Blogs

Patient-Limited Efficacy in Oral Conscious Protocols

What are the limitations of oral conscious sedation when treating very large and/or obese patients? DOCS Education faculty weigh in.

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Meet the Father of Dentistry

Nearly all of modern dentistry began with one man living in the early 1700s. Incisor takes a look at how the inventions and observations of Pierre Fauchard revolutionized dentistry.

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Optical Illusions in Dentistry

Can optical illusions interfere with treatment? A new study examines how the Delbouef illusion might influence the amount of material endodontists remove during a root resection.

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Hydroxyzine Reaction in Smoker?

A patient who is a pack-a-day smoker initially is sedated well, but arises agitated after several hours. Reaction to hydroxyzine or nicotine withdrawal? DOCS Education faculty weigh in.

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Paging Dr. Snake: Researchers Create Therapeutic Venom Database

Could venom from dangerous animals be used for medicine? Data scientists say it already has, and finding studies should be easier.

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Are Your Patients Damaging their Teeth with Whitening Products?

Are Your Patients Damaging their Teeth with Whitening Products?

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Is My Patient a Hyporesponder?

The importance of learning and disclosing all medications of a current patient is important, and may be a clue to why a patient doesn't respond to sedation as expected.

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Is Your Prescription Bankrupting your Patients?

What's behind the extreme variability in drug prices these days? Incisor takes a look at how fluctuations affect clinicians and patients alike.
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The Rise of No-Drill Dentistry

Is dentistry moving away from the handpiece? New atraumatic techniques may preserve oral health without the need for fillings in early cases.
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Tooth Extraction After Heart Surgery

A patient needs an abscessed tooth extracted, but his blood-thinning medication could complicate the procedure. DOCS Education faculty weigh in.
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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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