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Author Archives: JCDA Oasis

How Effective Is the Neuromuscular Occlusion Approach in diagnosing and treating TMD?

This summary is based on the Rapid Response Report developed by the Canadian Agency for Drugs and Technologies in Health:  Neuromuscular Occlusion Concept-based Diagnosis and Treatment of Tempromandibular Joint Disorders: A Review of the Clinical Evidence  Full Report (PDF) Key Messages Diagnosing TMD: The use of electromyograms (EMG) is not supported by evidence. There is insufficient evidence to determine the diagnostic value of kinesiography. Treating TMD: Electrical stimulation is not supported by evidence. The efficacy of occlusal splints is uncertain. Context Temporomandibular disorder (TMD) is a group of clinical problems involving the chewing muscles, the temporomandibular joint (TMJ), and related structures. Symptoms may ...

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How Can I Treat A Patient With Previous Myocardial Infarction (MI)?

This medical Condition Consult is presented by the JCDA Oasis Team. The consult is also available through the JCDA Oasis Mobile Myocardial infarction (MI) is a consequence of obstruction in the coronary artery blood supply to the heart, resulting in death of the myocardium. Predisposing risk factors include atherosclerosis (thickening of arterial wall caused by the accumulation of lipid plaques), obesity, smoking, hyperlipidemia, family history of MI, and undue stress.   LA/Vasoconstrictors Drug Interactions Use vasoconstrictors with caution, due to increased risk for adverse outcomes1. Increased risk of cardiac arrhythmias in patients taking digitalis (e.g., digoxin).2. Increased risk of a ...

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Do Automated External Defibrillators (AEDs) have an impact on outcomes in health-care settings?

This question was submitted by a practising dentist: AEDs have become somewhat of a comfort object in a number of our offices emergency kit. Recently, a physician colleague commented on the generally unfavourable morbidity/mortality outcomes despite the use of AEDs to re-establish cardiac activity. Is this true?? Dr. Alan Lane, anaesthesiologist at the Ottawa General Hospital provided this initial response: I would say the literature supports that view. Reports indicate that the rate of successful hospital discharge for out-of-hospital cardiac arrests (OOHCA) is around 5%. Sudden OOHCA survival depends on adequate bystander CPR, on successful early defibrillation of a shockable ...

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How do I manage a patient who swallowed or aspirated parts of an orthodontic appliance?

This Dental Urgent Care Scenario (USC) is adapted and presented by the JCDAOASIS team in collaboration with Dr. James Noble of Orthodontics at Don Mills in Toronto You can find the full USC on JCDAOasis Mobile Context Patients receiving orthodontic treatment are at a very high risk of having appliances swallowed into the oropharynx during treatment due to the small size of brackets and clipped wires. Orthodontic appliances that can be swallowed include wires, brackets, transpalatal arches, temporary skeletal anchorage devices, and keys for expanders and removable appliances among others. Foreign bodies entering the alimentary canal rarely represent a serious ...

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Burning Mouth Syndrome (BMS): what should you know?

This Dental Urgent Care Scenario (USC) is adapted and presented by the JCDAOASIS team in collaboration with Dr. Deepika Chugh and Dr. David Mock You can find the full USC on JCDAOasis Mobile Context Burning Mouth Syndrome (BMS) is an idiopathic burning sensation of the oral mucosa with no apparent underlying cause. Although the origin of the condition is unknown, there is possible evidence of a neuropathic basis. BMS is most found in middle-aged and elderly people, predominantly in perimenopausal and postmenopausal women. Signs & Symptoms Usually, onset is spontaneous, but previous trauma or dental treatment may be precipitating factors Most commonly ...

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What type of palliative care can I provide for persistent generalized dentin hypersensitivity?

This question was submitted to us by a practising dentist: “I had a patient present today with ongoing generalized sensitivity. No clinical evidence of recession; no bruxism or clenching that she is aware of; and no dietary changes. I would like to make trays to better deliver some palliative relief (she is currently using desensitizing toothpaste). What is the best product for the trays? Would Fluoride or relief gel or some other product that I am unaware of be best?” Dr. Hardy Limeback, former head of preventive dentistry at the University of Toronto provided this initial response: Persistent generalized dentin ...

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Case Study 2: Exploring treatment alternatives for the unsatisfactory removable partial denture

We are pleased to present to you the second JCDA Oasis Case Conference, a new treatment challenge, in collaboration with Dr. Bill Abbott of the International Team for Implantology (ITI). Please view the short video (< 3 minutes) and anonymously submit your treatment suggestions, comments/feedback, and clinical questions online before March 16th, 2013. After March 16, Dr. Abbott and a specialist colleague will present a video SOLUTIONin which they answer the main questions raised by you and other colleagues and they tell us how the case was actually treated.  At that time, you will also be able to see the summary input of your colleagues. As ...

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All-ceramic dental crowns VS. metal-ceramic dental crowns: what is the clinical and cost effectiveness?

This Rapid Response is produced by the Canadian Agency for Drugs and Technologies in Health (www.cadth.ca) Report in Brief (PDF)                                         Full Report (PDF) Key Findings The short term (< 5 years) survival of all-ceramic crowns when used for anterior teeth is comparable to porcelain fused to metal crowns. Summary of Findings Dental Crown Survival Posterior all-ceramic crowns fabricated from alumina, reinforced glass-ceramic, zirconia, or lithium disilicate had comparable survival rates to posterior PFM crowns (< 5 years analysis). InCeram and glass-ceramic, ...

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