Blogs

Herbal Remedies and Sedation Medications: Know the Dangers

Find out how the use of seemingly-innocuous herbal supplements might affect patient response to your procedures. What are the ingredients you need to watch out for?
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Are You Ready for the New Boom in Pediatric Dentistry?

Pediatrics is the fastest-growing market in dentistry. Dr. Roger Sanger explains how DOCS Education's updated protocols can keep you on top of the new wave.
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Resolution 77: The Most Monumental Mistake the ADA Could Ever Make

The ADA is voting on revised sedation guidelines, known as Resolution 77, on November 10. The resolution will obliterate oral sedation dentistry—and put you and your patients at risk.

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One Step Closer to an Enamel Restorative Treatment

Researchers in England report progress in the search for an effective restorative agent that can curtail infection and sensitivity. If dentinal tubules, nanoparticles and fluorosurfactants are your thing, keep reading.

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Why Anesthetics Aren't Effective for Long Cases

A member has been on a losing streak when it comes to keeping his patients numb and comfortable for restorations. Why isn't the anesthetic as effective?

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The Single Most Important Reason Why Every Dentist Needs Advanced Life Support Training

It's inarguable, infallible and undisputable. Just ask veteran dentist and longtime DOCS Education Member Dr. Steve E. Chamish.

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Millennials Prefer Dentists to the Banking Industry

A study shows that Millennials are primed to wreak havoc on the banking industry, which has nothing to do with dentistry. Or does it?

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Is it Safe to Sedate a Bipolar, Diabetic Smoker with Active Hep. C?

A patient presents with multiple medical conditions, including bipolar disorder, diabetes and an active HCV infection. To top it all off, she's a smoker. Should the clinician proceed with oral conscious sedation?

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Why Google and the Movie Industry are Fighting over Dental Aligners

A lawsuit between two dental alignment device-makers is pitting Google and Apple against the movie and recording industries. Who knew dentistry could be so divisive?

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Should I Take on this Case or Punt to OR?

Sometimes even the most experienced sedation dentists need a little help from their friends. A DOCS Education Fellow seeks advice from faculty about whether he should take on a sedation case or refer it out.

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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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