The Journal of the American Dental Association
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Randomized Controlled Trial Comparative Study
Flumazenil reversal of sublingual triazolam: a randomized controlled clinical trial.
Incremental sublingual (SL) dosing of triazolam has emerged as a popular sedation technique. Nevertheless, few studies have evaluated the technique's safety or efficacy. Given its popularity, an easily administered rescue strategy is needed. ⋯ A single intraoral injection of flumazenil (0.2 mg) cannot immediately reverse oversedation with triazolam. A higher dose might be effective. Reversal for the purpose of discharging the patient early is neither appropriate nor safe.
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The Robert Wood Johnson Foundation, Princeton, N.J., the W.K. Kellogg Foundation, Battle Creek, Mich., and The California Endowment, Los Angeles, collaborated in funding a five-year (2002-2007) national demonstration program (Pipeline, Profession & Practice: Community-Based Dental Education [Dental Pipeline]) to reduce dental care access disparities. Fifteen dental schools were selected to participate in the Dental Pipeline program. The goals were to have senior students spend more time in community sites providing care to underserved patients; to prepare students to treat diverse, low-income patients; and to increase enrollment of underrepresented minority (URM) students. ⋯ On average, the participating dental schools were successful in meeting program goals.
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Randomized Controlled Trial Comparative Study
A comparison of a refrigerant and a topical anesthetic gel as preinjection anesthetics: a clinical evaluation.
The authors used a split-mouth design to determine the effectiveness of a refrigerant compared with that of a topical anesthetic gel in reducing the pain experienced during a posterior palatal anesthetic injection. ⋯ The potential benefits of using a refrigerant rather than a topical anesthetic gel are pain reduction, decreased application time, ease of application and avoidance of displeasing taste.
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The authors review the epidemiology, clinical features, pathophysiology, diagnosis, treatment, orofacial presentations and dental implications of trigeminal autonomic cephalalgias (TACs): cluster headache (CH), paroxysmal hemicrania (PH) and short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT). ⋯ Although the prevalence of TACs is small, it is important for dentists to recognize the disorder and refer patients to a neurologist. This will avoid the pitfall of administering unnecessary and inappropriate traditional dental treatments in an attempt to alleviate the neurovascular pain.