NSU CDM Lasting Impressions Fall 2018

NOVA SOUTHEASTERN UNIVERSITY | 9 J effrey Simon saw his dentist vigilantly. He never missed a cleaning and kept up on his periodic dental examinations. Four years ago, when he was living within walking distance to Nova Southeastern University’s College of Dental Medicine (CDM), Simon noticed a pamphlet hanging on his door describing dental services at the college. “I thought I’d try it,” Simon said. “I called right away and got an appointment.” Simon was scheduled at the CDM Patient Care Center’s main clinic on the Fort Lauderdale/Davie Campus. While dental X-rays had been processed before, Simon had not previously received a panoramic X-ray. Panoramic radiography is a two-dimensional X-ray that captures the entire mouth in a single image—the teeth, upper and lower jaws, surrounding structures, and tissues. Patients coming in for examina- tions at the CDM clinic receive a panoramic X-ray as part of their initial consultation. “In order to qualify for services, and to be treated by our students, patients need to have a complete evalua- tion by our restorative dental faculty,” said Steven Kaltman, D.M.D., M.D., chair of the Department of Oral and Maxillofacial Surgery and assistant dean of hospital and extramural affairs for the CDM. “During that appointment, they discovered that Mr. Simon had a large lesion on the right side of his jaw.” Simon recalled it was less than 10 minutes into his appointment when they asked him if he was aware of the lesion. “They wanted to know if I ever had numb- ness or pain,” he said. “No,” he replied. He was referred to the oral and maxillofacial surgery department and was seen immediately. “I was weak in the knees at this point,” Simon said. “They had me meet with Dr. Kaltman, and he explained the situation. While he calmed me down, I still was shocked that I hadn’t known anything about this before, that my regular dentist hadn’t discovered it.” The lesion had encapsulated onto Simon’s lower right jaw and wisdom teeth, which had never been removed. Simon’s surgery took place three weeks later. The aggressive cyst was removed in the operating room by CDM residents working in the trauma unit at Memorial Regional Hospital in Hollywood, Florida, with Kaltman as the supervising physician. “It is a teaching experi- ence for these students, no doubt,” confirmed Kaltman. “We present each case preoperatively, and, in this case, we went over the type of cyst, how it should be treated, and what complications there might be.” An oral biopsy showed that the cyst was benign, “much to my relief,” Simon said. According to Kaltman, if the lesion had not been diagnosed, it’s likely it would have continued to grow. “It was big, but it would have gotten bigger,” said Kaltman, adding that, eventually, the lower jaw bone would be weakened to such a point that it could have caused a pathological fracture. “This could have caused a number of mounting prob- lems,” said Kaltman. “He may have lost teeth, and, rather than enucleation—removing the cyst—and letting it heal over time, this patient may have needed to have a large bone graft had this not been discovered.” Kaltman said the patient has some numbness in the area that will be permanent, because the cyst was wrapped around a nerve. “That is something I can live with when I think about what could have happened,” Simon said. While Simon was someone who had cared about his oral health, Kaltman said there is still a valuable message to be learned from his story. “The ‘take home’ here is whether it is a benign, aggressive lesion, or a malignancy, not getting routine dental care and the proper X-rays can lead to these types of problems getting out of hand,” Kaltman said. Simon credits that flyer about NSU CDM services with “saving his life.” After the CDM clinic diagnosed the lesion, Simon vowed to never return to his former dentist and said he won’t go anywhere but the CDM’s clinic for his dental needs. He has since had multiple procedures done in the clinic, including two implants to replace teeth that had been missing for years from sports injuries, and has had some periodontal work done on his gums. “I like that I feel I have a whole team of dentists working with me at the CDM,” Simon said. “They are precise, and I know they care. They do whatever they can to make your life better, and they’ve certainly improved mine. I will be forever grateful to NSU’s College of Dental Medicine.” u ROUTINE SCREENING UNCOVERS LARGER PROBLEM BY MICHELLE F. SOLOMON