Blogs

Seizures Induced by Dental Fear

When a patient seizes during a routine hygiene appointment, their companion mentions that it may be due to acute dental fear. Can the clinician safely provide this patient a comfortable experience?

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Why You Should Ask Your Patients About Their Sleeping Habits

Could sleeping tendencies and oral health be connected? A new study implicates sleeping habits as a potential source of enamel erosion.

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New Study Links Higher Amelogenin Levels To Healthier Enamel

Genetic predisposition to weaker or stronger enamel might influence caries formation more than previously thought.

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Pre-Sedation Baseline Vitals

A DOCS Education Gold member inquires:

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Is Your Patient-Acquisition Technique Inclusive to Everyone?

A new dental consumer survey highlights disparities on how patients look for dentists, choose dental insurance, and receive care.
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Topical Anesthesia Weak? Add Electricity!

A new method of local anesthesia administration has emerged using electricity to increase tissue penetration. Could high-fear patients stand to benefit?

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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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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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