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Which medications are most effective for moderate to severe post-operative dental pain?

The following question was posted by a practising dentist: There is quite a bit of variation in the office with respect to drugs dentists like to prescribe for post-operative pain. Which pain medications are the most effective for moderate to severe pain and have the least number of side effects? Dr. Mark Donaldson from the University of Montana and the Oregon Health & Sciences University provided this initial response: The goal should be: “the most effective dose for the shortest period of time.”  We want to get our patients out of pain as quickly as possible. Two good recent articles come to ...

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What is the QT-Prolonging effect of Epinephrine on Patients Taking SSRIs?

The following question was submitted by a practicing dentist: What may happen with patients who have a prolonged QT due to their SSRI or Prozac medication when they are administered a local anesthetics-containing epinephrine? The following response is provided by Dr. Joonyoung Ji, resident in the Department of Dental Anesthesia at the University of Toronto Main take-away message Epinephrine, stress, and using more than one psychotropic increases the QT interval. The majority of patients have significant medical co-morbidities in reported cases of arrhythmia associated with psychotropics. Therefore, limiting the use of epinephrine to under 40 mcg or no more than 2 cartridges of ...

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Can you visualize the medical data explosion?

With the explosion of cone beam CT the amount of data being generated is staggering. Anders Ynnerman gives a TED talk about how data is being stored and re-processed to help us better understand the human body. He covers the size of the data explosion, virtual autopsy, functional MRI and more. A very interesting lecture.

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Did you know: How much sugar the average Canadian consumes?

From Dr. Hans Skariah Did you know how much sugar the average Canadian consumes? The average Canadian consumed 26 teaspoons of sugar a day in 2004. (Wow!) Source: Statistics Canada, http://www.statcan.gc.ca/pub/82-003-x/2011003/article/11540-eng.htm (read on Nov 25/2012)

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My next patient is diabetic: what are the implications for the dental treatment I provide?

(Peer-reviewed content that will appear in the JCDA OASIS “point of care” searchable database at www.jcdaoasis.ca – which will be introduced at the beginning of 2013. Diabetes Mellitus Diabetes mellitus (DM) is a disease of glucose, fat, and protein metabolism characterized by hyperglycemia, which results from impaired insulin secretion or varying degrees of insulin resistance, or both. • Types: Type 1 DM, Type 2 DM, Gestational DM Local Anesthetic Precautions  Use vasoconstrictors with caution: Routine use of local anesthetic with 1:100,000 epinephrine is generally well tolerated. However, epinephrine has a pharmacologic effect that is opposite to that of insulin, so blood glucose could rise ...

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Managing the patient claiming to be allergic to dental materials

I recently sent the following message to the members of the JCDA Restorative Dentistry Expert Panel Question A lady called the CDA office today distraught because she has called 21 dental offices seeking treatment, and all have refused her. She tells us that she is allergic to 9 different materials using in dental offices. She claims that because of the complications she would present to a general dental office, they are refusing to treat her.   Do you have any advice that we could give her please? Is there any practical “next steps” advice that we can pass on to ...

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