Blogs

Too Early to Recommend EDTA Dental Gel as Toothpaste Replacement, Say Experts

Recently recommended by famed inventor Sir James Dyson, a new dental gel claims to be more effective than toothpaste with no abrasives, foam or antibiotics.

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Breaking the Biofilm: New Nanoparticle Shows Promise

Iron nanoparticles may disrupt the ability of cariogenic bacteria to form biofilms, paving the way for next-generation anticavity treatments.

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Sedating Patient on Morphine for Back Pain

A patient requests treatment under sedation, and discloses she has had two back surgeries with morphine as the principal painkiller. Can she safely be sedated per DOCS protocols?

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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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A DOCS Education member seeks the faculty’s assistance:

I am an endodontist who has received a referral for a 31-year-old caucasian male with a history of methemoglobinemia in response to esophageal benzocaine spray. The patient needs two root canals on vital teeth #4 and #19 and seven fillings.

After reviewing the literature with my local anesthesiologist's help, bupivacaine seems to be the medication with the least amount of risk. The recommendation from the anesthesiologist is not to perform sedation in the office, other than possibly nitrous as well as having an IV ready for up to 50 mgs TOP DOSE of methylene blue 1.0 -2.0 mg/kg IV every 60 minutes and very small amounts of bupivacaine per session. The other option would be general anesthesia.

What are your thoughts?


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A DOCS Education Member seeks the faculty’s assistance:

I had a 24-year-old, recovering drug addicted female weighing 142 lb presents with multiple caries. She will require extractions, implants and dentures. Her rehab therapy medications are Suboxone® 8 mg two times daily along with 12.5 mg of Klonopin® daily. The patient is anxious about her dental treatment. She states she can come off these meds two days before her appointment. Is this ok and is there an OCS protocol for her?


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A DOCS Education member seeks the faculty’s assistance:

I have a patient who has a GFR of 31. I understand that the normal GFR is 131 to 140 and that the minimum acceptable level is 60.

The patient's nephrologist said he considers the patient stable and that she could under-go anesthesia. However, he acknowledged he did not understand which type of anesthesia we would be using.

He also said that any medications utilized should be dose adjusted for her GFR. Should I stay away from treating her totally? Or, with him considering her stable is there a way that I can treat her with local anesthesia and sedation safely?


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A DOCS Education member seeks the faculty’s assistance:

I would like to get all suggestions for sedating a 79-year-old female with a pacemaker and a history of heart problems. The patient is on clonazepam, 81 mg aspirin, verapamil, digoxin, hydroxychlorine, levothyroxine, meloxicam, metropolol, saccurate(?), Nitrostat® and potassium. Her MD has instructed us not to use any epinephrine. The patient is allergic to penicillin and MD suggested clindamycin, which is what I will prescribe.


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A DOCS Education member seeks the faculty’s assistance:

I have a patient who is ASA III, Mallampati 2, base line BP 135/86 Spo2 98%. The patient has depression, stable angina, high blood pressure, hyperlipidemia and arthritis. Last exam was 3 weeks ago.


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A DOCS Education member has an upcoming diabetic patient who takes their medication, but does not monitor their blood sugar. How will this affect a planned, upcoming sedation dentistry procedure?


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