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Preventive Dentistry

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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How do you manage a severely disabled and G tube-fed patient?

This question was submitted by a general dentist: Is there a resource with current information on appropriate oral care for severely disabled and G tube-fed population? There are many position papers and guidelines indicating that this population needs care. However, I found only limited information on the actual clinical treatment provided to them and on what the treatment goals should be. These patients often present with gross calculus, limited cooperative ability for professional cleaning, and present with the risk of an aspiration pneumonia. Any attempt to clean the teeth in the office is limited at best, then the question is: what ...

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Tips on assessing patients with orofacial pain and temporomandibular disorders

This summary is based on the article published in the Dental Clinics of North America: Clinical assessment of patients with orofacial pain and temporomandibular disorders (October 2013) Key points Accurate diagnosis of chronic pain disorders of the mouth, jaws, and face is frequently complex because there are multiple structures localized in 1 small anatomic region that can be a source of painful sensations. Pain can originate from multiple structures including teeth, sinus, eye, nerves, blood vessels, temporomandibular joint, and masticatory muscle sources.  It is common for patients with chronic orofacial pain to consult multiple clinicians and receive an incorrect diagnosis and receive ineffective treatment ...

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What are some of the clinical approaches to oral mucosal disorders?

This summary is based on the Preface article published in the Dental Clinics of North America: Clinical Approaches to Oral Mucosal Disorders (October 2013) Dr. P. Sollicito, DMD, FDS, RCSEd Dr. Eric Stoopler, DMD, FDS, RCSEd Oral health and disease are intimately related to general health status. Clinicians understand that the oral cavity does not exist in isolation, but as an integral component of the human body. The oral cavity and peri-oral region consist of various tissues that are not unlike other organ systems, including mucous membranes, nerves, ligaments, and bone. The oral cavity is perhaps more intricate than other areas because, in addition ...

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Could Chlorhexidine varnish be effective in preventing root caries?

This summary is based on the Critical Summary published in the Journal of the American Dental Association: Use of chlorhexidine varnish to prevent root caries may benefit some patients (September 2013) Clinical Question The critical summary was in response to the following question: “Does the application of CHX-V reduce the incidence or activity of root caries in adult patients with gingival recession compared with that in adult patients who do not receive CHX-V application?” Key Message Chlorhexidine varnish (CHX-V) may be effective in preventing root caries in the absence of regular professional tooth cleaning and oral hygiene instructions for patients who need special care. Clinical Implications Although ...

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Is there a relationship between GERD and dental erosion?

This summary is based on the Critical Appraisal published in the Journal of Esthetic and Restorative Dentistry: Dental Erosion (June 2013) Context Dental erosion or erosive tooth wear not only can be caused by extrinsic (dietary) acids but also intrinsic acids. Historically, anorexic and bulimic patients have been the population dentists have had to be aware of, but with the increasing prevalence of gastroesophageal reflux disease (GERD) in the general population, another population must be monitored. Tooth wear is usually multifactorial, and it is often difficult to assign a specific etiology; abrasion, attrition, and erosion must all be considered as potential etiologies. This critical ...

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How would you treat a patient with neuropathic orofacial pain?

This summary is based on the article published in the Journal of the American Dental Association: Dental treatment for patients with neuropathic orofacial pain (September 2013) Clinical Case A 56-year-old woman visited a dental office with acute dental pain in the left mandibular molar area. The treating dentist established a diagnosis of trigeminal neuralgia (TN) related to the left V3 branch, for which the patient was treated with nerve membrane–stabilizing anticonvulsants. The patient’s medical history included mild hypertension, hypothyroidism and intermittent low back pain for which she was being treated adequately by her physician.  The clinical examination revealed the left mandibular permanent first molar (tooth ...

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What should you tell your patient about quitting smoking?

This fact sheet is courtesy of the Centers for Disease Control and Prevention: Smoking and Tobacco Use PDF version  Do you have any particular question on this topic? Do you have any comments or suggestions? Email us at oasisdiscussions@cda-adc.ca You are invited to comment on this post and provide further insights by posting in the comment box which you will find by clicking on “Post a reply“ below. You are welcome to remain anonymous and your email address will not be posted.  

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