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Where's the peppermint? How the dentists can teach the podiatrists a thing or two.

The history of dental hygiene is actually an interesting story. At the onset of the 20th century, dental hygiene was virtually non-existent. A green stick was used to scrape only the most obvious of plaque and toothpaste was scoffed. Toothpaste recipes that included burnt bread, pulverized brick and chalk were used as abrasives. But it wasn't until the brilliant Dr. Washington Sheffield of Connecticut discovered that if you put mint into the toothpaste, people actually enjoyed using it (what a concept, right?)

When and why do you cancel surgery?

I'm on call this week for our hospital's Critical Limb Care program. First thing Monday morning I had a call from a cardiologist who wanted to know whether to proceed or cancel an angioplasty (PCA). The case was an ablation of the right atrium. The problem was that the patient presented with a mid shin wound that had been present for 3 weeks. The question at hand was whether the wound was infected and would contaminate the procedure. "What should I do? Cancel the case?"

Does methotrexate influence wound healing?

Methotrexate is an antimetabolite that works by inhibiting dihydrofolic reductase. This enzyme is important in the production of DNA. Methotrexate targets rapidly growing cells such as inflammatory cells in rheumatoid arthritis or psoriasis. Methotrexate was originally used as a cancer drug for malignancies including acute lymphoblastic leukemia and lymphomas.