Journal - Canadian Dental Association = Journal de l'Association dentaire canadienne
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Using recent Canadian health survey data, we investigated the effect of socioeconomic status on patients' use of dental services and dental insurance coverage. Our results point to an important socioeconomic gradient in the use of dental services. ⋯ The insurance effect appears to operate through a reduction in price paid at point of service, not decisions by those with high anticipated need for dental care to selectively purchase insurance. Indeed, those with poorer self-assessed oral health, as well as those from Quebec (where dental benefits are subject to personal income tax) and those over 65 years of age (who have likely lost employer provided coverage) were less likely to be insured.
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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.
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The antibacterial and antifungal effects of medicated gutta-percha (MGP) over different time periods have not been evaluated. The aim of this study was to evaluate and compare the antimicrobial and antifungal effectiveness of MGP and regular gutta-percha cones over different time periods using the disk diffusion method. ⋯ The antimicrobial and antifungal characteristics of MGP may offer additional advantages over conventional gutta-percha.
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Cervicofacial subcutaneous emphysema is an infrequently reported sequela of dental surgery. It may be caused by the inadvertent introduction of air into the soft tissues during procedures using high-speed, air-driven handpieces or air-water syringes. In this paper, we present a case in which subcutaneous emphysema developed in a middle-aged woman following routine restorative treatment. We review the features of the condition and its treatment and discuss means of prevention.