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Medicine

Are there any approaches to caries prevention and therapy for the elderly?

This summary is based on the article published in Advances in Dental Research: Approaches to Caries Prevention and Therapy in the Elderly (September 2013) Context The population of the world is aging. A greater proportion of older people are retaining increasing numbers of natural teeth. Aging is associated with changes in oral architecture and muscle weakness, making personal oral hygiene more difficult, particularly for the oldest and most frail individuals. Furthermore, there is exposure of root dentin with its higher pH for demineralization in addition to enamel as a substrate for caries. Aging is also associated, for many in the developed world, with taking multiple medications, with the associated ...

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How efficient are Toluidine Blue and Brush Biopsy in diagnosing oral lesions?

This summary is based on the article published in the International Journal of Oral and Maxillofacial Pathology: Efficacy of Toluidine Blue and Brush Biopsy in Oral Lesions (January 2013) Context Oral cancer is a global health problem and its early detection is of prime importance. In vivo stains and brush biopsy have emerged in recent years to aid as clinical diagnostic tools.  Purpose of the Study The study assessed the efficacy and accuracy of Toluidine blue and brush biopsy in comparison to wedge biopsy in patients with oral pre-malignancies and malignant lesions.  Key Messages The combined evaluation of Toluidine blue ...

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What will it be: Ibuprofen or acetaminophen for pain relief after surgical removal of lower wisdom teeth?

This summary is based on the Cochrane systematic review: Ibuprofen versus paracetamol (acetaminophen) for pain relief after surgical removal of lower wisdom teeth  Context Both paracetamol and ibuprofen are commonly used analgesics for the relief of pain following the surgical removal of lower wisdom teeth (third molars). In 2010, a novel analgesic (marketed as Nuromol) containing both paracetamol and ibuprofen in the same tablet was launched in the United Kingdom. This drug has shown promising results to date and there is a need to compare the combined drug with the single drugs using this model. In this review, the optimal doses ...

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Why must you know about your patients’ pharmacological history?

By Drs. Jacob Fitzgerald, Joel Epstein, Mark Donaldson, Karen Fung, Gordon Schwartz, Cameron Jones Classes of medications reported by patients (PDF) There are many reasons why we need to be aware of the medications that our patients are taking. We need to make sure that there are no adverse reactions to these medications with the treatments or drugs that we prescribe. Additionally, we need to have an understanding of the effects these medications on the oral environment. Importantly, knowing exactly what a patient takes can also provide insight into their medical conditions. Some medications have oral side effects upon saliva, mucosa ...

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Which are safe drugs for patients suffering from renal failure?

This information is courtesy of Dr. Mark Donaldson Dr. Mark Donaldson is Director of Pharmaceutical Services at the Kalispell Regional Medical Center,  Clinical Professor in the Department of Pharmacy at the University of Montana, and Clinical Associate Professor in the School of Dentistry at the Oregon Health and Sciences University Safe Drugs in Renal Failure (PDF)   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 ...

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How do you treat an oral infection in a patient with a history of C. Difficile?

This question was submitted by a general dentist: A patient presents with an oral infection for which I would like to consider antibiotics as part of overall care. However, she has a history of C.Difficile infection and there is concern that the antibiotic chosen might reactivate the residual C.Difficile in her gut. What is the best course of action in treating the oral infection? Dr. Dan Haas, DDS, PhD, FRCD(C) Professor and Dean, Arthur Zwingenberger Decanal Chair, Faculty of Dentistry at the University of Toronto Dr. Dan Haas provided the following quick and initial response:  A recent history of Clostridium Difficile-associated colitis ...

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Misuse of opioid pain medication in dentistry: Fact or fiction?

Derived from the Chronic Orofacial Pain Workshop of the Network for Canadian Oral Health Research, IMHA, Canadian Institutes of Health Research, Montreal, November 2013 Gilles Lavigne, DMD, PhD, FRCD,  Professor, Faculté de médecine dentaire, Université de Montreal Mary Lynch, MD FRCPC,Professor Anesthesiology Psychiatry Pharmacology,Dalhousie University, To understand the misuse of prescription opioid analgesics (POA), it is critical to examine the definitions used in the research. The Canadian Alcohol and Drug Use Monitoring Survey (CADUMS) is an ongoing national survey that examines alcohol and drug use in Canadians 15 years of age and older. CADUMS defines the nonmedical use of prescription ...

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Are local anesthetics still controversial for patients taking oral anticoagulants?

This summary is based on the article published in the British Journal of Oral and Maxillofacial Surgery: Safety of local anaesthesia in dental patients taking oral anticoagulants: is it still controversial? (January 2012) Purpose of the Study To investigate the safety of local infiltration techniques and the inferior alveolar nerve block (IANB) in dental patients taking oral anticoagulants. Main Findings Bleeding as a result of the use of local anaesthesia in patients with therapeutic INR is unlikely, provided that the IANB is done correctly. IANB in patients with INR within therapeutic range is safe. Haemorrhagic complications after local anaesthesia, including the IANB (possibly even other nerve blocks), ...

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