the right SEO can net you thousands of visitors and attention, the wrong moves can hide or bury your site deep in the search results where visibility is minimal.

In addition to making content available to search engines, SEO also helps boost rankings so that content will be placed where searchers will more readily find it. The Internet is becoming increasingly competitive, and those companies who perform SEO will have a decided advantage in visitors and customers.
Can I do SEO for myself?

The world of SEO is complex, but most people can easily understand the basics. Even a small amount of knowledge can make a big difference. For the most part, SEO education is free and available on the web, including guides like this. Combine this with a little practice and you are well on your way to becoming a guru.

Depending on your time commitment, willingness to learn, and complexity of your website(s), you may decide you need an expert to handle things for you. Firms that practice SEO can vary; some have a highly specialized focus, while others take a more broad and general approach. Optimizing a web site for search engines can require looking at so many unique elements that many practitioners of SEO (SEOs) consider themselves to be in the broad field of optimization and website strategy.

Still, even in this case, it's good to have a firm grasp of the core concepts.
How much of this article do I need to read?

If you are serious about improving search traffic and are unfamiliar with SEO, we recommend reading this guide front-to-back. It's short and easy to understand. There's a printable PDF version for those who'd prefer, and dozens of linked-to resources on other sites and pages that are worthy of your attention. Because you've given us your attention, we've attempted to remain faithful to Mr. William Strunk's famous quote:

How is Lung Cancer Diagnosed?

In general, the search for a lung tumor begins when a patient complains of a symptom or symptoms consistent with lung cancer. The doctor will complete an extensive and thorough history and physical. The patient will be asked about smoking history and exposure to secondhand smoke, asbestos exposure, radon exposure and exposure to certain other chemicals and toxins. The patient’s age and family history will also be taken into account. If the patient’s history fits with a possible diagnosis of lung cancer and the symptoms could be coming from a tumor, the physician’s suspicion of lung cancer is increased and the search for a tumor begins.

There are a number of tests and studies performed in the search for a lung tumor; some tests are routine and others more specific for the diagnosis of lung cancer. Two routine tests that are performed are a complete metabolic panel (CMP; serum chemistry) and the complete blood count (CBC). The serum chemistry should include calcium and liver enzyme tests (also known as LFTs or liver function tests). The CBC includes counts of red and white blood cells and measurements of platelets. One or more abnormalities on these blood tests may support the diagnosis of lung cancer, but they cannot make the diagnosis alone.

A chest X-ray is the standard first study to diagnose lung cancer. X-ray radiation applied to the chest is captured on a sensitive film which provides information about structures inside of the chest. The radiologist will carefully examine the chest X-ray searching for abnormalities. The detail provided by a standard X-ray can usually show if there is an abnormal growth; rarely will it show if the abnormality is cancer or not. In most cases, the X-ray simply provides a strong reason to pursue further testing.

The other test that is often used in the initial diagnosis of lung cancer is sputum cytology. The patient is asked to cough up mucus from the lungs. Alternatively, the throat is stimulated to produce a sample of cells from deep within the lungs. In the laboratory, this sample is concentrated and the cells are examined by a pathologist.

Lung cancer cells appear abnormal and can provide a good indication of the presence of cancer. Sputum cytology can even predict cancer type, but it is not usually sufficient for diagnosis. A positive sputum sample generally leads to a more definitive diagnostic procedure. Of note, the sputum cytology sample is of no use for tumors that are on the periphery (edge) of the lungs since the patient will not be able to produce sputum from this distant location.

A definitive diagnosis of lung cancer requires that cells be taken directly from the tumor. The manner by which these cells are obtained depends on where they are in the chest. If the tumor is in the center of the chest, near a bronchus or large bronchiolCT scan for lung cancere, a sample may be obtained byr bronchoscopy. A bonchoscope is advanced down the airway and can be maneuvered through the bronchus to the site of the tumor. The bronchoscope has small surgical instruments in the tip which allow the pulmonologist to take a bit of the tumor for analysis.

On the other hand, if the tumor is in the periphery of the lung, a sample could be reached by using a needle placed through the chest wall. A fluoroscope, which is an X-ray/CT scan hybrid that instantly provides images of the inside of the chest, is used to guide the biopsy needle. When this external approach is possible, the patient can avoid a surgical procedure to diagnose the lung cancer.

In some instances, the tumor cannot be reached by bronchocopy or fluoroscopy. In these cases, a surgical procedure must be performed. The least invasive of these surgical procedures is the thoracoscopy. A thoracoscopy is an endoscopic procedure in which a relatively small incision is made in the chest and a thoracoscope (endoscope) is advanced to the tumor. A biopsy is taken for further testing.

In highly inaccessible tumors, an open surgical procedure may be necessary. This open procedure is called a thoracotomy. In a thoracotomy, the chest is opened and the entire tumor can be seen directly. When a thoracotomy is needed for diagnosis, the entire tumor may be removed along with some surrounding lung tissue. If so, pulmonary function tests (such as those that test lung capacity) should be performed ahead of time.

Once a biopsy has been taken, regardless of the means, it is sent to a pathologist. This medical specialist will apply stains and histochemical markers to the sample and examine it under a microscope. This will provide a very accurate lung cancer diagnosis including a determination of the lung cancer type.

What is Lung Cancer?

Lung cancer is the uncontrolled growth of abnormal cells in the lung. Normal lung tissue is made up of cells that are programmed by nature to create lungs of a certain shape and function. Sometimes the instructions to a cell go haywire and that cell and its offspring reproduce wildly, without regard for the shape and function of a lung. That wild reproduction can form tumors that clog up the lung and make it stop functioning as it should. Because of the large size of the lungs, cancer may grow for many years, undetected, without causing suspicion. In fact, lung cancer can spread outside the lungs without causing any symptoms. Adding to the confusion, the most common symptom of lung cancer, a presistent cough, can often be mistaken for a cold or bronchitis.

How common is lung cancer?

Lung cancer is one of the most common cancers in the United States, accounting for about 15 percent of all cancer cases, or 170,000 new cases each year. At this time, over half of the lung cancer cases in the United States are in men, but the number found in women is increasing and will soon equal that in men. Today more women die of lung cancer than of breast cancer.

The majority of people who get lung cancer have been cigarette smokers, but not all people who smoke get lung cancer. And, some people who have never smoked get lung cancer.

Throughout this section there are questions you may wish to answer for yourself. There is a form you can print out to write down your answers.

Members of my family or others close to me who have the same kind of cancer I have:

That person's experience with lung cancer and how it affected me or how I felt about it:

What are the symptoms of lung cancer?

Lung cancer may cause a number of symptoms. A cough is one of the more common ones and is likely to happen when a tumor grows and blocks an air passage. Another symptom is chest, shoulder, or back pain, which feels like a constant ache that may or may not be related to coughing. Other symptoms may include shortness of breath, fatigue, repeated pneumonia or bronchitis, coughing up blood, hoarseness, or swelling of the neck and face.

There may also be symptoms that do not seem to be at all related to the lungs. These may be caused by the spread of lung cancer to other parts of the body. Depending on which organs are affected, symptoms can include headaches, weakness, pain, bone fractures, bleeding, or blood clots.

The symptoms I have:

What are the different types of lung cancer?

The type of cells found in a tumor determines the kind of cancer. The two main types of lung cancer are small cell and nonsmall cell. The terms small cell and nonsmall cell refer to the type of cell a doctor can see under the microscope, not to the size of the tumor. There are more than a dozen different kinds of lung cancer.

The following types of lung cancer cause about 90% of all lung cancer cases:

    Small cell carcinoma (also called oat cell carcinoma): usually starts in one of the larger breathing tubes, grows fairly rapidly, and is likely to be large by the time of diagnosis.

    Nonsmall cell lung cancer (NSCLC): is made up of the following three subtypes:

    Epidermoid carcinoma (also called squamous cell carcinoma) : usually starts in one of the larger breathing tubes and grows relatively slowly. The size of these tumors can range from very small to quite large.

    Adenocarcinoma: starts growing near the outside surface of the lung and may vary in both size and growth rate. Some slowly growing adenocarcinomas are call alveolar cell cancer.

    Large cell caracinoma: starts near the surface of the lung, grows rapidly, and is usually large when diagnosed.

The names of some of the uncommon types of lung cancer are carcinoid, cylindroma, mucoepidermoid, and malignant mesothelioma. Approximately 5% to 10% of lung cancers are of these types.

The type of lung cancer I have:
(If you don't know, ask your doctor or nurse and have them write it down for you.)

How is lung cancer diagnosed?

If lung cancer is suspected or detected, you will have a series of tests designed to confirm the disease (diagnosis) and to determine how widely the cancer has spread (staging).
What are the roles of X-rays, MRIs, and CT scans

If a doctor suspects lung cancer, he or she may order a chest X-ray as a first step in diagnosis. Frequently, a CT (computer assisted tomography) scan or an MRI (magnetic resonance imaging) will also be ordered. CT scans and MRIs are test that use computerized pictures to show the body in great detail. They can show the size, shape, and location of a tumor. These tools are also useful in finding out if the tumor has spread from the lung to other parts of the chest or to other parts of the body.

The following are the tests I have had and the results of those tests:
What is a lung biopsy?

A biopsy is a test in which tissue is removed from the suspected tumor and looked at under a microscope to see if cancer cells are present. This may be done by inserting a needle through the chest wall to take a sample of tissue from a known tumor, or it may involve surgery in which the doctor opens the chest wall to remove a part or all of the tumor. A biopsy is necessary for the doctor to confirm a cancer diagnosis and to identify the specific type of cancer you have.

The results of my biopsy:
What is sputum cytology?

Cells that are coughed up from the lungs or breathing tubes can be examined under a microscope to see if they contain cancer. This procedure is called sputum cytology. In some cases, sputum cytology can reveal lung cancers in patients with normal X-rays or can determine the type of lung cancer. Because it cannot pinpoint the tumor's location, a positive sputum cytology test is usually followed by further tests.
What does "staging" mean?

Staging is a process used by physicians to describe how advanced the cancer is. Staging assists the physician in determining a prognosis (what is likely to happen to the person because of the cancer). Knowing the stage helps the physician in planning treatment and evaluating the results. Different staging systems are used for different types of cancer. The staging system used for nonsmall cell lung cancer is discussed in the next section.

The results of my sputum cytology:

what is TransUnion ?

TransUnion® is a global company whose main business is consumer credit reporting. Part of a group commonly referred to as “the big three” in the consumer credit industry, with the other two leaders being Equifax and Experian®, TransUnion® is the third largest consumer credit reporting company in the United States. Though they provide services other than consumer credit reporting, this is the business aspect for which they are best recognized. TransUnion® has locations throughout the world, with their headquarters being located in Chicago, Illinois and primary US consumer locations being Chester, Pennsylvania and Fullerton, California.

TransUnion® was founded in 1968 and has been an independent company since 2005. As a credit bureau, or credit reporting agency, TransUnion® gathers information reported from different sources on individual consumers. Information that TransUnion® and other credit bureaus gather primarily includes payment history, credit history, and borrowing history and habits. Consumer lenders, such as banks, credit unions, and credit card companies use this information to help compare credit worthiness and credit risk and determine availability of consumer loans to individual applicants.

In the United States, credit reporting agencies like TransUnion® and their policies are governed by the federal government. The Fair Credit Reporting Act sets legal terms for credit reporting agencies and the oversight is the responsibility of the Federal Trade Commission (FTC). Under the Fair Credit Reporting Act, consumers are entitled to review their credit report from all three major credit reporting agencies, including TransUnion®, once per calendar year.

Obtaining a free report can be done online or by phone or mail, but only the information regarding past and current lenders and payment history is supplied. Your actual credit score as reported by each agency is not included in the annual free credit report. Individual credit scores can be obtained by paying a company’s fee or directly from lenders to whom an individual has applied for a loan.

In addition to consumer credit reporting, TransUnion® also provides consumer services such as identity theft protection, fraud protection, and credit monitoring. By public policy and law, TransUnion® is required to investigate any discrepancies a consumer may have with regards to the credit information they have reported. Commonly referred to as a “dispute,” a discrepancy or mistake on an individual’s credit report can cost them valuable points on their overall credit score.

Financial experts recommend that individuals monitor their credit reports and review them annually at the minimum. To obtain a free credit report from TransUnion® individuals can visit their website and click on “Free Credit Report.” Their website also provides contact information should consumers need to place a security freeze or fraud alert on their report due to identity theft or fraud.

What is TransUnion, and why is it important?

Trans Union is one of the “Big Three” major credit reporting bureaus which are commonly used by insurers and lenders to obtain information on their applicants credit history. Based in Chicago, Illinois – TransUnion in 1968 by Union Car Company. As of 2006 it operates more than 200 offices across the country, and around the world.

Trans Union, much like the other two big credit reporting agencies (Equifax and Experian), now market their credit reports directly to consumers, in addition to their core business of providing the reports to potential creditors. Which is good news for consumers, because now anyone can view their credit report as a potential lender would see it.
What is an Trans Union Credit Report?

A Trans Union Credit Report is a compilation of credit reporting data from many sources. It can be delivered instantly online after your identity is confirmed, and you also have the option of printing it out if needed. You can also get your Trans Union Credit Score (FICO Score) along with your report.
Is a Trans Union Credit Report the same as the others?

In many ways, yes it is very similar, but not exactly the same. Lenders don’t always report to all three major credit bureaus. Some only report your payment history and balances to one or two of the major bureaus, so it is important to check all three agencies to thoroughly review your credit history, and to check for errors or signs of identity theft in your credit report. Your report from each of the “Big Three” bureaus will usually differ slightly.

Pain Free Dentistry- Is It A Reality?

One of the reasons most people fear going to see a dentist is knowing they could get the dreaded drill inserted into their mouth.

However recent research, if true, could spell the end of painful dentistry.

The new device is said to have been invented by scientists at the University of Missouri and which is said to be an alternative to the dentist drill. The device itself is reported to look like an electric toothbrush which cleans out cavities using high energy gas and liquid particles.

Called a non-thermal argon plasma brush (NAPB) the new invention blasts the decaying tooth with electrically charged particles which then kill bacteria instantly.

Pain is caused by traditional drills because the machine has to essentially root out the decay and any lingering bacteria. The drill creates vibrations which in turn affects the nerves in the root causing the patient to feel pain.

Researchers however believe that this new NAPB device doesn’t create vibration, nor does it upset the structure of the tooth being treated. Hence treatment is pain free. This in turn should help patients feel more relaxed.

Tooth decay occurs because bacteria attack the tooth enamel. As such, dentists believe it is far better to ensure that teeth are looked after before they get to the stage where they either have to be filled or extracted.

So, while this device if manufactured for the wider market could be a God send for those who fear the drill, it shouldn’t become a substitute for not looking after teeth and gums properly.

Nevertheless if it becomes a reality it is one less reason to fear the dentist.

Tags: NAPB device, non-thermal argon plasma brush, pain-free treatment, University of Missouri

This entry was posted on Thursday, August 30th, 2012 at 9:28 am and is filed under Dental phobia. You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed.

IASP Curricula Outline on Pain for Dentistry

Task Force Members: Antoon De Laat (Chair), Barry J. Sessle, Peter Svensson
Outline Summary

    Introduction
    Principles
    Objectives
    Curriculum Content Outline
     I. Multidimensional Nature of Pain
     II. Pain Assessment and Measurement
     III. Management of Pain
     IV. Clinical Conditions
    References
    Appendix: Curriculum Outline on Orofacial Pain
    Additional Resource: Postdoctoral Outline

Introduction

Pain is a multidimensional and complex phenomenon that requires comprehensive and ongoing assessment and effective management. The multidimensional nature of orofacial pain requires an interdisciplinary approach to assessment and management. All health care professionals need to serve as advocates for the person in pain and ensure that pain management is based on evidence-based standards and guidelines and ethical principles. Traditionally, Dentistry has focused on the prevention, diagnosis and management of intraoral and orofacial pain.

This means that dental students need to be knowledgeable about (orofacial) pain mechanisms, the epidemiology of pain, barriers to effective pain control, the variety of orofacial pain conditions, and variables which influence the patients' perception of and response to pain. They should be trained to apply valid and reliable methods of clinical pain assessment and to adequately master the range of available methods for the alleviation of orofacial pain.
Principles

The following principles guide the pain curriculum for the entry level dentist:

    Pain is a multidimensional experience requiring comprehensive and ongoing assessment and effective management.
    Dentists play an essential role in the prevention, diagnosis and management of intraoral and orofacial pain.

Objectives

Dentists at the completion of this pain curriculum will be able to:

    Provide an adequate diagnosis of intraoral and orofacial pain
    Perform a comprehensive pain assessment including its impact on the patient
    Adequately manage the pain and evaluate the effectiveness of those actions

Curriculum Content Outline (Entry-level, predoctoral)

I. Multidimensional Nature of Pain

A. Introduction

    Pain as a public health problem
    Pain as an obstacle to optimal dental care
    Epidemiology, societal consequences
    Economic impact
    Medico-legal, ethical, and compensation issues

B. Definition of Pain

    Relationship between acute, incident, breakthrough and chronic pain
    Pain terms
    Philosophical issues
    Historical aspects of the study of pain
    Biological significance of acute pain (survival value) versus chronic pain

C. Peripheral and Central Mechanisms of Pain Transmission and Pain Modulation

    Theories of pain
    Peripheral distribution of the trigeminal nerve and other nerves of the head and neck, the anatomic relations of the structures which they innervate, and their primary central connections
    Receptors and afferents of the trigeminal system, non-neural (e.g., glia) mechanisms
    Brainstem
    Thalamus and cerebral cortex
    Features that distinguish the trigeminal system from the spinothalamic and dorsal column lemniscal systems, e.g., the proportion of myelinated to unmyelinated fibers, the occurrence of sites (e.g.,tooth pulp, cornea) predominantly or exclusively innervated by nociceptive afferents, the bilateral and disproportionately large representation of the orofacial region in higher levels of the somatosensory system, the nuclear and subnuclear organization of the trigeminal brainstem complex
    Related motor centers and mechanisms underlying orofacial movement
    Segmental and brain centers modulating pain transmission
    Neurochemicals involved in pain transmission and control
    Genetic aspects
    Affective, cognitive, behavioral, developmental and aging aspects
    Interpersonal and psychosocial issues; illness behavior; the influence of political, governmental, and social welfare programs

II. Pain Assessment and Measurement

    Measurement of pain, as well as disability, associated distress, and suffering
    Assessment of pain relief
    Patient evaluation (psychological and physical status)
    Objective tests and procedures, e.g., physical exam, tooth vitality tests, radiographs, microbiology, hematology, serology, nerve blocks, chair-side sensory tests, etc.

III. Management of Pain

A. Control of preoperative and operative pain and apprehension

    Non-pharmacological methods
        Psychological and behavioral methods
        Interpersonal strategies of patient management
        Hypnosis, acupuncture, etc.
    Pharmacological methods – analgesics
        Review of physiologic and pharmacologic considerations
        Selection of agents
        Techniques of administration
        Prevention, recognition and management of complications and emergencies, including principles of advanced life support
    Pharmacological methods – local anesthesia
        Review of anatomic and physiologic considerations
        Selection of agents
        Technique of injections
        Prevention, recognition and management of complications and emergencies, including principles of advanced life support
    Pharmacological methods – conscious sedation (anti-anxiety treatments)
        Review of related cardiovascular, respiratory, and central nervous system physiology and pathophysiology and psychopathology
        Selection of agents
        Techniques of administration
        Prevention, recognition, and management of complications and emergencies, including the principles of advanced life support
    Overview of general anesthesia and deep sedation
    Interaction of pharmacological and psychological methods

B. Control of postoperative pain and apprehension

    Use of appropriate instructions and interpersonal strategies
    Selection of appropriate pharmacological agents based on procedures and patient's psychological background

IV. Clinical Conditions

A. Taxonomy of orofacial pain

    Familiarity with the classification of acute pain and chronic orofacial pain syndromes, the principles upon which it is based, and the application to specific cases is required.
    The IASP classification of chronic pain syndromes (Bogduk & Merskey 1994) and DSM IV Classification of Somatoform Disorders (Diagnostic and Statistical Manual of Mental Disorders (4th Ed)

B. Diagnostic features, etiology, mechanisms and management of orofacial pain associated with:

    Specific sites, e.g., tooth, TMJ, muscle, mucosa, skin, sinus, bone
    Infections, e.g., herpes, candidiasis
    Non-dental referral, e.g., earache, cardiac, headache
    Orofacial referral patterns
    Orofacial pain conditions
        Trigeminal neuralgia
        Glossopharyngeal neuralgia
        Postherpetic neuralgia
        Temporomandibular Disorders
        Oral dysesthesia, burning mouth syndrome
        Atypical facial pain, atypical odontalgia, etc.
        Orofacial malignancy
        Headaches, e.g., migraine, cluster headache
        Peripheral nerve injury and deafferentation pain
        Others, e.g., carotidynia

Appendix

Curriculum Outline on Orofacial Pain

I. Anatomical, physiological, and psychological aspects of orofacial pain

    To have a broad general knowledge of the anatomy and physiology of the orofacial structures, particularly of the peripheral nerve distribution of the major trigeminal nerve trunks and other cranial nerves, the anatomic relations of the structures they innervate, and their primary central connections.
    Be familiar with the commonalties between the trigeminal system and the spinal and lemniscal systems that make current concepts of neurobiology, nociceptive transmission and its control applicable to the trigeminal system.
    Similarly, be aware of features that distinguish these systems, e.g., in the trigeminal system, the proportion of myelinated to unmyelinated fibers and the properties of some of these fibers are different from those in spinal nerves; the occurrence of sites (e.g., tooth pulp, cornea) in the orofacial region that are predominantly or exclusively innervated by nociceptive afferents; the bilateral and disproportionately large representation of the orofacial region in higher levels of the somatosensory system; the exquisite sensibility of orofacial tissues.
    Be familiar with psychological, psychosocial, genetic and environmental factors associated with orofacial pain and other pain conditions.

II. Diagnosis of orofacial pain

A. To have a broad general knowledge of the major diagnostic features and possible etiological, epidemiological, and pathophysiological aspects of pain associated with:

    Specific sites: tooth and surrounding structures, temporomandibular joint, muscle, mucosa, sinus, bone, salivary glands
    Orofacial pain conditions including cranial neuralgias and neuropathic pain, temporomandibular disorders, neurovascular and other headaches, idiopathic pain conditions such as burning mouth syndrome, atypical odontalgia , atypical facial pain.

B.

    Be familiar with the general principles of taking a structured orofacial pain history and carrying out a clinical examination of the orofacial region and adjacent structures.
    Be aware that there are objective and validated tests and procedures used for differential diagnosis of many of the above but that some diagnostic approaches still lack reliability, validity, specificity, or sensitivity. Tests and procedures include tooth pulp vitality and tooth percussion tests, muscle palpation tests, salivary tests, quantitative sensory and neurophysiological tests, and other physical exams; behavioral and psychosocial assessments; radiographs and other imaging techniques; microbiological and serological tests; biopsies; and controlled nerve blocks.
    Be aware of the common orofacial patterns of pain referral. Also be aware that orofacial pain may sometimes be referred from remote sites (e.g., earache, cardiac pain, intracranial lesions).

III. Management of orofacial pain

A. Be aware of the current evidence-based management approaches, and their indications and contra-indications, for the different types of orofacial pain noted in section II. Some of the commonly used therapeutic approaches include pharmacological agents, surgery, physical medicine, and multidisciplinary management, including cognitive behavioral approaches, as well as the use of support groups. Be able to inform the patient on these topics.
References

Sessle B.J., Lavigne, G., Lund J.P. Dubner, R. Orofacial Pain: From Basic Science to Clinical Management. 2nd Ed. Quintessence, Chicago, 2008

de Leeuw R. Orofacial Pain. Guidelines for assessment, diagnosis and management. 4th Ed. The American Academy of Orofacial Pain. Quintessence Publ Co, 2008

Sessle BJ, Baad-Hansen L, Svensson P. Orofacial Pain. In: Clinical Pain Management: A Practical Guide. Lynch M, Craig K, Peng P (Eds.) Wiley Blackwell, 2010

Sharav Y, Benoliel R. Orofacial Pain and Headache, Mosby Elsevier 2001

Zakrzewska, J. Harrison S.D. Assessment and management of orofacial pain, Elsevier, 2002
Additional Resource
Postdoctoral Curriculum

I. Multidimensional Nature of Pain

A. Representative and associated non-dental syndromes and conditions, e.g., phantom pain, causalgia, cancer pain, arthritis, reflex CRPS I and II, fibromyalgia, etc.

B. Pain in special contexts

    Postoperative pain (including prophylaxis)
    The harmful effects of unrelieved severe acute pain
    Children and infants (signs of pain, evaluation and management, physiology, acute and chronic pain)
    Cancer-related pain (death and dying, palliative care)
    Aged patients
    Intellectually impaired patients
    Occupational issues (e.g., use syndromes, post-traumatic stress disorders)

C. General anesthesia and deep sedation

    Survey of agents used and their proper selection
    Survey of adjunctive agents and rationale for their use
        Anticholinergics
        Sedatives
        Analgesics
        Muscle relaxants
    Indications and contraindications for use of general anesthesia in ambulatory patients
    Patient selection and preparation
    Complications associated with use of general anesthesia and deep sedation

II. Pain Assessment and Measurement (Examination, differential diagnosis, and clinical decision analysis in orofacial pain)

    Fundamental examination and diagnostic principles in medicine and dentistry
    Radiological interpretation of soft and hard tissue components of the masticatory system
    Neurological interpretation of acute and chronic pain disorders including quantitative sensory testing
    Predictors of and treatment outcome measures in orofacial pain disorders

III. Management of chronic pain

    General principles
        The measurement, quantification and recording of pain
        The multiperspective approach (multidisciplinary pain clinics)
        The clinician-patient relationship
    Clinical pharmacology
        Nonsteroidal anti-inflammatory drugs
        Systemic and spinal opioids
        Local anesthetics
        Other drugs (anticonvulsants; antidepressants; agents influencing 5-HT, endorphins, and other endogenous neurochemicals)
    Neurostimulation techniques
        Transcutaneous nerve stimulation
        Acupuncture
    Nerve blocks
        Local anesthesia
        Neurolytic solutions
    Neurosurgical techniques
        Nerve decompression
        Neurectomy
        Sympathectomy
        DREZ
        Tractotomy
        Others
    Psychosocial and behavioral approaches
        Individual, family and group psychotherapy
        Cognitive-behavioral therapy
        Relaxation techniques (biofeedback, etc.)
        Hypnotherapy, operant approach, stress management
    Physical therapy
        Exercise, massage, heat, hydrotherapy, etc.