Compendium of continuing education in dentistry
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Compend Contin Educ Dent · Jan 2000
ReviewPreemptive vs preventive analgesia: which approach improves clinical outcomes?
Administering a drug that blocks painful (nociceptive) input from entering the central nervous system before a surgical procedure attenuates the development of changes that manifest as increased pain at later time points. Clinically, this strategy predicts not only less pain during the initial postoperative period, but also lowers the intensity of pain during the days after the procedure. ⋯ The adaptation of this method as a standard clinical practice has been delayed by controversy over whether the pharmacological intervention should be administered before the surgical event (preemptive analgesia), before pain onset (preventive analgesia), or by repeat administration over the expected postoperative course. Evidence reviewed in this article supports all of these approaches for decreasing the development of central sensitization, attenuating postoperative pain, decreasing analgesic consumption, and enhancing recovery.
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Compend Contin Educ Dent · Jul 1998
ReviewCraniofacial pain of myofascial origin: temporomandibular pain & tension-type headache.
Craniofacial pain of myofascial origin is a common chronic disorder. When the pain is unilateral and located periauricularly, masticatory myalgia is likely. ⋯ The possible interrelationship with generalized myofascial disorders are discussed. Practical approaches to history-taking, diagnosis, and treatment are suggested.
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Dentists attempt to overcome patients' fears by using various oral, intramuscular, intravenous, and inhalational anxiolytic agents. This article discusses the use of oral midazolam as an alternative to oral diazepam in the management of the pediatric patient.
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Some special patients are unable to tolerate dental care in outpatient dental offices. Providing dental care under general anesthesia in an operating room setting involves various medical, dental, and hospital issues and procedures that differ from outpatient care. This article reviews pertinent information for the dental management of patients who require general anesthesia.