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Medically Compromised Patients

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CDA Oasis Conversations: Dr. Archie Morrison speaks about the update to the systematic review on osteonecrosis of the jaw

In this short interview, Dr. Archie Morrison speaks about the update to the 2009 systematic review on osteonecrosis of the jaw.  List of authors and their affiliations (PDF) Highlights of the updated review Spontaneous resolution of ONJ is possible. Early treatment recommendations discouraged surgical intervention, with conservative therapy continuing indefinitely or until there was progression of disease. Others have had reasonable success with surgical management. There is still no comfortable proven treatment algorithm for the various stages of this disease. The International Task Force believes that surgical intervention is required for Stage 3 disease and for those Stage 2 patients that are ...

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Case Conference: How would you manage this case?

This case is presented by Dr. Aviv Ouanounou from the Faculty of Dentistry at the University of Toronto. Watch the Case Presentation   We welcome your input about this topic. You have the option to remain anonymous in leaving your feedback. Please note that all your comments are moderated by the CDA Oasis Team and no comments go live immediately. Your feedback is sent to us in the form of an email which is accessed by the CDA Oasis Team and is not shared by a third party. You can safely leave your name and email allowing us to contact you, ...

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Acetaminophen: a new foe?

This summary is based on the article published in the Journal of Endodontics: Acetaminophen: Old Drug, New Issues (May 2015) Anita Aminoshariae, DDS, MS, and Asma Khan, BDS, PhD Context The Food and Drug Administration (FDA) Drug Safety Communication states that ‘‘acetaminophen-containing prescription products are safe and effective when used as directed, though all medications carry some risks’’ (2). During the past decade, acetaminophen has been identified as the leading cause of acute liver failure in the United States, and up to 50% of the cases are caused by an unintentional overdose (3–6). In 2011, confirming acetaminophen as a dose-dependent ...

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Should vasoconstrictors be avoided in any patients with cardiovascular disease?

In patients at major risk of developing perioperative cardiovascular complications, vasoconstrictors should be used only in consultation with the patient’s physician who may recommend that vasoconstrictors be avoided. This high-risk category includes the following conditions: Acute or recent MI (between 7 to 30 days prior); Decompensated heart failure; and Significant arrhythmias (e.g., AV block, ventricular-related arrhythmia). Some studies have shown that very modest quantities of a vasoconstrictor are safe in these high-risk patients when accompanied by oxygen, sedation, nitroglycerin, and adequate pain control.   Source: Dental Secrets, Elsevier, 2015

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Is it safe to treat a patient who has undergone heart transplantation in an outpatient dental office?

Elective dental treatment should be avoided during the first 3 months after heart transplantation. During this period, various systemic complications and infections are common because the patient is receiving an intensive course of immunosuppressive medications. Emergency dental treatment can be provided in consultation with the patient’s physician. If treatment is required during these first 3 months, antibiotic prophylaxis should be administered. Emergency dental treatment should be completed only after consultation with the patient’s cardiologist. In the stable post-transplantation period (usually after 3 months, but the timing is determined in consultation with the physician), heart transplant patients can receive elective dental treatment. The use of prophylactic antibiotics during ...

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CDA Oasis Resource: Understanding Substance Use Disorders, Drug Diversion and Pain Management

This resource is provided courtesy of Wiley Publishing and the American Dental Association.  Read and download the resource in PDF     Watch the video presentation  

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CDA Oasis Conversations: Dr. Aviv Ouanounou speaks about medication abuse among the elderly population

Dr. Aviv Ouanounou spoke with Dr. Suham Alexander about medication abuse among the elderly population and what considerations should the oral health care professional take when treating an elderly patient. Dr. Aviv Ouanounou is Assistant Professor, Pharmacology, in the Faculty of Dentistry at the University of Toronto.     Watch the vide interview  

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Update for dentists: Osteonecrosis of the jaw

This paper is an adaptation, with permission, of the recent systematic review published in the Journal of Bone and Mineral Research by the International Task Force on Osteonecrosis of the Jaw. Archibald Morrison, DDS, MS, FRCD(C); Aliya Khan, MD, FRCPC, FACP, FACE; Sotirios Tetradis, DDS, PhD; Edmund Peters, DDS, MSc, FRCD(C) Read the full article (PDF)   This work provides a systematic review of the literature from January 2003 to April 2014 pertaining to the incidence, pathophysiology, diagnosis, and treatment of osteonecrosis of the jaw (ONJ), and offers recommendations for its management based on multidisciplinary international consensus. Purpose of the ...

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