M-Scan: A Simple EMG for Dentistry to Consider

Figure 3. M-Scan

INTRODUCTION Innovation in the technologies that dentistry enjoys, generally provide yields that include; 1) better patient care, 2) outcomes that are more predictable as well as 3) higher shared (between the patient and dentist) confidence levels. It is with these concepts in mind that a recent tool, the M-Scan, was introduced in 2011. M-Scan is … Read more

Oral Appliances for the Treatment of Snoring & Sleep Apnea

Figure (b). At right is a three-month follow-up recorded while wearing the Moses appliance. Note the significant drop in snoring volume (labeled Volume), dramatic improvement in the saturation of peripheral oxygen (SpO2), substantially less ANS arousals shown in Pulse rate, and vast improvement in apnea-hyopnea index (Resp). The apnea-hypopnea index at baseline was 72.1 but plummeted to 5.7 when wearing the appliance.

Urban newspapers regularly carry display advertising from dentists with some version of the all-too-familiar query, “Do you despise, detest, deplore or generally just dislike your CPAP?” There are a substantial number of dentists carving a significant niche in the marketplace soliciting and treating patients clinically diagnosed with sleep apnea who are unable to tolerate their … Read more

DENTAL INTERNET DIRECTORY

ASSOCIATIONS ASSOCIATION OF DENTAL TECHNOLOGISTS OF ONTARIO The official voice of Registered Dental Technologists in Ontariowww.ADTO.org CANADIAN DENTAL PROTECTIVE ASSOCIATION Because bad things happen to good dentists.www.cdpa.com ONTARIO ACADEMY OF GENERAL DENTISTRYQuality of care through life long learning.www.ontarioagd.org TORONTO ACADEMY OF DENTISTRY Toronto Meetings Calendar, CE, Winter Clinic, Society Listings, etc.www.tordent.com CONTINUING EDUCATION FACULTÉ OF ORTHODONTIC RESEARCH & CONT. … Read more

Sleep, Pain, TMJ and the Dentist

Janice Goodman graduated from University of Toronto Dental School in 1979. She teaches Essix Minor Tooth Movement, was on the advisory board for Dentsply Raintree Essix and practices general practice dentistry in Toronto. She is on the editorial board of Oral Health.

There is a paradigm shift occurring in dentistry. We, as dentists, identify and sometimes treat conditions that will affect the health of an individual. A dentist should be able to converse intelligently with the family physician and communicate issues seen in the mouth that are of concern. It is important for the profession as a … Read more

Crazy

Dr. Peter Nkansah is a dentist-anaesthesiologist with a private practice in Toronto. He is also Past President of the Canadian Academy of Dental Anaesthesia, an international lecturer, and a member of the teaching staff in the Discipline of Anaesthesia at the Faculty of Dentistry, University of Toronto.

As a child, I would spend the first half of each Saturday with my father (the second half was all about hockey). I don’t know if it was designed as bonding time, or if it was just a function of how the day worked out best for everyone (i.e. my parents). I never asked and … Read more

1 Minute in Your Dental Chair Can Save a Life…

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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

Glucagon in the Dental Emergency Kit?

The prevalence of diabetes mellitus in the general populace continues to grow, and along with increasing life expectancy it can be expected that dentists will have an increasing proportion of diabetic patients. Data from Statistics Canada show in the period of 2009 to 2010, nearly 140,000 new cases of diabetes were diagnosed in Canada with … Read more

A History of Patient Comfort (Part 2) – Passing Gas (1540-1847)

Figure 1 - A poster advertising a "laughing gas" exhibition in 1845. (Image taken from http://www.general-anaesthesia.com/people/laughinggas-poster.html)

The story of inhalational anaesthesia leading up to Ether Day is as much about personalities as it is about science. Actually, it’s more about the people than the chemistry. Oxygen, nitrous oxide and ether were each discovered before their use could really be sorted out, not unlike the Internet. The personalities involved included (in alphabetical … Read more

Dental Internet Directory

ASSOCIATIONS ASSOCIATION OF DENTAL TECHNOLOGISTS OF ONTARIO The official voice of Registered Dental Technologists in Ontariowww.ADTO.org CANADIAN DENTAL PROTECTIVE ASSOCIATION  Because bad things happen to good dentists.www.cdpa.com ONTARIO ACADEMY OF GENERAL DENTISTRY  Quality of care through life long learning.www.ontarioagd.org TORONTO ACADEMY OF DENTISTRY Toronto Meetings Calendar, CE, Winter Clinic, Society Listings, etc.www.tordent.com CONTINUING EDUCATION  FACULTÉ OF ORTHODONTIC RESEARCH & … Read more

2011 SLSA Quiz Answers

Tabel 1 - 2011 SLSA Quiz Answers

2011 was the final year of the SLSA program in Oral Health. The 8-question quiz appearedin the November ’11 issue. Unlike previous years, SLSA was not invloved in processing the results of forwarding names of particpants to the provinival licensing auhorites. Contact your own CE administrator at your provincial licensing autority. Please see SLSA Quiz … Read more

Pre-Veneered Stainless Steel Crowns – An Aesthetic Alternative

Fgure 5. Case MD, 6 months post-op.

Years ago, a father came into my offce with his young son. The boy had rampant decay involving multiple surfaces on all of his primary molars. To make matters more complex, the child had behavioural issues – as we seem to see more and more frequently these days. ADHD and sensory perception disorder made it … Read more

Atypical Presentation of a Suspected Malignant Hyperthermia Episode

Figure 1. Panoramic image of the patient at the time of consultation

INTRODUCTION There is a growing trend towards performing community-based dental treatment under deep sedation or general anaesthesia. Indications for dental treatment under anaesthesia may include patients with extensive treatment needs, acute situational anxiety, uncooperative age appropriate behaviour, immature cognitive function, disabilities or medical conditions.1 Patients known or suspected to be susceptible to malignant hyperthermia (MH) … Read more

We Are What We Drink!

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As a paediatric dentist, I am presented with young patients having multiple carious lesions on a daily basis. In my discussion of risk factors with the patient/parent(s), the use of fluoride is always brought up. I am shocked at how many families don’t drink tap water and are therefore not benefiting from the preventative effects … Read more

A Failure to Report Abuse

Dr. Stechey is a general dentist in Hamilton, Ontario and a recognized forensic expert in how dentistry can be used for the detection & recognition of abuse on victims of all ages.  Email: fstechey@gmail.com

We are all familiar with the following recent headlines; “Paterno and Sandusky are indicted at Penn State”; “Player abuse should have been reported years ago”; “the coaches should have acted sooner.” But failing to report suspected abuse could just as easily involve Canadian dentists and not sports professionals. Some Interesting facts are as follows:• Over 60% … Read more