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Supporting Your Practice

What is the most effective antibiotic therapy for an acute odontogenic infection?

(Content under development) The following question was submitted by a practising dentist: What is the most effective antibiotic therapy for an acute odontogenic infection? If you ask the oral surgeons they say doxycycline , when you ask the infectious disease specialists they say amoxicillin. In the literature some papers state clindamycin and then others the combination of flagyl. JCDA Editorial Consultant Dr. Mark Donaldson of Kalispell, Montana provided this initial response for consideration: The correct antibiotic is the one that works! If we remember that the basic tenet of infectious diseases is to match the right drug to the right ...

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Advice on fluoride supplements for children in non-fluoridated areas

(Content under development) The following question was submitted by a practicing dentist: As I now practice in a newly “non-fluoridated” area I am looking at my recommendations for supplemental fluoride for my pediatric population. Are there any universally adopted guidelines available? JCDA Editorial Consultants Drs Felicity Hardwick of Nanaimo and Sarah Hulland of Calgary provided this initial response for consideration: Since the question relates to a newly non-fluoridated area we would firstly recommend that the dentist check that water fluoride status is indeed below the recommended optimal level of 0.7 ppm. Before prescribing fluoride supplements, a thorough clinical examination, dental ...

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Does placing a resin coating on a setting GIC impair fluoride release?

(Content under development) The following question was submitted by a practising dentist: Is there any solid evidence that the coating recommended for Resin Based Glass Ionomer Restorations impedes the release or uptake of Fluoride? JCDA Editorial Consultant Dr. Alan Kilistoff of the University of Alberta provided this initial response for consideration: The immediate answer is yes, but in context it is probably not clinically significant.  An article from Mazzaoui et al, demonstrates that fluoride release is about 75-90% less available after coating with a resin adhesive, but that fluoride is still available. The main purpose of the coating is to ...

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Does use of local antibiotic as an adjunct to flap surgery confer benefit?

(Content under development) The following question was submitted by a practising dentist: What is consensus on using local antibiotic with or without flap involvement? Is raising a flap and using antibiotics significantly better than without? JCDA Editorial Consultant Dr. Debora Matthews of Dalhousie University provided this initial response for consideration: When we talk about using antibiotics for our patients we have to think about the risk/benefit ratio. While the risk of systemic side effects is low, other potential risks exist, including increasing bacterial resistance, and the potential for allergic reactions. It is important to ask ourselves if these risks (for ...

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Does deep periodontal pocket disinfection with a soft tissue diode laser work?

(Content under development) The following question was submitted by a practising dentist: What clinical evidence is available for the efficacy of deep periodontal pocket disinfection with a soft tissue diode laser? What protocols are proven and recommended in terms of frequency of treatment? JCDA Editorial Consultant Dr. Debora Matthews of Dalhousie University provided this initial response for consideration:  There are two issues related to this question. The first is, does a soft tissue diode laser disinfect periodontal pockets (pocket disinfection therapy, or PDT)? The more important question, however, is whether diode lasers provide any additional clinical benefit over traditional scaling ...

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How was that case with the missing 2.2 treated?

Last month, JCDA OASIS and ITI, initiated Phase 1 of a joint treatment planning challenge pilot project. Just over 100 colleagues had agreed to participate in this exercise and many gave us feedback on a completely anonymous basis. For Phase 2 of the project, We have placed links below to a representative sample of the inputs we got from over 50 Canadian dentists to the following 3 principal questions: Q 1: What further information is needed to create a treatment plan?  Question 1 Input Q 2: What range of options would you present to the patient?  Question 2 Input Q 3: ...

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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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