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Dental Specialties

Are there recommended guidelines for reducing the incidence of shingles in a patient that has a history of developing shingles after dental care?

This question was submitted by a general dentist: Are there recommended guidelines for reducing the incidence of shingles in a patient that has a history of developing shingles after dental care? Dr. George Sandor, DDS MD and Dr. Suham Alexander, Oasis Clinical Editor provided this initial response.  Shingles (herpes zoster) is the reactivation of the chicken pox virus (varicella zoster) which typically establishes dormancy in dorsal root or cranial nerve ganglia during childhood. Reactivation usually occurs later in life mainly affecting thoracic and lumbar dermatomes; however, a small proportion of patients present with trigeminal nerve involvement. Herpes zoster may occur spontaneously ...

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How effective are non-pharmacological interventions in the relief of dry mouth?

This summary is based on the review published in the Cochrane database of systematic reviews: Interventions for the management of dry mouth: non-pharmacological interventions (September 2013) Furness S, Bryan G, McMillan R, Birchenough S, Worthington HV     Context Xerostomia is the subjective sensation of dry mouth. Common causes of xerostomia include adverse effects of many commonly prescribed medications, disease (e.g. Sjogren’s Syndrome) and radiotherapy treatment for head and neck cancers. Non-pharmacological techniques such as acupuncture or mild electrostimulation may be used to improve symptoms. Purpose of the Review To assess the effects of non-pharmacological interventions administered to stimulate saliva ...

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Does the use of antibiotics reduce the frequency of implant failure and post-operative infection?

This summary is based on the article published in the International Journal of Oral and Maxillofacial Surgery: Do antibiotics decrease implant failure and postoperative infections? A systematic review and meta-analysis (January 2014) J. Ata-Ali, F. Ata-Ali, F. Ata-Ali       Context Dental implants are an effective, safe and predictable solution for those who have lost a tooth or teeth due to dental caries, periodontal disease, injury, or other reasons.(1) It is believed that a certain number of early dental implant losses are due to bacterial contamination at implant insertion.(2) It is still debated whether early dental implant failure and ...

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What are the effects of orthodontic treatment for distalising upper first molars in children and adolescents?

This summary is based on the review published in the Chochrane database of systematic reviews: Orthodontic treatment for distalising upper first molars in children and adolescents (October 2013) Safa Jambi, Badri Thiruvenkatachari, Kevin D O’Brien, Tanya Walsh   Context When orthodontic treatment is provided with fixed appliances, it is sometimes necessary to move the upper molar teeth backwards (distalise) to create space or help to overcome anchorage requirements. This can be achieved with the use of extraoral or intraoral appliances. The most common appliance is extraoral headgear, which requires considerable patient co-operation. Further, reports of serious injuries have been published. ...

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How do you gauge patient satisfaction with aesthetic dental treatment?

This summary is based on the article published in the British Dental Journal: Why simple aesthetic dental treatment in general practice does not make all patients happy (June 2014) S. Sarin, D. Gilbert and K. Asimakopoulou       Context The provision of general dental care has seen a paradigm shift in recent years.(1 ) This shift is due in part to new materials and bonding techniques but also due to the appetite of the public who now request an aesthetic result for all their treatment, be it a simple filling or denture replacing teeth in the aesthetic zone, through ...

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Does adrenaline in local anesthetics increase or decrease bleeding at the surgical site?

This question was submitted by a general dentist: Does adrenaline in local anesthetics increase or decrease bleeding at the surgical site? Dr. Mark Donaldson, in collaboration with Dr. Suham Alexander, Oasis Discussions Clinical Editor, provided this initial response.  Dr. Mark Donaldson is Director of Pharmaceutical Services at the Kalispell Regional Medical Center, Clinical Professor in the Department of Pharmacy at the University of Montana, and Clinical Associate Professor in the School of Dentistry at the Oregon Health and Sciences University Local Anesthetic Composition Most local anesthetic cartridges contain the following ingredients: Local anesthetic drug Vasoconstrictor Preservative, if contains vasoconstrictor Sodium chloride Distilled ...

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Does previous drug use cause a level of tolerance to local anesthetics?

Question: “I have a patient with history of cocaine and heroin addiction, but has been clean for 5 years.  It seems that local anesthetic (lidocaine 2%, 1:100k epi) for minor restorative wears off sooner than I would normally expect. Would her previous drug use cause a level of tolerance to the local anesthetics?” Dr. Joonyoung Ji provided the below answer. He is resident in the Department of Dental Anesthesia at the University of Toronto     What is pain? Under the International Association for the Study of Pain, “Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or ...

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What are some of the immunological diseases encountered in dental practice?

This summary is based on the article published in the British Dental Journal: General medicine and surgery for dental practitioners: part 5. Immunological disease and dental practice (August 2014) M. Greenwood, J. G. Meechan and C. Stroud   Context At some stage in clinical practice all dental practitioners will encounter patients with disorders of the immune system. It is therefore important that dental practitioners are aware of the potential implications for safe practice. Purpose of the Paper Provides an overview of clinical immunology and how it interfaces with dentistry. Highlights signs of possible immunodeficiency. Discusses oral conditions that may be ...

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