Evidence-based dentistry
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Evidence-based dentistry · Sep 2013
CommentOral hygiene regimes for mechanically ventilated patients that use chlorhexidine reduce ventilator-associated pneumonia.
The Cochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, CINAHL, LILACS, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Wan Fang Database, OpenGrey and ClinicalTrials.gov databases were searched. Reference lists of identified articles were also scanned for relevant papers. There were no language restrictions. ⋯ Effective OHC is important for ventilated patients in intensive care. OHC that includes either chlorhexidine mouthwash or gel is associated with a 40% reduction in the odds of developing ventilator-associated pneumonia in critically ill adults. However, there is no evidence of a difference in the outcomes of mortality, duration of mechanical ventilation or duration of ICU stay. There is no evidence that OHC including both CHX and toothbrushing is different from OHC with CHX alone, and some weak evidence to suggest that povidone iodine mouthrinse is more effective than saline in reducing VAP. There is insufficient evidence to determine whether powered toothbrushing or other oral care solutions are effective in reducing VAP.
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Evidence-based dentistry · Mar 2013
CommentAudit and feedback had small but potentially important improvements in professional practice.
Cochrane Central Register of Controlled Trials (CENTRAL), the Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register, Medline, Ovid; Embase, CINAHL, EBSCO, Science Citation Index and Social Sciences Citation Index, ISIWeb of Science ⋯ Audit and feedback generally lead to small but potentially important improvements in professional practice.
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Evidence-based dentistry · Jan 2013
CommentDebatable evidence for the adverse drug reactions to local anaesthetics.
Medline, Embase, Chinese National Knowledge Infrastructure VIP Database for Chinese Technical Periodicals (and Chinese Biomedical Literature Database. ⋯ The present study demonstrated that the adverse drug reactions of local anaesthetics could not be ignored, especially in oral and ophthalmologic treatments. Some adverse drug reactions could be avoided by properly evaluating the conditions of patients and correctly applying local anaesthetics.
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Evidence-based dentistry · Jan 2012
CommentEvidence lacking to determine whether preoperative analgesic use reduces post dental treatment pain for children.
The Cochrane Oral Health Group Trials Register, CENTRAL, Medline, Embase, LILACS and the ISI Web of Knowledge and relevant dental journals were searched with no restrictions. ⋯ From the available evidence we cannot determine whether or not preoperative analgesics are of benefit in paediatric dentistry for procedures under local anaesthetic. There is probably a benefit in prescribing preoperative analgesics prior to orthodontic separator placement.
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Evidence-based dentistry · Jan 2012
CommentWeak evidence that oral midazolam is an effective sedative agent for children undergoing dental treatment.
Medline, Embase, Cochrane Central Register of Controlled Trials, Dissertation Abstracts, SIGLE, the WorldWideWeb (Google) and the Community of Science Database were searched for relevant trials and references. Reference lists from relevant articles were scanned and the authors contacted to identify trials and obtain additional information. There were no language restrictions. Trials pre-1966 were not searched. ⋯ There is some weak evidence that oral midazolam is an effective sedative agent for children undergoing dental treatment. There is very weak evidence that nitrous oxide inhalation may also be effective. There is a need for further well designed and well reported clinical trials to evaluate other potential sedation agents. Further recommendations for future research are described and it is suggested that future trials evaluate experimental regimens in comparison with oral midazolam or inhaled nitrous oxide.