Check Please

Through 2013, I was fortunate enough to be a student in a year-long mini-residency in implant dentistry instructed by Dr. Jim Lai and Dr. Joe Fava through the University of Toronto. It was a wonderful course that I recommend wholeheartedly to anyone wanting to introduce the discipline of implantology into their practice. Along with the … Read more

Treatment and Billing Practices Among Dentists Providing Dental Care for Children in Publicly Funded Programs

ABSTRACTObjective: The purpose of this paper was to review treatment and billing practices by Nevada dentists participating in Public Funded Programs (i.e., Medicaid, CHIP), which can lead to higher costs and unnecessary treatment of children needing dental care. Methods: Seventy-five thousand Medicaid/CHIP claim forms for dental care were reviewed by a licensed dentist representing the largest … Read more

The Mystery of Meal Time Swellings Revealed

Patients often present with complaints that are not directly related to structures in the oral cavity, but rather to those around it. The salivary glands are examples of peri-oral structures that are sometimes at the root of a dental patient’s chief complaint. There are many disorders of the salivary glands, but the most common conditions … Read more

Trends in Paediatric General Anesthesia in Canada

In October 2013, the Canadian Institute of Health Information (CIHI) released a very thorough and comprehensive report entitled: Treatment of Preventable Dental Cavities in Preschoolers: A focus on day surgery under general anaesthesia. The report states that every year in Canada there is approximately 19,000 day-surgeries to treat early childhood caries (ECC) in children under … Read more

Diagnostic Challenge

CASE A post-orthodontic panoramic radio­graph was acquired on a 27-year-old female patient. On this panoramic radiograph, an altered bone pattern with a mixed radiolucent/radiopaque density was noted in the periapical region of the right mandibular premolar and molar teeth. A periapical radiograph and a posterior mandibular standard occlusal radiograph were acquired to further characterize the … Read more

Welcome to the Pacific Dental Conference

 The 2014 Pacific Dental Conference will once again be held at the Vancouver Convention Centre, West Building. We’re excited to see the consistent growth of the conference over the past years with a new record of 12,200 participants in attendance at the 2013 PDC. Partnering with valued exhibitors such as yourself is important to our … Read more

Inaugural Conference of the Academy of Craniofacial Asthestics in India on Occlusion, TMD & Full Mouth Rehabilitation at the Taj Exotica, Goa from September 13th – 15th, 2013.

Academy of Craniofacial Aesthetics in India

We are extremely happy to announce that we have organized a Conference on behalf of the Academy of Craniofacial Aesthetics in India at Taj Exotica, Goa from 13 – 15 September 2013. This is the1st ever Conference by the Academy of Craniofacial Aesthetics in India and 1st ever conference on Craniofacial Aesthetics with World renowned … Read more

King Pyrrhus and Dental Anaesthesia

Dr. Nkansah is a specialist in Dental Anaesthesia with a private practice in Toronto. He is a member of the editorial board of Oral Health and is an educator with the University of Toronto, Western University and Sunnybrook Health Sciences Centre.

In 280 BC and 279 BC, King Pyrrhus led his army to victories against the Romans in two separate battles during the Pyrrhic War. Although his armies were victorious, they were also decimated in number and were eventually overrun. Their experience has led to the term “Pyrrhic victory” when recounting battles that maybe never should … Read more

To Have or Not to Have: Dentures versus Prosthodontic Services

Prosthodontic services have been rapidly growing in dental offices. I have had a long history of gum disease which led to restorative dentistry, and after progressive deterioration, I had to confront the issue of whether I was going to have some kind of plate, partial, total, or prosthodontics. When I started on this journey as … Read more

Nitrous Oxide and Postoperative Morbidity and Mortality: A Concise Literature Review of the ENIGMA Trials and New Evidence

Table 1.

Nitrous oxide is a principal agent in the practice of conscious sedation and general anaesthesia. There has been a growing trend among anaesthesiologists to decrease the use of nitrous oxide because of concerns about cardiovascular morbidity and mortality. While the ENIGMA trials are quoted to further spur the movement for discontinuing nitrous oxide use, critical … Read more

Airway Assessment and Management in Conscious Sedation Cases

During conscious sedation, the primary goal of any anaesthesia provider is to protect the airway. In dentistry this is a double-edged sword, since we work in the mouth. It affords us the ability to constantly monitor the airway, but it also means we are often moving the head and neck into a position that might … Read more

A History of Patient Comfort (Part III): Comfortably Numb

W.S. Halsted

One of the facets of dentistry that makes it unique in the field of healthcare is the ability to anaesthetize whatever tissues we are working on. This was not always reliably true, which in addition to the fact that our jobs take place in a highly personal, sensitive area of the body, has contributed to … Read more

Flumazenil: Be Careful How You Administer It

The need for sedation in dentistry is evident. According to Chanpong et al., in 2003 of Canadians, about 10% of the general population were somewhat afraid of dentistry, 5% had a high fear level, and many appointments were avoided or canceled in relation to these patients’ worries and fears of undergoing dental treatment. Furthermore, this … Read more

Non-Injectable Local Anaesthesia in Dentistry: A Review and Case Study

Figure 14.

Dental practitioners depend on the evolution of their field to provide patients with the highest quality, most advanced and comfortable dental care. Halsted first gave an inferior alveolar nerve block using cocaine and boiling water in 1884 and cocaine was earlier demonstrated as a topical anesthetic for eye surgery by ophthalmologist Karl Koller that same … Read more

Welcome to the Pacific Dental Conference

The Pacific Dental Conference is one of the largest dental conferences in North America offering a varied and contemporary selection of continuing education programs. With over 150 open sessions and hands-on courses covering topics relating to clinical excellence, practice excellence and personal development — we have you and your entire dental team covered. In addition … Read more

1 Minute in Your Dental Chair Can Save a Life…

Picture 1

Lise Fabello is one of the lucky ones. Routine screening with UFIT, an advanced vital signs monitoring device, led to the diagnosis of a serious medical condition and may even have saved her life. Although she was feeling unwell for some time, Lise didn’t go to her doctor. It was only when her dentist started … Read more

Trance & Communication – An Alternative Paradigm

Dentistry has credibility issues. Over many years we have reassured ourselves that we are a much loved and appreciated profession, However, the reality is actually worse than we have lead ourselves to believe. How do we know this? The Canadian Dental Association commissioned an Ipsos-Reid survey. The results are sobering. Apparently only nine percent of … Read more

Practical Considerations for Treating the Anxious Dental Patient

INTRODUCTIONDental anxiety is a common phenomenon. In a recent Canadian survey, 5.5% of respondents reported being “very afraid or terrified” of dental visits, and a further 9.8% were “somewhat afraid”.1 Dental anxiety prevalence, of a clinical significance, varies based on criteria used to measure it and the population studied. In general, worldwide estimates range from … Read more

The Hypertensive Patient

Table 4 - Dental treatment Recommendations According to the Measurement of High Blood Pressure

(A review of the latest Joint National Committee on Prevention, Detection, Evaluation and Treatment of Hypertension as it applies to the dentist)

Caffeine Withdrawal from Procedural Sedation

CASE:  A 45-yr-old male presented for restorative treatment under deep intravenous sedation indicated by dental anxiety to the sound of the drill. The medical history included sleep apnea, depression, paranoid delusional disorder, insomnia, chronic pain from sciatica, and obesity (BMI 36.1 kg/m2). Current medications included daily use of morphine 240 mg, three tablets of Percocet, haloperidol 3 mg, amitryptyline 75 mg, zopiclone 7.5 mg and 8 cups of coffee. The patient rigidly followed preoperative instructions, ingesting no food after midnight, having only water or apple juice three hours prior to the afternoon appointment, in addition to his prescribed medications. Induction was achieved with midazolam, fentanyl, glycopyrrolate and a propofol bolus and infusion. The patient was spontaneously ventilating and the airway was supported throughout. Haemodynamics were stable throughout. Emergence and recovery was uneventful, except for postoperative headache which persisted in the evening despite administration of ibuprofen 400 mg po during the recovery period.

CASE: A 45-yr-old male presented for restorative treatment under deep intravenous sedation indicated by dental anxiety to the sound of the drill. The medical history included sleep apnea, depression, paranoid delusional disorder, insomnia, chronic pain from sciatica, and obesity (BMI 36.1 kg/m2). Current medications included daily use of morphine 240 mg, three tablets of Percocet, … Read more