Features

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

Policy on Patients with Special Health Care Needs

The American Academy of Pediatric Dentistry (AAPD) defines Special Health Care Needs (SHCN) to include any physical, developmental, mental, sensory, behavioral, cognitive or emotional impairment or limiting condition that requires medical management, health care intervention and/or use of specialized services or program. The condition may be congenital, developmental or acquired through disease, trauma or environmental … Read more

All Children Deserve a Healthy Smile

Canada's Tooth Fairy

Nathaniel, a child with special needs, was just five years old. This little boy was unable to eat and suffered severe headaches, fevers and pain due to three infected teeth. Night after night, his mother held her son as he cried, her heart breaking with each sob as she watched the little boy she loved … Read more

Orthodontic Care at Holland Bloorview Kids Rehabilitation Hospital

Figure B. After orthodontic treatment. Note hyperplasia of gingival secondary to anti-seizure medication

One of the foundations upon which health care professionals practice is a commitment to provide the best possible treatment to each and every one of their patients. For some patients, medical or socioeconomic circumstances may present a challenge to the delivery of optimal care. Fortunately, we live and practice in a country that provides an … Read more

Treatment Planning for Missing Maxillary Lateral Incisors

Figure 4F.

INTRODUCTIONTreatment planning for missing maxillary lateral incisors is a common clinical predicament encountered by orthodontists, particularly at Holland Bloorview Kids Rehabilitation Hospital where congenital absence of maxillary lateral incisors is a common feature of many of our patients afflicted by syndromal or non-syndromaloligodontia. Three main treatment options exist including: canine substitution; a tooth supported restoration; … Read more

Dentistry at Holland Bloorview Kids Rehabilitation Hospital

Figure 8. The Holland Bloorview Northern Outreach Team

INTRODUCTION AND VISIONHolland Bloorview Kids Rehabilitation Hospital is Canada’s largest rehabilitation hospital, serving children and youth with dis­abilities, not only in Ontario, but also throughout Canada and around the world. By pioneering treat­ments, technologies and real ­world programs that give children with disabilities the tools to participate fully in life, Holland Bloorview strives to fulfil … Read more

Non-pharmacologic Management of Patients with Special Health Care Needs

INTRODUCTION Dentistry at Holland Bloorview Kids Rehabilitation Hospital provided care to 1,649 unique patients with special health care needs (SHCN) in 2011/12. Children with SHCN include children with autism spectrum disorder, cerebral palsy, spina bifida, muscular dystrophy, complex medical conditions and syndromes, global developmental delay, and more. These children present a unique challenge in the … Read more

ICON Treatment of Post Orthodontic White Spot Lesions

Figure 13. Final post-operative.

FORWARDIn the dental world, new products are introduced all the time. Dental technology and our materials are evolving daily. In this evolution, products are often introduced and labeled as “ground breaking” or “revolutionary.” These descriptions are all too often thrown around indiscriminately. As dental professionals we must be able to make informed decisions about the … Read more

Noteworthy Trends in a Successful Governmental Dental Program in Alberta

The Alberta Child Health Benefit (ACHB) is a program administered by Alberta Human Services, formerly Alberta Human Resources and Employment. It was launched in response to the need for a health benefit program in low-income families identified by Albertans before the National Child Benefit (NCB) program was introduced.1,2 The ACHB is Alberta’s key provincial reinvestment … Read more

In a World of Zeros, Let Us Reclaim the Degrees

Dr. Fay Goldstep sits on the Oral Health Editorial Board (Healing/Preventive Dentistry), has served on the teaching faculties of the Post-graduate Programs in Esthetic Dentistry at SUNY Buffalo, the Universities of Florida (Gainesville), Minnesota (Minneapolis), and has been an ADA Seminar Series speaker. She has lectured nationally and internationally on Soft-Tissue Lasers, Electronic Caries Detection, Healing Dentistry and Innovations in Hygiene and has published numerous textbook chapters and articles on these topics. Dr. Goldstep is a consultant to a number of dental companies, and maintains a private practice in Markham, Canada. She can be reached at goldstep@epdot.com.

The word judgment is defined as the “the ability to judge, make a decision, or form an opinion objectively, authoritatively and wisely, especially in matters affecting action”. Judgment is based on good sense and discretion. In today’s world we dismiss this important attribute. Our language is full of “don’t judge me … let go of … Read more

Dental Remineralization: Simplified

Table 2.

Throughout our patients’ lives we interact at regular intervals, assessing and treating as their oral condition requires. The ongoing progression of disease in dental hard and soft tissue is often a multifactorial downward spiral. It does not have to be. The dental team must fully understand the disease process and then proactively intervene to slow … Read more

Imagine a World Without Occlusal Caries: Are Glass Ionomer Sealants the Answer?

Figure 4B. Molar after sealing with glass ionomer plus the deciduous second molar. Note: glass ionomer has been flowed under the operculum.

AbstractDental sealants have been utilized for over 50 years in different parts of the world with varying degrees of success.1 Dentists, dental hygienists, dental assistants and even patients have spent much effort in either providing dental sealants or receiving them on their own teeth. Still, international information sadly reports that occlusal caries is present and … Read more

Remineralization of Carious Lesions – It Really Does Work!

Figure 8.

Dental caries is one of the two common diseases we treat in clinical practice on a daily basis. We place restorations to restore teeth ravaged by caries. We place implants, bridges and partial dentures to replace teeth destroyed by caries. Our preventive therapies for the most part involve cleaning tooth surfaces and applying fluoride-based products. … Read more

Interproximal Demineralization: Automated Detection and Analysis

Figure 8.

Oral radiography, in use for over a century, is well-established in the dental profession. A curiosity at first, it quickly carved out an important role in dental caries detection. Today, dental radiography is a standard part of the dental examination, identifying and locating sites of dental disease that are inaccessible to other diagnostic methods. Digital … Read more