Blogs

Beware the "Mount Everest Toothache."

We all have patients who complain that a sore tooth feels like it's going to explode, but did you know this is actually possible in certain circumstances? Incisor takes a look at barodontalgia.

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Mouth-To-Body Infections: What's the Actual Risk?

Experts are conflicted on whether antibiotic prophylaxis is necessary to treat patients with heart stents, knee replacements or other implanted surgical appliances. Get the facts here.

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Sedation of Patients with Benzodiazepine Allergy

What are the options when you cannot relieve a patient's anxiety with benzodiazepine medication? DOCS Education faculty weigh in.

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You'll Never Guess Which Famous People Used to Be Dentists

A career in dentistry can lead many places, from the Old West to the Silver Screen. Check out these historical and contemporary figures who got their start on the humble handpiece.

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"My Patient Eats Bricks!" – Problematic Patterns in Patients with Pica

Lots of activities can cause dental damage, but what do you do about patients who are compelled to eat non-food items?

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Moving Forward After a Break-In

When a DOCS member experiences a break-in damaging her DEA Cabinet, what should she do to continue serving the patients scheduled for the next day?

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Study Finds Women Predisposed to Develop Dry Socket

An analysis published in the Journal of the American Dental Association suggests that women may be predisposed to alveolar osteitis as a result of higher estrogen.

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Oral Cancer Risk may be Increased by Gum Disease Bacteria

Periodontitis associated bacteria have been found to secrete metabolic by-products that could lead to an increased risk for a type of oral cancer.

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Flossing for the High Score - Motivation in the 21st Century

Could goal-tracking software help patients maintain oral hygiene? The next step in getting patients to floss might be one of these apps.

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Promising New Painkillers in Development

Could researchers be on the brink of discovering a brand-new class of painkillers?

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A member of DOCS Education writes: I have a 55 year old female being treated for central adrenal insufficiency, multiple sclerosis, hypertension, hypercholesterolemia, ADD, hypothyroidism and hormone replacement therapy. All are well controlled at this time. Her physician has recommended tripling her dose of Cortef® the day of surgery. She has been a patient for years and is very relaxed in the chair, even for long appointments.
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A Member of DOCS Education asks: I have a 61 year old, 175 lbs female patient requiring a long sedation appointment. She is currently taking Advair®, Cartia XT®, losartan HCT and fenofibrate. Due to the medication interactions we cannot use diazepam or triazolam. Would it be possible for me to use lorazepam the night before, and if so, at what dosage should it be administered? Then at what incremental and loading dose should the lorazepam be given an hour prior to the appointment? After assessing the patient on arrival, what dose of hydroxyzine should be given? Finally, what incremental doses of lorazepam should be given at what intervals?
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A member of DOCS Education writes: I have been sedating patients for over ten years but I wanted your help. I have an 85 year old insulin-dependent diabetic patient that has requested sedation. Her BP reads 146/74, pulse 69. She takes 20 units of Lantus® insulin at 100 unit/ML once a day and 15 units of Humalog® insulin at 100 unit/Ml once a day. If I were to sedate her, should she eat a small dinner and her normal small breakfast and not take any insulin on the day of sedation? Other medications the patient is taking are: amlodipine 5mg, lovastatin 40 mg, quinapril GCL 10 mg, HCTZ 12.5 mg, aspirin 325 mg, 2 x 220 mg Aleve®, CalCarb 600/D 600-400 MG-unit. The patient does not have asthma or any breathing issues but I don't feel comfortable with sedation.
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A member of DOCS Education asks: I have a patient interested in sedation but I have several concerns with her health. The patient has lupus, sarcoidoisis and rheumatoid arthritis. My practice is located in VA and, therefore, I am only able to use single dose protocols. With the fact that she takes Azathrioprine, Ventolin® and Hydroxycholorquine for her systemic issues, would you recommend IV sedation instead of oral? Patient is coming in tomorrow for a consultation and I have been waiting to get the medical consults back. Her primary care physician took no issue with the use of normal protocols, but I am not comfortable doing that. I have yet to hear from her pulmonary physician or the rheumatoid doctor. What would your advice be for this case? Thank you.
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A member of DOCS Education writes: Our office has been doing oral conscious sedation for several years now and, thankfully, we have never faced an emergency situation with a patient. There are two questions that arise from my patients and my staff that we would appreciate input on.
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A member of DOCS Education writes: I have an upcoming patient who is a 21-year-old male with Landau-Kleffner syndrome that is to be sedated for a two-surface filling. The patient was seen by another dentist four years ago, and at that time was given two .25mg tabs of Triazolam prior to dental work. The patient has Autism-type movements and struggles to sit still, making monitoring difficult.
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