The Journal of the American Dental Association
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Comparative Study Clinical Trial Controlled Clinical Trial
Efficacy of diphenhydramine hydrochloride for local anesthesia before oral surgery.
The efficacy of diphenhydramine hydrochloride with epinephrine was tested against lidocaine with epinephrine in a double-blind study. Patients with allergic reactions to general local anesthetics were safely and effectively treated with diphenhydramine hydrochloride as an anesthetic alternative.
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Intensive chemoradiotherapy damages the mucosal barrier of the mouth and throat and is often associated with severe oral inflammation and infection. This study examined the use of a 0.12% chlorhexidine gluconate mouthrinse for prophylaxis against oral complications in patients receiving bone marrow transplants. Use of chlorhexidine mouthrinse produced reductions in oral soft tissue disease and oral microbial burden, including a significant decrease in oral mucositis and Candida infections. The advantage for patients undergoing intensive antineoplastic therapy, and potentially for other immunocompromised patients susceptible to oral infections, was studied.
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Surveyed were 133 directors of training programs in anesthesiology. The directors reported an average incidence of 1:1,000 dental injuries during or after 1,135,212 tracheal intubations in 1 year. A well-documented dental evaluation before delivery of anesthetics and appropriate precautions and protective devices during intubation will prevent most dental trauma related to the delivery of general anesthetics. Also, early use of dental and risk management services often will ensure timely resolution of such problems.