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

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

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

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

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

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

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…

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

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

Tylenol 3 is such an ‘ugly’ drug

From Science Daily – July1, 2011 In the cover article of this month’s Journal of the American Dental Association, a group of nine dentists, pharmacists, and addiction experts provides new research and recommendations to help dentists combat, rather than contribute to, abuse of addictive painkillers. Read more Related articles Research examines dentists’ role in painkiller abuse (medicalxpress.com) … Read more

Safety-Engineered Needles for Dentistry: Some Clinical Impressions

The Needle Safety Regulation (O. Reg. 474/07) under Ontario’s Occupational Safety and Health Act (OSHA) was extended to include dental offices as of July 1, 2010. This Regulation mandates the use of safety-engineered needles (SEN) as opposed to conventional hollow-bore needles in dentistry, as well as in other healthcare professions and locations. This Regulation is … Read more

Is It Dangerous? (February 01, 2011)

 A ll professionals in their interactions/interviews with patients/clients, have to prepare for “The Question“. The Question is a question that when answered correctly, removes barriers to your services. In general dentistry, it’s “How much will it cost?”; in endodontics, it’s “How much will it hurt?”; in teaching, it’s “Will this be on the test?”; and … Read more

Hemisection as a Treatment Option: A Case Report

Figure 4-The final restoration at recall radiograph showing adaption of restoration and excellent bone height in the area of root removal.

Abstract Patients are becoming more educated in the available treatments and will ask for services by name. This paper offers a treatment option that preserves tooth structure in cases that are carefully selected. In the right situation a fine restorative result can easily be attained using the hemi-section option. In every clinical situation there are … Read more