Special care in dentistry : official publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric Dentistry
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This article discusses the issues of morbidity and mortality associated with deep sedation and general anesthesia specifically in the dental office-based setting for patients with special needs (PSN). A focused review of a particular environment and patient population was challenging as it was difficult to identify articles that discuss the unique scope of this subject. During the review of the literature, no article was identified that discussed this exact topic. ⋯ In addition, an analysis of the author's practice over a 4-year period is discussed in an effort to present relevant data per the scope of this article. After reviewing the literature and the author's clinical practice, it appears that the incidence of mortality for PSN in the dental office-based setting is minimal and the incidence of morbidity for this same population is limited to relatively minor events. Ultimately, it was concluded that the delivery of general anesthesia for PSN in the dental office-based setting can be considered a very safe and successful procedure.
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The prevalence of diabetes mellitus in the general population has been increasing sharply. Currently, much is feared but little is known about postoperative complications of oral surgery among persons with diabetes. ⋯ This practice may contribute to the rising problem of microbial resistance and may increase overall healthcare costs. The growing number of dental patients with diabetes warrants strengthening the evidence base to guide their dental care and prevent possible morbid complications.
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Various methods for statistical analysis of data are available to clinicians and researchers. Meta-analysis is a tool by which small, related studies are identified and, through systematic review, are combined into a common data pool for a single, larger population analysis. ⋯ Additionally, meta-analysis is dependent upon the quality of data applied, the bias of the test itself, and the interpretation of the results. This article will discuss these aspects of meta-analysis, including the history of its development and usage in the scientific community, basic terminology, and a relevant literature review.
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Clinical Trial
Doxepin rinse for management of mucositis pain in patients with cancer: one week follow-up of topical therapy.
This study assessed the effectiveness of oral doxepin rinse for mucositis-related pain management in patients following 1 week of repeated dosing. Patients with oral mucositis due to head and neck radiation therapy or hematopoietic stem cell transplant (HSCT) were recruited to participate in a 1-week follow-up study. Subjects who gave informed consent rinsed with doxepin (5 ml) during the initial visit and were then told to use doxepin rinse over the next week as needed, three to six times per day, and return for a follow-up visit. ⋯ Patients recalled that their pain significantly dropped within 5 minutes of rinsing over the week of repeated dosing (p < .05). At the follow-up visit, subjects reported statistically significant pain reduction 5 minutes after doxepin rinsing (p < .05). These results indicate that doxepin rinsing continues to produce reduced intensity of pain levels over a 1-week span of repeated dosing.
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The purpose of this study was to examine New Zealand general dentists' beliefs about older people's oral health and to identify the important barriers that prevent dentists from treating institutionalized older adults. A postal survey was distributed nationwide to a representative sample of 700 dentists (response rate 64.5%). Dentists' beliefs were mostly consistent with current epidemiological knowledge, although most (81.5%) mistakenly believed that the root surface caries increment was greater than that for coronal caries. ⋯ The results suggested that the areas most in need of attention were the LTC staff's oral health knowledge and attitudes, as well as government policies. Although dentists' beliefs, practices, and attitudes occasion some optimism, the increase in the dentate older population means that policymakers will need to examine efficient, dentist-acceptable ways of delivering care. The profession will need to develop and sustain an appropriate workforce.