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Medically Compromised Patients

Managing Type 2 Diabetes in the Dental Practice

This post was prepared by Drs. Aviv Ouanounou and Suham Alexander    Diabetes occurs in approximately 6-15% of the general population and typically, in those over the age of 45 years. Up to 25-30% of the adult population over 65 years is diagnosed with some form of diabetes. Diabetes is the 6th most common cause of death and can result in blindness, end-stage renal disease, cardiac disorders as well as neuropathies. Type I Diabetes Insulin Dependent Diabetes Mellitus (IDDM) Also, known as Juvenile Diabetes Occurs mostly in young children and teens Affects ~10% of the diabetic population Destruction of beta ...

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CDA Oasis Conversations: Finding the Missing Link: Periodontal Disease and Cardiovascular Disease

Drs. Liran Levin and Maria Febbraio spoke with Dr. John O’Keefe about the latest research done at the University of Alberta’s School of Dentistry about the missing link between periodontal disease and cardiovascular disease. Watch the interview Dr. Liran Levin Dr. Levin is the Head of the Periodontology Division at the Faculty of Medicine and Dentistry, University of Alberta, Canada. He is also a visiting professor at the Harvard School of Dental Medicine, Boston, MA. Dr. Levin was the Head of Research at the School of Dentistry, Rambam Health Care Campus, and Faculty of Medicine – Technion IIT Haifa, Israel. Dr. ...

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Exploring Xerostomia in the Elderly with Dr. Aviv Ouanounou

Dr. Aviv Ouanounou explores with Dr. Suham Alexander the topic of xerostomia in the elderly patient.  Video Highlights Xerostomia or dry mouth is a common condition that occurs in the elderly population. In xerostomia, salivary flow is reduced. Because saliva has several important functions in the oral cavity including but not limited to antimicrobial effects, digestion, swallowing and speech, decreased salivary flow has many important implications. Prevalence in the elderly ranges from 45-50% compared to 10-14% in the general population 3 main causes in the elderly Use of non- and prescription medications Medical conditions such as salivary gland disorders (Sjogren’s syndrome), ...

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Exploring Epilepsy and Epileptic Drugs with Dr. Aviv Ouanounou

Dr. Aviv Ouanounou explores with Dr. Suham Alexander the topic of epilepsy and anti-epileptic drugs and their relevance to dentistry.   Video Highlights Epilepsy is one of the first diseases noted in history and it afflicts ~1% of the population. While most epileptics are well-controlled with medication, there is still a fairly high number of people that have uncontrolled seizures. In this video presentation, Dr. Aviv Ouanounou, discusses the pathophysiology, medications and dental implications of patients with this disease. 3 types of seizures – partial, generalized, status epilepticus Anti-epileptic drugs reduce voltage regulated Ca2+ channels, enhance GABA neurotransmission and interact with glutamate ...

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CDA Oasis Resource: Anesthetic Considerations for the Hypertensive Patient

This resource is provided courtesy of Wiley Publishing. Read and download the presentation (PDF) Watch the video presentation Source: Anesthesia Complications in the Dental Office, First Edition. Wiley Publishing, 2015.

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What are the dental considerations for treating patients suffering from acute adrenal insufficiency?

  Cortisol, a glucocorticoid produced by adrenal cortex is essential for the human body to survive in stressful situations. The deficiency of cortisol in the human body leads to adrenal insufficiency which in turn can compromise the individual’s ability to adapt to a stressful situation, such as a dental appointment. Adrenal insufficiency can manifest as loss of consciousness, a decrease in peripheral vascular resistance, shock, and ventricular asystole leading to death. Based on the underlying pathophysiology, adrenal insufficiency can be classified as primary adrenal insufficiency (Addison’s disease) due to autoimmune adrenalitis, and secondary adrenal insufficiency due to disuse atrophy of ...

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What precautions do I need to take with patients suffering from heart failure or acute pulmonary edema?

  Heart failure is described as the inability of the heart to fill and eject the blood or supply the proper amount of oxygenated blood to meet the metabolic needs of the body. Normal heart functioning is influenced by three basic factors: preload, afterload, and contractility of heart muscles. Preload is basically an end diastolic volume and a decrease in preload will decrease the amount of stroke volume ejected. On the other hand, afterload is defined as resistance to left ventricular ejection. The third factor, contractility, is the inherent property of heart muscle and is regulated by the sympathetic nervous ...

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Dr. Aviv Ouanounou: How important is polypharmacy in the elderly population?

Dr. Aviv Ouanounou discusses the topic of polypharmacy including the causes and ways to reduce this phenomenon in the video below. Video Highlights Polypharmacy is fairly common in the elderly, affecting approximately 1 in 3 elders and is one of the leading causes of death in North American geriatric patients. The term polypharmacy refers to patients who take more than 9 medications than are clinically warranted. As patients take more medications, they incur a corresponding cost increase, a higher probability of prescription errors given the multiple medications, as well as an increased incidence of drug interactions and adverse drug reactions. Polypharmacy can lead ...

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