This post is based on a Q&A published on the Nordic Institute of Dental Materials website Can a patient react against composite resin fillings when he or she has been diagnosed with a contact allergy to epoxy? Should existing composite fillings be removed, and placement of new fillings avoided? Could resin-based luting cements pose a risk of allergy? The potential cross-reaction between BIS-GMA − a commonly used constituent of many composite resins − has been a matter of concern. However, an association has not been established. BIS-GMA has chemical similarities with epoxy, but contains an acrylic moiety, which is ...Read More »
Medically Compromised Patients
This question was submitted by a general dentist: Does anyone have a polite and professional way to address the HPV issue with patients in a dental office setting? Drs. Nita Mazurat, from the University of Manitoba, and Suham Alexander provided a quick initial response. The major role of the dentist with respect to HPV is to provide a head and neck examination, to encourage patients to perform regular self-examinations, to encourage adult patients and parents of appropriately aged children to consider having HPV vaccine, and to refer patients with suspicious lesions or persistent symptoms. The patient’s health history, particularly any verbal ...Read More »
This summary is based on the article published in the Journal of Dental Research: Diabetes and oral implant failure: a systematic review (September 2014) B.R. Chrcanovic, T. Albrektsson, and A. Wennerberg Context Dental implant survival is initially dependent on successful osseointegration following placement. As an implant is restored and placed into function, bone remodeling becomes a critical aspect of implant survival in responding to the functional demands placed on the implant restoration and supporting bone. The critical dependence on bone metabolism for implant survival may be heightened in patients with diabetes (1). Diabetic patients have increased frequency of periodontitis and ...Read More »
How do you treat a patient with scleroderma who has periodontal issues – advanced recession, stripping of the attached gingiva from the roots?
This question was submitted by a general dentist: How do you treat a patient with scleroderma who has periodontal issues – advanced recession, stripping of the attached gingiva from the roots? Dr. George Sandor, DDS MD and Dr. Suham Alexander, Oasis Clinical Editor provided this initial response. Systemic Scleroderma Systemic scleroderma is a relatively rare condition that affects ~19/1,000,000 adults annually. Women experience the condition 3 times more than men. A vasoconstrictive event known as Raynaud’s phenomenon is often one of the first signs of the disease which is precipitated by emotional distress or exposure to cold. (It should ...Read More »
This question was submitted by a general dentist: Is it safe to use vasoconstrictors in patients with sickle-cell disease? Which one is the best choice? Could I perform a painless dental extraction without vasoconstrictors in these cases? Dr. George Sandor, DDS MD and Dr. Suham Alexander, Oasis Clinical Editor provided this initial response. Sickle Cell Anemia Sickle cell anemia is a genetic disorder of hemoglobin synthesis occurring predominantly in African, Mediterranean and Asian populations. Affected individuals with carrying one allele have the sickle cell trait and may experience some sickling with exercise or in high altitudes due to lower oxygen tensions. ...Read More »
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 ...Read More »
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 ...Read More »
This summary is based on the article published in the British Dental Journal: General medicine and surgery for dental practitioners: part 3. Management of specific medical emergencies in dental practice (August 2014) M. Greenwood and J. G. Meechan Note: The article could contain medication that is not similarly labelled in Canada. Purpose of the Article The actions needed to manage specific medical emergencies are discussed. Each emergency requires a correct diagnosis to be made for effective and safe management. Contemporar The article: Discusses treatment for specific emergencies and where appropriate the drugs used. Recognises signs and symptoms of relevant ...Read More »