Unnecessary antibiotics for toothache

In the United Kingdom (U.K.) over half of all patients who visited their general practitioner (GP) with a dental problem in the last 10 years were not offered a long term treatment for their pain and instead were prescribed antibiotics. Some of these antibiotics were unnecessarily given. In a 10 year retrospective study published in the British Journal of General Practice researchers examined dental consultations and the resultant number of antibiotics prescriptions. The study found many patients are visiting their general practitioner rather than seeing their dentist, and that over half of these consultations resulted in antibiotics being prescribed. Many dental problems cannot be managed by a GP and this places an unnecessary burden on busy GPs. A severe toothache often needs an extraction or root canal which can only be undertaken by a dentist. The researchers were alarmed about the large amount of antibiotics being prescribed. This raises concerns about the UK’s long term dental health and the potential contribution to antibiotic resistance. Antibiotic drug resistance, which occurs when bacterial infections no longer respond to antibiotics is problematic for developed countries. Antibiotics carries a risk of adverse reaction and is likely to increase the number of medical consultations for dental conditions in the future. The researchers are […]

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Can poor oral health accelerate cognitive decline?

A new study published in the Journal of the American Geriatrics Society reviews studies focused on oral health and cognition. It is possible that better oral hygiene and regular dental visits may play a role in slowing cognitive decline as one ages. Researchers have questioned whether there is an association between oral health and cognition for older adults. Evidence suggests that the frequency of oral health problems increases in those that are cognitively impaired. Furthermore, factors associated with poor oral health like poor nutrition and systemic diseases are also associated with poor cognition. Researchers analyzed relevant cross-sectional (data collected at one specific point in time) and longitudinal (data collected over an extended period of time) studies published between 1993 and 2013. Some studies found that oral health measures such as the number of teeth, the number of cavities, and the presence of periodontal disease (gum disease) were associated with an increased risk of cognitive decline where as others studies were unable to show such an association. Researchers noted that findings based on the number of teeth or cavities are conflicting, and limited studies suggest that periodontal conditions are associated with poorer cognitive status. The researchers feel there is not enough evidence to conclude that a causal […]

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Migraine treament with monoclonal antibodies

Migraine headaches affect around 6 to 8% of males and 10 to 12% of females. It is one of the top five neurological conditions and costs people healthy lives. There is little research on how the current preventative treatments for migraine work. Researchers have speculated that the suppression of cortical spreading depression could be a process at play. Typically migraine patients are given beta-blockers such as propranolol and metroprolol, anticonvulsants valproate and topiramate, and the calcium channel bocker flunarizine as first line medications. These drugs have been shown in randomized placebo controlled studies to reduce the frequency of migraine attacks. A new treatment option could be placed in monoclonal antibodies that target a neuropeptide called CGRP (Calcitonin Gene-related Peptide). CGRP plays is thought to play a key role in headaches. CGRP receptor antagonists have been developed for the treatment of acute migraine and prevention. The medication has proved effected but in some cases treatment had to be abandoned due to acute side effects, including increases of liver enzymes. This has caused CGRP receptor antagonists to have not been approved to date. Newer studies show that the new monoclonal antibody against CGRP, or its receptor, appears to cause less side effects. As […]

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Computer Assisted Retrieval of Accidentally Displaced Wisdom Teeth

An article titled “Use of Computer-Assisted Navigation in the Retrieval of Accidentally Displaced Third Molars,” appears in the 2016 Journal of Oral and Maxilofacial Surgery, written by Yi Guo and et al., vol. 74, pp. 889-894. The article describes using a computer to retrieve accidentally displaced mandibular third molars. A total of 12 patients in the study successfully had their roots retrieved. They all healed successfully without complications. In rare cases when performing wisdom teeth surgery, a tooth or a tooth root can be displaced. When they are displaced into difficult to access areas surgery retrieving the displaced molars should be performed by conventional methods which include extending the original operative exposure or planning a new operative approach and then finding and removing the tooth. This surgery can cause severe tissue injury or complications. The paper discusses computer-assisted navigation in the retrieval of displaced mandibular third molars and to evaluate the effectiveness of this method. The criterion for using this technique of computer-assisted navigation involved teeth or tooth fragments that were displaced into difficult-to-access areas (sublingual space, pterygomandibular space, lateral pharyngeal space, submandibular space, and lateral cervical space). To localize the displaced mandibular third molar or root fragment computed tomographic […]

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Comparing Complications from Anesthesia with Wisdom Teeth Extractions

An article titled “Anesthesia Complications of Diazepam Use for Adolescents Receiving Extraction of Third Molars,” appears in the 2016 Journal of Oral and Maxilofacial Surgery by Gino Inverso and et. al, vol. 74, pp. 1140-1144. The article seeks to evaluate the safety of midazolam and diazepam for adolescents during wisdom teeth extraction and whether any differences in complications exist when using the 2 benzodiazepines alone or in combination. Compared with diazepam, midazolam has a faster onset of action, greater incidence of amnesia, and shorter recovery time. The authors hypothesized that diazepam, when used as an intravenous sedative agent for third molar extraction, would be associated with a higher rate of anesthetic complication than midazolam. The study included patients enrolled in the OMSOS from January 2001 through December 2010. To be included, patients had to be adolescents (<21 yr old) who underwent at least 1 third molar extraction by an oral and maxillofacial surgeon in the ambulatory setting. The study cohort was divided into 3 groups: patients who received diazepam as the only parenteral benzodiazepine, patients who received midazolam as the only parenteral benzodiazepine, and patients who received a combination of diazepam and midazolam. The primary outcome was perioperative anesthetic complications. Complications […]

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