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Dental Specialties

How can dentists prevent the abuse of prescription opioids?

This summary is based on the article published in the Journal of the American Dental Association: Prevention of prescription opioid abuse: the role of the dentist (July 2011) Full-text article (PDF) Context  Opioids are analgesics that have potential for misuse, abuse or addiction. Up to an estimated 23 percent of prescribed doses are used non-medically. As prescribers of 12 percent of immediate-release (IR) opioids in the United States, dentists can minimize the potential for misuse or abuse. The authors participated in a two-day meeting in March 2010 co-hosted by Tufts Health Care Institute Program on Opioid Risk Management, Boston, and Tufts University School of Dental Medicine, Boston. The ...

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Updated post with full-text article: How would you manage this case: crown fracture with complicated chisel-type fracture?

This case was presented in the Dental Traumatology journal (December 2013). We are asking for your feedback on how you would treat this case. The full-text article is now available. Full-text article (PDF) The Clinical Case A 24-year-old male patient came to The Department of Restorative Dentistry and Endodontics at the Dental Clinic in Vojvodina with dental injury of the maxillary left central incisor. The patient reported a sport injury that had occurred the night before during a football match. Clinical and radiographic examination revealed a complicated oblique crown fracture that extended subgingivally on the mesiopalatal area with a single ...

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What is the Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain (CNCP)?

Canadian medical regulatory authorities undertook guideline development in response to: Physicians and other stakeholders seeking guidance regarding safe and effective use of opioids  A growing concern about opioid misuse creating patient and public safety issues, and  The lack of systematically developed national guidelines on opioid use for CNCP. Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain: Executive Summary and Background (PDF) Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain: Recommendations for Practice (PDF) Summary of the Recommendations Cluster 1: Deciding to Initiate Opioid Therapy R01 Before initiating opioid therapy, ensure comprehensive documentation of the patient’s pain ...

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Prolongement du projet pilote lié à la politique endodontique des SSNA, moyennant certaines conditions

Points clés Toutes les dents susceptibles d’être traitées sans prédétermination dans le cadre de la politique endodontique du Programme des SSNA doivent répondre aux deux critères suivants : un espace biologique suffisant (c.-à-d. 3 mm ou plus) un rapport couronne-racine d’au moins 1-1 Si vous avez le moindre doute, il est conseillé de faire une demande de prédétermination. Santé Canada a annoncé le prolongement d’un projet pilote lié au Programme des services de santé non assurés (SSNA) pour évaluer la possibilité d’éliminer la prédétermination exigée pour un traitement de canal standard des prémolaires et des premières molaires. Le projet lancé le 1er avril ...

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NIHB Endodontic Trial Extended With Strings Attached

Key Message All teeth considered for treatment without predetermination under the NIHB endodontic policy should meet the following criteria: •   adequate biologic width (i.e., 3 mm or more) •   a crown/root ratio of 1:1 or more If you have any doubts about a tooth meeting these criteria, you are advised to submit for predetermination. Health Canada recently announced an extension of a Non-Insured Health Benefits (NIHB) Program trial that assesses the feasibility of removing the predetermination (PD) requirement for standard root canal treatment (RCT) procedures on bicuspids and first molars. The trial, initiated on April 1, 2011, has been extended ...

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What are the reasons for the failure of posterior dental restorations?

This summary is based on the article published in the European Journal of Oral Sciences: Longevity of posterior dental restorations and reasons for failure (December 2012) Context and Purpose of the Study Tooth-coloured restorative materials are being used increasingly more often in Class II preparations in permanent teeth. The authors used a practice-based study design to assess the survival time of Class II restorations and to identify factors relevant to their longevity. Key Messages In this practice-based study, amalgam restorations showed significantly better longevity than resin composite.  Secondary caries were the most common reason for replacing resin-composite restorations. Failure of the resin-composite restorations was significantly related ...

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How safe is sedation for overweight/obese children?

This summary is based on the article published in the Pediatric Dentistry Journal: The safety of sedation for overweight/obese children in the dental setting (September/October 2012) Purpose of the Study Examine childhood overweight/obesity as a risk factor for adverse events during sedation for dental procedures. Key Messages Overall, weight percentiles were higher in children who had one or more adverse events. Similarly, patients with higher body mass index (BMI) percentiles were more likely to experience adverse events. Although preliminary in nature, these findings suggest that childhood overweight/obesity may be associated with adverse events during sedation for dental procedures. In the interim, practitioners should obtain ...

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Follow-up: Anti-infectives pediatric dosage

This is a follow-up post to the Refresher: Why use anti-infectives? A number of dentists inquired about the pediatric doses for the anti-infectives mentioned in the post. Sources of information: Lexicomp and e-Therapeutics.ca Amoxicillin Children ≤3 months: Oral: 20-30 mg/kg/day divided every 12 hours Children >3 months and <40 kg: Oral: 20-100 mg/kg/day in divided doses every 8-12 hours Children >3 months and ≥40 kg: Refer to adult dosing. Children ≥12 years: Oral: Extended-release tablet: 775 mg once daily Amoxicillin and Clavulanate Susceptible infections: Infants <3 months: Oral: 30 mg/kg/day divided every 12 hours using the 125 mg/5 mL suspension Mild-to-moderate ...

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