Derived from the Chronic Orofacial Pain Workshop of the Network for Canadian Oral Health Research, IMHA, Canadian Institutes of Health Research, Montreal, November 2013 Gilles Lavigne, DMD, PhD, FRCD, Professor, Faculté de médecine dentaire, Université de Montreal Mary Lynch, MD FRCPC,Professor Anesthesiology Psychiatry Pharmacology,Dalhousie University, To understand the misuse of prescription opioid analgesics (POA), it is critical to examine the definitions used in the research. The Canadian Alcohol and Drug Use Monitoring Survey (CADUMS) is an ongoing national survey that examines alcohol and drug use in Canadians 15 years of age and older. CADUMS defines the nonmedical use of prescription ...Read More »
This summary is based on the article published in the British Journal of Oral and Maxillofacial Surgery: Safety of local anaesthesia in dental patients taking oral anticoagulants: is it still controversial? (January 2012) Purpose of the Study To investigate the safety of local infiltration techniques and the inferior alveolar nerve block (IANB) in dental patients taking oral anticoagulants. Main Findings Bleeding as a result of the use of local anaesthesia in patients with therapeutic INR is unlikely, provided that the IANB is done correctly. IANB in patients with INR within therapeutic range is safe. Haemorrhagic complications after local anaesthesia, including the IANB (possibly even other nerve blocks), ...Read More »
This summary is based on the article published in the International Dental Journal: Clinical efficacy of antibiotics in the treatment of peri-implantitis (August 2013) Context Various treatment regimes for Peri-implantitis (PI) have been proposed in the literature. As it is known that bacteria can transfer from periodontally involved teeth to an implant, and that the microbes associated with PI resemble those of periodontal disease, local or systemic delivery of antibiotics with traditional PI treatment regimes may eliminate periodontopathogenic bacteria to a greater extent compared with when these treatment regimes are performed alone. This in turn may facilitate healing of PI ...Read More »
This summary is based on the article published in the Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology journal: Adverse drug reactions to local anesthetics: a systematic review (March 2013) Context Local anesthetics (LAs) are widely used, especially in oral and ophthalmologic treatments. The types, doses, means of administration of LAs, and combined drugs are the main factors that could induce adverse drug reactions. Purpose of the Review Analyze adverse drug reactions (ADRs) associated with local anesthetics (LAs) and to characterize the safety proﬁle of LAs in clinical application. Results A total of 922 articles were retrieved, and 101 of them, containing 1,645 events, ...Read More »
This Urgent Care Scenario (USC) is presented by the JCDA Oasis Team in collaboration with Dr. Henry Lapointe. It is also available on the Oasis Help system Dr. Henry Lapointe is Chair of the Oral & Maxillofacial Surgery Program at the Schulich School of Medicine and Dentistry, University of Western Ontario A mandible fracture is a sudden, intra-operative fracture of mandibular bone. Do you need further information related to this subject? Do you have any comments or suggestions? Email us at firstname.lastname@example.org Your are invited to comment on this post and provide further insights by posting in the comment box which ...Read More »
This Urgent Care Scenario (USC) is presented by the JCDA Oasis Team in collaboration with Dr. Daisy Chemaly. The USC is also available through Oasis Help Complication of wound healing following the extraction of a tooth. The patient experiences severe throbbing pain caused by bone exposure at the site of extraction. Following the extraction, a blood clot forms at the socket to protect the bone. When the clot dislodges or dissolves prematurely, the nerves and bone become exposed, leading to pain. Do you need further information related to this subject? Do you have any comments or suggestions? Email us at email@example.com ...Read More »
Is inadequate osseointegration a concern in radiation-treated patients, if implants are treatment planned?
This question was submitted by a general dentist: Is inadequate osseointegration a concern in patients who have received radiation therapy for a head and neck malignancy if implants are treatment planned? Dr. Jeff Chadwick, at Princess Margaret Hospital, Dental Oncology, Ocular, and Maxillofacial Prosthetics Group, provided a preliminary response to this question Yes, however … As with most questions related to this patient population, the answer is: “it depends.” Careful examination is a vital step in determining which restorative/prosthodontic approach best suits the individual. Examination also mandates a thorough review of their cancer diagnosis as well as the constituents and sequence ...Read More »
What are the risk factors for osteoradionecrosis (ORN), in a xerostomic radiation-treated patient, if extractions are required?
This question was submitted to us by a general dentist: If extractions are required, what are the risk factors for osteoradionecrosis (ORN) in a xerostomic patient with rampant decay two years after the successful treatment of their head and neck cancer (radiation, chemotherapy and surgery)? Dr. Jeff Chadwick, at Princess Margaret Hospital, Dental Oncology, Ocular, and Maxillofacial Prosthetics Group, provided a preliminary response to this question: With the numerous comorbidities associated with head and neck radiation (oral mucositis, radiodermatitis, dysgeusia, dysphagia/odynophagia, trismus, and xerostomia), arises a critical issue with tooth extraction is the altered biology of the maxilla and mandible due ...Read More »