Compendium of continuing education in dentistry
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Dentures may be boring, but they are a major part of dentistry, and will be for the foreseeable future. While implants are growing in popularity, there will always be patients who opt for dentures. ⋯ Be sure to manage patient expectation and to create an effective system for prompt payment. This will enable you to help patients achieve good oral health, while maximizing your profit.
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The use of core build-up materials is likely to increase in coming years. The ease of use of direct materials, such as amalgam and composite-based core materials, will most certainly dominate product selection. The historic standard of the custom cast post-and-core technique is decreasing in the private practice of dentistry. ⋯ An extreme amount of professional judgement and past experience must be used in the absence of sound scientific validation. Unfortunately, little sound research, especially clinical research, exists to assist dentists in this area. New clinical studies in this area would be of tremendous benefit to the practicing dentists and would benefit the general public greatly.
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Postoperative pain control is often inadequate because of insufficient pain relief or unacceptable side effects. Nonsteroidal antiinflammatory drugs (NSAIDs) are very efficacious for pain of dental origin, but their ceiling of efficacy does not result in greater peak analgesia if the dose is raised beyond recommended limits. ⋯ Combining NSAIDs with opioids has been largely unsuccessful and still results in opioid side effects. The combination of NSAIDs with acetaminophen holds promise for greater analgesia than either drug alone, but without the increased side effects associated with opioids in ambulatory dental patients.
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In dentistry, local pain management is a critical component of patient care. When efforts to achieve local anesthesia are unsuccessful, the resulting stress for both the patient and practitioner can be significant. This Forum has reviewed new technologies that are reported to increase the probability of a favorable outcome with local anesthesia. ⋯ However, the potential benefits of the new devices and techniques available in local anesthesia broaden the practitioners' choices. There may not yet be a "magic bullet" in local anesthesia, but the advances reviewed here hold great promise. Our participants seem to agree that predictable local anesthesia will always require a thorough understanding of the broad range of devices, techniques, and drugs available and a commitment by the dentists to use them wisely.