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Pharmacology

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Herbal-Drug Interactions Important to Dentistry

Dr. Mark Donaldson spoke about the prevalence of herbal medicine and why it is important for dentists to know their interactions with more conventional drugs.   This topic is the focus of a CE course offered by Dr. Mark Donaldson. You can access the entire course material by following this link.  We would like to thank Dr. Donaldson for allowing us to share the course material.    

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Evidence-Based Recommendations for Analgesic Efficacy to Treat Pain of Endodontic Origin

Dr. Anita Aminoshariae, Director of Predoctoral Endodontics in the School of Dental Medicine at Case Western Reserve University, spoke to Dr. Chiraz Guessaier regarding evidence-based recommendations with respect to the analgesic efficacy when treating pain of endodontic origin. Third molar extraction usually serves as the pain model for evaluating analgesic efficacy. However, these patients are usually young without any comorbidities or significant health risks or issues. Endodontic patients, typically, are older individuals who may be taking medications for existing conditions and have periapical infection and/or pulpal inflammation. Key Findings • NSAIDS are the drug of choice unless there are clear ...

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What are some of the implant complications associated with systemic disorders and medications?

This summary is based on information found in Dental Implant Complications: Etiology, Prevention, and Treatment, 2 (Wiley Publishing, 2015) Key messages Patient selection is the critical factor for implant success and survival in any medically complex situation. When medical conditions are managed wisely, most patients have improved overall health with fixed replacements as opposed to removable appliances. Exceptional care must be taken so that any implants placed will be successful and safe for the clinician and the patient. It is essential to routinely review the literature and expect that protocols for patients with systemic diseases or taking medications will be regularly updated as our knowledge of dental implants advances.   Although ...

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To stop or not to stop anticoagulants in patient prior to dental surgery?

Dr. Jose Lança, from the Faculty of Dentistry and the Faculty of Medicine at the University of Toronto, speaks with Dr. John O’Keefe about the important decisions dentists need to make when treating patients who are on anticoagulants and who need dental surgery: should they, or not, ask the patient to stop taking their anticoagulant medication? Highlights The monitoring of warfarin anticoagulation is aimed at conventional anticoagulation INR of 2.0-3.0 (normal INR:0.9-1.1). Intensive anticoagulation is defined as an INR of 2.5-3.5, and critical values of >4.5-5.0. Do not be quick in discontinuing oral anticoagulants just because the patient might experience ...

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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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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 Conversation: EpiPen Efficacy & Safety – What Every Dentist Needs to Know with Dr. Mark Donaldson

Dr. Mark Donaldson, Director at VHA, US health care network of not-for-profit hospitals, speaks about the safety and efficacy of the long-used EpiPen. Highlights Epinephrine is one of the most important medications in an emergency kit. It is the reversal agent required for anaphylactoid reactions. EpiPen In most cases, there should be 3 EpiPens or EpiPen, Jr. in the office if treating an adult or pediatric patient, respectively. An ampule of epinephrine has a longer shelf life than an EpiPen. There is a high risk and incidence of auto-injection of health care professionals when attempting to administer the medication to the ...

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