Journal - Canadian Dental Association = Journal de l'Association dentaire canadienne
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Hemostasis is a finely balanced process in which an insult to a blood vessel wall, either by injury or surgical intervention, stimulates a pair of parallel, yet associated, pathways that lead to the termination of blood loss. The coagulation cascade is initiated by the interaction between exposed subendothelial tissue factor and circulating blood and includes a series of amplification steps that result in thrombin generation. Concurrently, exposed subendothelial collagen stimulates platelets, which, in the presence of thrombin, are consolidated by fibrin to form a blood clot, thus terminating blood loss. ⋯ Furthermore, several drugs, including over-the-counter preparations, also adversely affect hemostasis. These present significant concerns to the dentist conducting invasive procedures as they can prolong postoperative bleeding, impair wound healing and increase risk of infection. In this article, we review the current knowledge of bleeding abnormalities and discuss preoperative systemic precautions and intraoperative hemostatic measures.
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Since the late 1960s, investigators have assessed the risks associated with exposure to a variety of potentially harmful agents used in dental practice. This paper provides a brief overview of the epidemiologic literature examining the associations between occupational exposures to elemental mercury and anesthetic gases and reproductive outcomes, such as spontaneous abortion, congenital abnormalities and reduced fertility. ⋯ At this time, evidence of a relationship between exposure to elemental mercury and spontaneous abortion, congenital abnormalities and reduced fertility is limited. Good mercury hygiene by dental personnel and the use of scavenging equipment on nitrous oxide systems and exhaust systems on ethylene oxide sterilizers may reduce the risk of adverse reproductive outcomes.