Acute dental pain in children can stem from various conditions, such as extractions, pulpitis, or apical abscesses. Managing this pain effectively is crucial for improving the child’s comfort and reducing distress for both the patient and their caregivers.
Afew weeks ago, I was delivering a continuing education session to a group of lovely general dentists, and following my lecture I opened the floor to questions. I found myself in an intriguing situation: a dentist in attendance asked if I had heard about patients taking several Tums before receiving local anesthesia to enhance its … Read more
Cardiovascular disease (CVD) encompasses illnesses of the heart and blood vessels.1 Worldwide, amongst all the CVDs, coronary heart disease (CHD) is leading cause of mortality and loss of Disability Adjusted Life Years (DALYs) globally.2,3 In Canada, approximately 2.6 million people aged 20 and above are diagnosed with heart disease.4 Although mortality in patients with known heart disease has … Read more
In addition to financial and physical barriers in accessing care, people living with intellectual and developmental disabilities (IDD) are on a spectrum for their ability to tolerate dental procedures (Fig. 1).3 Oral Health Care Provider’s ability and willingness to treat are factors determining the delivery of oral health care. Many oral health care providers feel they … Read more
Epinephrine is the second-most frequently administered medication by dentists as it is present in almost all local anesthetic cartridges. Epinephrine is an endogenous hormone released from the adrenal medulla. Its main function is to support the body in times of physiologic stress by increasing cardiac output and glucose delivery to tissues.1 Within dentistry, epinephrine serves … Read more
The maxillary nerve (V2) block via the greater palatine canal is a technique for providing profound anesthesia of the hemi-maxilla. However, many dentists lack confidence with respect to administering the maxillary block, as they are relatively unfamiliar with the anatomy of the region as it relates to this method. It has the advantage of obviating … Read more
Semaglutide, more commonly known by the brand names Ozempic®, Rybelsus®, and Wegovy™ is a glucagon-like peptide-1 (GLP-1) agonist that has been used for several years in the management of type 2 diabetes mellitus (T2DM). Ozempic® and its cousins are recognizable names now because of their role in weight loss programs. The first GLP-1 agonist was … Read more
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 December 14, 2023, the Royal College of Dental Surgeons of Ontario (RCDSO) published a document entitled “Best Practices for Orthognathic Surgery in Out-Of-Hospital Facilities” (referred to as the “Best Practices Document” in the rest of this article), in which it specified a recommendation that, “[t]he general anaesthesia is administered by a medical anesthesiologist…” but … 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
Introduction The COVID-19 pandemic has made people more conscious about their overall health. It is a good moment to discuss tobacco smoking cessation with our patients. Tobacco smoking has overall devastating effects on health. It continues to be the number one cause of preventable disease and death in Canada. An estimated 45,000 Canadians die each … Read more
Are there limits to the convenience culture? In a world where a click of an app can keep you well read, well fed and cozy in bed, all without leaving the house, consumers have come to not just prefer just-in-time service, but they expect it. Dentistry is not exempt from this sea change in customer … Read more
(Updated March 2020) The profession of dentistry in Canada, particularly in Ontario, has experienced some negative publicity in recent years as a result of practices that have been inspected and closed due to infection prevention and control breaches. In some of the cases, patients were notified that they may have been exposed to infectious diseases … Read more
The two most common methods for administering systemic medications to dental patients is by enteral (PO) or intravenous (IV) routes. In an emergency, the PO route has a slow onset of action. The drug, administered PO, needs to be absorbed before being systemically available.1 The IV route will offer faster onset, but IV access can … Read more
Current nil per os (npo) standards promote pre-operative fasting as an approach to reduce the volume and acidity of a patient’s stomach contents to reduce the risks of regurgitation and subsequent pulmonary aspiration. Pre-anesthesia fasting standards apply to any procedure where sedative medications reduce the protective airway reflex that under normal conditions prevent aspiration. The … Read more
Epistaxis (nasal bleeding) is a relatively common complication that may arise during a dental visit that utilizes sedation/anesthesia. While rarely fatal, appropriate and prompt management of peri-operative epistaxis is critical in order to prevent further harm. This article will discuss a case report of epistaxis encountered during dentistry under deep sedation. In addition, the anatomy, … Read more
All practitioners who deliver nitrous oxide to their patients should be intimately familiar with the relative and absolute contraindications to its administration. Relative Contraindications Nasal obstruction: Nitrous oxide sedation can proceed if despite some degree of nasal obstruction, the patient is still able to respire through the nares (or one naris) in such a way … Read more
Abstract When difficulty in obtaining adequate mandibular anesthesia is encountered a systematic approach incorporating the evaluation of patient factors and operator technique will substantially improve outcomes. Even for the most experienced dental practitioners, consistent, profound mandibular anesthesia remains difficult to achieve 100 percent of the time. This can be stressful for both dentist and patient … Read more
Pre-operative airway assessment and management is essential to successful dental treatment under procedural sedation. In the event of oversedation, defined as the transition from an intended level of sedation to an unintended deeper level of sedation, the patient’s ability to independently maintain ventilatory function may be impaired. This can result from an inability for the … Read more
“Sign, sign, everywhere a sign/Blockin’ out the scenery, breakin’ my mind/Do this, don’t do that/Can’t you read the sign?” – Signs by The Five Man Electrical Band A repeated discussion that I have with colleagues is that dentistry, as a profession, is over-regulated. While it’s true that we have rules governing everything in our practices … Read more