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Supporting Your Practice

How do you manage pain due to food impaction?

This Urgent care Scenario (USC) is presented by the JCDA Oasis Team in collaboration with Dr. Samer Nuwwareh. The USC is also available through the Oasis Help system Food impaction is the forceful wedging of food into the periodontium by occlusal forces. It may occur as a consequence of gingival tissue recession or disease, caries, severe attrition, plunger cusp, or inappropriate interproximal contact and clearance.     Resources Gastaldo JF, Cury PR, Sendyk WR. Effect of the vertical and horizontal distances between adjacent implants and between a tooth and an implant on the incidence of interproximal papilla. J Periodontol. 2004;75(9):1242-6. Hancock EB, Mayo ...

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What is subluxation and how is it treated?

This post is an adaptation of the Subluxation article found in the Dental Trauma Guide Description An injury to the tooth supporting structures resulting in increased mobility, but without displacement of the tooth. Bleeding from the gingival sulcus confirms the diagnosis. Diagnosis An injury to the tooth supporting structures resulting in increased mobility, but without displacement of the tooth. Bleeding from the gingival sulcus confirms the diagnosis Visual signs: Not displaced Percussion test: Tender to touch or tapping Mobility test: Increased mobility Pulp sensibility test: Sensibility testing may be negative initially indicating transient pulpal damage. Monitor pulpal response until a ...

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How to improve patient safety?

This summary of evidence is based on the Annals of Internal Medicine Supplement (Ann Intern Med. 2013;158:365-368) and on the report by the Agency for Healthcare Research and Quality: Making Health Care Safer II: An Updated Critical Analysis of the Evidence for Patient Safety Practices Annals of Internal Medicine Supplement Full Report (PDF) Structured Abstract Study Objective To review important patient safety practices for evidence of effectiveness, implementation, and adoption. Data Sources Searches of multiple computerized databases, gray literature, and the judgments of a 20-member panel of patient safety stakeholders. Results From an initial list of over 100 patient safety practices, ...

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Should the transmission (gears) inside prophy heads and slow speed hand pieces be sterilized between patients?

This question was submitted by a general dentist: “Should the transmission (gears) inside prophy heads and slow speed hand pieces be sterilized between patients? I find to my surprise that assistants and hygienists leave these on the angle nose cones.” A quick initial response is provided by Dr. Nita Mazurat, Associate Professor in the Faculty of Dentistry at the University of Manitoba, representing the Organization for Safety, Asepsis and Prevention (OSAP) 1. Should all hand pieces be sterilized following patient use? The recommendations from the Center for Disease Control (CDC) “Guidelines for Infection Control in Dental Health-Care Settings – 2003” is “to ...

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How useful is three-dimensional imaging in predicting a positive outcome for intentional tooth replantation?

This abstract is presented by the JCDA Oasis Team from the article published in the Journal of Oral Sciences (Open Access): The usefulness of three-dimensional imaging for prognostication in cases of intentional tooth replantation Authors Hiroaki Kabashima, Section of Periodontology, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka, Japan Kunitaka Mizobe, Section of Periodontology, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka, Japan Takako Sakai, Section of Fixed Prosthodontics, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka, Japan Hiroyoshi Nakamuta, Private Practice, Fukuoka, Japan Kenichi Kurita, Section of Fixed Prosthodontics, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, ...

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How can you deliver effective oral hygiene instruction to children with autism?

This question was submitted by a general dentist: “How can we deliver effective oral hygiene instruction to children with autism?” Dr. John O’Keefe, Director of Knowledge Networks at CDA interviewed Dr. Clive Friedman,  past President of the International Association for Disability and Oral Health (IADH) and current member of IADH Education Committee Understanding your patient is crucial The key to success in treating an autistic child is to follow an approach based on understanding the patient, not only in terms of their diagnosed condition, but also of their psychosocial environment. It is important to understand where a child fits on ...

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Are there any trials to inform the treatment of displaced luxated permanent teeth?

This review summary is adapted from The Dental Elf blog post on May 1st 2013: Cochrane Review finds no trials to inform the treatment of displaced luxated permanent teeth Cochrane Authors’ Conclusion “We found no randomised or quasi-randomised trials of interventions to treat displaced luxated permanent front teeth. Current clinical guidelines are based on available information from case series studies and expert opinions. Randomised controlled trials in this area of dental trauma are required to robustly identify the benefits of different treatment strategies.” To read the post and review the review sources, click here   The Cochrane Collaboration Cochrane Reviews ...

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How do I treat a patient with hemophilia?

This Medical Condition Consult is presented by the JCDA Oasis Team. It is also available through the Oasis Help system Our sincere thanks go to the MDs who developed and reviewed this medical consult.  Hemophilia is a hereditary bleeding disorder caused by low factor VIII coagulant activity (hemophilia A) or low levels of factor IX coagulant activity (hemophilia B). Both forms have an X-linked recessive pattern of inheritance. Men are usually affected. Women are carriers. Hemophilia Severity Classification Mild: No spontaneous bleeding; delayed onset of bleeding after trauma, surgery, or dental extractions (6%–49% of the normal clotting factor). Moderate: Bleeding with minor ...

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