The Journal of the American Dental Association
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Oral health care professionals may encounter patients who have had bariatric surgery and should be aware of the oral and nutritional implications of these surgeries. Bariatric surgery is an effective therapy for the treatment of obesity. Consistent with the 1991 National Institutes of Health Consensus Development Conference on Gastrointestinal Surgery for Severe Obesity recommendations, patients must meet body mass index (BMI) criteria for severe obesity, defined as a BMI greater than or equal to 40 kilograms per square meter, as well as for those with a BMI of greater than or equal to 35 kg/m(2) with significant comorbidities. ⋯ The oral health care practitioner familiar with the most common bariatric procedures performed in the United States and their mechanisms of actions, risks, and benefits is in the position to provide guidance to patients on the nutritional and oral complications that can occur.
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Review Meta Analysis
Phentolamine mesylate to reverse oral soft-tissue local anesthesia: A systematic review and meta-analysis.
Knowing that patients desire reduced duration of local anesthesia, the authors performed a meta-analysis to evaluate the efficacy of phentolamine mesylate (PM) in reducing anesthesia duration and the occurrence of adverse effects. ⋯ Based on limited evidence, PM is effective in reducing the persistence of anesthesia duration on the lower lip and tongue, with infrequent adverse effects of little clinical significance.
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Statistical methods and adverse events (that is, harms) data affect the accuracy of conclusions about the risk-to-benefit ratio of treatments for temporomandibular disorders (TMDs). The authors reviewed the quality of reporting in TMD clinical trials to highlight practices that are in need of improvement. ⋯ This review is designed to alert authors, reviewers, editors, and readers of TMD clinical trials to these issues and improve reporting quality in the future.
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"Pain catastrophizing" refers to an exaggerated negative mental set brought to bear during an actual or anticipated painful experience. A patient's perception of a dental care experience as catastrophic can result not only in poor satisfaction with the therapy but also in avoidance of necessary treatments, resulting in the deterioration of oral health. ⋯ To manage the care of patients who catastrophize, the clinician can actively probe patients' pain experience, help them reappraise threat, manipulate their attention to pain and improve dentist-patient communication.
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Review Meta Analysis
Combining ibuprofen and acetaminophen for acute pain management after third-molar extractions: translating clinical research to dental practice.
Effective and safe drug therapy for the management of acute postoperative pain has relied on orally administered analgesics such as ibuprofen, naproxen and acetaminophen, or N-acetyl-p-aminophenol (APAP), as well as combination formulations containing opioids such as hydrocodone with APAP. The combination of ibuprofen and APAP has been advocated in the last few years as an alternative therapy for postoperative pain management. The authors conducted a critical analysis to evaluate the scientific evidence for using the ibuprofen-APAP combination and propose clinical treatment recommendations for its use in managing acute postoperative pain in dentistry. ⋯ The results of the quantitative systematic reviews indicated that the ibuprofen-APAP combination may be a more effective analgesic, with fewer untoward effects, than are many of the currently available opioid-containing formulations. In addition, the authors found several randomized controlled trials that also indicated that the ibuprofen-APAP combination provided greater pain relief than did ibuprofen or APAP alone after third-molar extractions. The adverse effects associated with the combination were similar to those of the individual component drugs. Practical Implications. Combining ibuprofen with APAP provides dentists with an additional therapeutic strategy for managing acute postoperative dental pain. This combination has been reported to provide greater analgesia without significantly increasing the adverse effects that often are associated with opioid-containing analgesic combinations. When making stepwise recommendations for the management of acute postoperative dental pain, dentists should consider including ibuprofen-APAP combination therapy.