Journal of the California Dental Association
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Patients with unrelenting pain in the teeth, gingival, palatal or alveolar tissues often see multiple dentists and have multiple irreversible procedures performed and still have their pain. Up to one-third of patients attending a chronic facial pain clinic have undergone prior irreversible dental procedures for their pain without success. In these cases, if no local source of infectious, inflammatory, or other pathology can be found, then the differential diagnosis must include a focal neuropathic pain disorder. ⋯ A list of these medications is provided in table form. Data suggest that once the patient has failed dental treatment and pain persists, the long-term outcome is less than 25 percent will have complete pain relief with treatment. With earlier treatment, better pain control, and improved nerve activity suppression medications, this should also prevent secondary psychiatric disease from developing and lower the number of inappropriate treatments.
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The goal of evidence-based dentistry is to help practitioners provide their patients with optimal care. This is achieved by integrating sound research evidence with personal clinical expertise and patient values to determine the best course of treatment. Though clinicians embrace this concept, its implementation in clinical practice has been slow. In this paper, barriers against the implementation of evidence-based care are examined and possible solutions are offered.
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This article addresses the dental faculty shortage as reported by the American Dental Association in its publication The Future of Dentistry and the Journal of Dental Education report on the demand nationally for dental school faculty. Budgeted full-time faculty vacancies in U. S. dental schools stand between 300 and 400 with present and anticipated state and federal shortfalls forecasting even further cuts or at least lack of government support. ⋯ A student loan reimbursement program for new faculty is a successful program in recruiting new, young full-time faculty. To provide for the long-term future of the research function of the school, a new program focusing on hiring doctoral (PhD)-prepared individuals who will be trained in the predoctoral DDS program at the expense of the school is in place. This article suggests further steps that can be taken to enhance the cause and reputation of the school's educational program.