Compendium of continuing education in dentistry
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Compend Contin Educ Dent · Nov 2016
ReviewPharmacological Reversal Agents in Dental Practice: Keys to Patient Safety.
Though uncommon, medical emergencies in the dental office are harrowing occurrences that can be the result of adverse drug reactions. Pharmacological antagonists have been developed for administration as reversal agents in emergency situations in which patients may have an untoward effect, typically caused by too much medication. Dental practitioners should be familiar with these agents to keep patients safe and help mitigate drug-induced medical emergencies. ⋯ Outside of emergency situations, the pharmacological antagonist phentolamine has been developed to reverse the effects of the vasoconstrictor in dental local anesthesia preparations when the effects of the agonist medication are no longer required. Such newer reversal agents are being considered for more routine use once the dental procedure is complete. This article is intended to assist dental practitioners who are familiar with pharmacological antagonists to be better able to help mitigate drug-induced medical emergencies should they occur.
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Compend Contin Educ Dent · Feb 2015
Use of opioid pain relievers following extraction of third molars.
Following extraction of third molars, it is common practice for oral and maxillofacial surgeons to provide a prescription for an opioid-containing analgesic such as hydrocodone with acetaminophen. Because the instructions for use most often indicate that these analgesics are to be taken "as needed for pain," it is unknown how many of the prescribed postoperative analgesic tablets are needed and actually taken. Therefore, an assessment of patient pain experiences and actual opioid analgesic usage was carried out using structured telephone interviews of patients performed 1 and 7 days following their thirdmolar extraction surgery. ⋯ Four patients reported nausea or vomiting in the first 24 hours, and six patients reported nausea or vomiting during the following 6 days of recovery. The initial prescriptions provided adequate relief for 45 of the 48 patients. Higher consumption of opioid pain relievers (OPRs) was associated with a longer duration of surgery and the occurrence of postoperative infections.
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Compend Contin Educ Dent · Apr 2014
Comparative StudyEffects of a vibratory device on pain from anesthetic injections.
A randomized block, split-mouth design was used to determine the effectiveness of a vibratory device with topical anesthetic compared to topical anesthetic only in reducing the pain experienced during an inferior alveolar nerve block. ⋯ The use of the vibratory device and topical anesthetic significantly reduced the pain experienced during the administration of a local anesthetic injection compared with the use of topical anesthetic alone (P = 0.006).
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Compend Contin Educ Dent · Sep 2013
Characterization and treatment of postsurgical dental implant pain employing intranasal ketorolac.
The intensity and duration of pain following surgical placement of dental implants has not been well studied. Thus, the aim of this open-label study was to characterize the nature of postsurgical pain following the placement of one to three implants. ⋯ Following implant surgery, postoperative pain was rated moderate or severe in 25/28 patients (89 percent), requiring prn analgesic dosing for up to 3 days in 14/25 individuals (56 percent). Intranasal ketorolac displayed an analgesic onset within 20 minutes, a duration of at least 6 hours, and was well tolerated by the cohort with brief stinging of the nasal mucosa reported by 9/25 individuals (36 percent).