Evidence-based dentistry
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Evidence-based dentistry · Jan 2006
CommentSeveral therapies may prevent or reduce the severity of oral mucositis associated with cancer treatment.
The Cochrane Oral Health Group Trials Register, Cochrane Central Register of Controlled Trials, Medline and Embase were searched to April 2006. Reference lists from relevant articles were scanned and the authors of eligible studies were contacted to identify trials and obtain additional information. ⋯ Several of the interventions were found to have some benefit at preventing or reducing the severity of mucositis associated with cancer treatment. The strength of the evidence was variable and implications for practice include consideration that benefits may be specific for certain cancer types and treatment. There is a need for well-designed RCT with sufficient numbers of participants to perform subgroup analyses by type of disease and chemotherapeutic agent.
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Evidence-based dentistry · Jan 2006
CommentRobust randomised control trials needed for drug treatments for trigeminal neuralgia.
Searches for appropriate studies were made using the following: Cochrane Neuromuscular Disease Group Register, Medline, Embase and LILACS (Latin American and Caribbean Literature on the Health Sciences) together the Chinese Biomedical Retrieval System, the database of the Chinese Cochrane Centre, conference paper databases and checked bibliographies. 10 Chinese journals were searched by hand. ⋯ Trials of non-antiepileptic drugs for treating trigeminal neuralgia have all been limited by poor methodological quality or poor reporting. There is insufficient evidence from randomised clinical trials to show significant benefit from non-antiepileptic drugs for trigeminal neuralgia.
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This guidance is intended to promote good clinical practice for the provision in dentistry of conscious sedation that is both safe and effective. It is not a recipe book for sedation and therefore does not include details of drug dosages. The recommendations are applicable to all patients receiving conscious sedation, to facilitate the provision of any type of dental treatment whether it is delivered in a dental practice, a community dental service clinic or a hospital setting. It also covers the provision of conscious sedation for dental treatment provided on a domiciliary basis. Specifically excluded from this guidance, however, are patients who require assisted ventilation, intensive care sedation, premedication for general anaesthesia, postoperative analgesia, sedation in palliative care, night sedation and sedation in the home setting other than for the provision of dental treatment on a domiciliary basis. ⋯ A number of recommendations were made regarding the future conduct and reporting of clinical trials. The following areas were highlighted as requiring further high-quality research: Fasting before conscious sedation. Conscious sedation of paediatric dental patients. Dental conscious sedation using combinations of drugs. Dental conscious sedation using continuous infusion. The choice of sedation method for dental patients. Cognitive and behavioural effects of conscious sedation. The interaction of pharmacological and nonpharmacological anxiety management techniques. The complete guidance is available for download at www.scottishdental.org/cep/guidance/dentalsedation.htm.