Fear and anxiety toward dentistry are common in all cultures. Such feelings usually originate in childhood, persist through life, lead to avoidance of dental therapy, and contribute to diminished dental health.1 Indeed, psychological factors pose significant barriers to access to oral health care. Dentists are by and large aware that anesthesia and sedation services assist … Read more
On February 17, 2023, the Canadian Dental Regulatory Authorities Federation approved the national recognition of Dental Anesthesia as a Specialty in Dentistry. Shall I be so bold to say “A New Era Has Begun”? As current President of the Canadian Academy of Dental Anaesthesia (CADA), I think I will be so bold as to name … Read more
Ralph Ellison’s 1952 masterpiece novel, Invisible Man, compares and contrasts being black in America in the South and the North. Towards the end of the story, the protagonist asks, “Whence all this passion toward conformity anyway? – diversity is the word. Let man keep his many parts and you’ll have no tyrant states.”1 Fast forward … Read more
Failed mandibular anaesthesia is a burden on both patients and dental practitioners, as lack of profound anaesthesia can result in pain, apprehension about dental visits, and rescheduling of appointments. When considering factors such as the provider, patient, and techniques used, the incidence of failed mandibular anaesthesia has been reported to be as high as 50%.1 … Read more
Medical emergencies can occur in dental offices. In fact, nearly 60% of dentists participate in the management of one to three medical emergencies annually.1 In North America, studies report syncope as the most frequent event witnessed by dentists.2 However, fatal emergencies are also possible. As a result of an increase in the number of older … Read more
Children of all ages may need dental care for a wide range of symptoms from pain during eruption of teeth, dental caries and infections to application of braces for misaligned teeth and complex repair of the facial bones in children with special needs. Dental procedures in children mandate a calm quiet child with an open … Read more
In Ontario, dentists are the third largest group of opioid prescribers after family physicians and surgeons, and therefore are possible contributors to the opioid crisis.1 The opioids commonly dispensed by Ontario dentists are codeine combination products (76.4%), oxycodone combination products (18.4%), and tramadol (2.8%).2 As recommended by the Royal College of Dental Surgeons of Ontario … Read more
Dental anxiety is a common phenomenon among Canadians. All clinically active dentists have anxious patients in their rosters. The simplest choices available to you for anxiolysis are nitrous oxide and oxygen or oral benzodiazepines. If your office does not offer nitrous oxide sedation or if nitrous oxide alone is inadequate for patient management, it might … Read more
Don’t it always seem to go/That you don’t know what you’ve got ‘til it’s gone. – Joni Mitchell (“Big Yellow Taxi”) There is an active application to recognize Dental Anesthesia as a dental specialty nationwide. Dental Anesthesia is recognized as a specialty in Ontario as well as in the United States and Japan. This assistive … Read more
Introduction Subcutaneous emphysema is a well-known complication that can occur during dental procedures. It arises when air is forcefully pushed into the submucosal spaces, leading to tissue distension. This trapping of air can progressively spread through the facial spaces, which are anatomical regions of loose connective tissue between muscles and bones. The consequences of subcutaneous … Read more
As dental care professionals, we are all familiar with measuring our patients’ blood pressure. Since the beginning of the COVID-19 pandemic, there have been several changes in our health care system, some of which have led to the question: is it time we make changes to the frequency of blood pressure measurements in the dental … Read more
Nitrous oxide is an odorless, colourless, inorganic gas that has been used in dental and surgical anesthesia since the mid-1800s. The combination of inhaled nitrous oxide and oxygen provides mild conscious sedation that can effectively manage dental anxiety. Beyond conscious sedation, nitrous oxide is commonly used in medical surgeries requiring general anesthesia in combination with … Read more
The primary function of an automated external defibrillator (AED) is to convert certain fatal non-perfusing heart rhythms back into perfusing heart rhythms (producing a pulse that can provide oxygen to vital organs). They are now a required component of the Basic Life Support (BLS) training courses for healthcare providers such as dentists and dental personnel. … Read more
Abstract Cornelia de Lange Syndrome (CdLS) is a rare genetic neurodevelopment disorder that can present challenging behavioral and airway management during general anesthesia. This case report involves a 25-year-old female patient with CdLS who received a moderate sedation for dental treatment at the Adult Surgicentre, Faculty of Dentistry, University of Toronto. CdLS is associated with … Read more
Introduction Rehabilitation of completely edentulous maxillary and mandibular arches should satisfy form, function and esthetics. Such rehabilitations can be carried out either with or without implants. Although contemporary rehabilitation of completely edentulous situations is inclining towards dental implants, the demand for conventional removable prosthodontics is still high owing to surgical, economic and patient’s medical limitations. … Read more
“It’s been too hard living/But I’m afraid to die/’Cause I don’t know what’s up there/Beyond the sky” – A Change Is Gonna Come by Sam Cooke. According to Bill Bryson’s book, The Body, there are about 8,000 things that can kill us. Of course, only one cause has to succeed, and at least one will … Read more
Summary This case report provides a review of the use of the intramuscular (IM) injection of glycopyrrolate bromide as an antisialagogue. In this case, copious saliva interfered with the ability to obtain an accurate impression of the tooth preparation. Glycopyrrolate was delivered intramuscularly to the deltoid muscle. Drying was adequate, and a successful impression was … Read more
No, it was not a copy editor who wrote the title of this opinion piece. It was I, Derek, a practising dentist anesthesiologist, who wrote this after having contemplated writing a piece on something rather the opposite. I thought it might be interesting to discuss Evzio, a naloxone auto-injector that is beginning to encounter more … Read more
Propofol (2,6-diisopropylphenol) is an intravenous (IV) sedative-hypnotic agent commonly used for the IV induction and maintenance of general anesthesia.1 It has a rapid-onset, provides a rapid recovery even after multiple bolus doses or continuous infusion, and has anti-emetic properties which decreases the incidence of post-operative nausea and vomiting.1 These benefits helped propofol become the most … Read more
Keywords: local anesthetic, allergy, diphenhydramine, emergency treatment Abstract Allergy to local anesthetics is a rare condition which poses a unique challenge for dental treatment. In this article, we present a case of suspected allergy to conventional local anesthetics which was managed successfully using 1% diphenhydramine solution with 1:100,000 parts epinephrine as an alternative means of … Read more