Archive | July, 2016

Shared decision making in cases of conflicted evidence

An interesting article titled “When clinical evidence is conflicted, who decides how to proceed? An opportunity for shared decision making,” appears in the October 2015 issue of JADA (vol. 146 issue 10, pp. 713-714) and written by Arthur H. Friedlander and et al. The article discusses the concept of shared decision making “…particularly necessary in dentistry at this juncture, given recommendations but inconclusive data available to support abandoning the provision of prophylactic antibiotics to patients with total joint prostheses.” I have previously talked about shared medical decision making in the blog post The Well Informed Patient http://blog.teethremoval.com/the-well-informed-patient/. The article talks about how historically patients were expected to consent to the recommendations of their doctors without much discussion. However, since this is not enough to be legally and ethically correct shared decision making can be used which is a “…collaborative process encouraging patients and their providers to make health care decisions together, taking into account the best scientific evidence available as well as the patient’s values and preferences.” The authors go on to state “This bioethical, patient-centered, informed consent process demonstrates respect for the patient’s autonomy and supports their empowerment at a time when illness renders them dependent and vulnerable. Furthermore, it enhances […]

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Chewing sugar free gum could help prevent tooth decay and save money

An interesting article titled “Oral health promotion: the economic benefits to the NHS of increased use of sugarfree gum in the UK” explores the effects of children chewing sugar free gum after eating or drinking in the U.K. Specifically the article finds out that in the National Health Service in England savings of £8.2 million a year could occur if all 12-year-olds across the U.K. chewed sugar free gum after eating or drinking, which is due to the role it plays in helping to prevent tooth decay. This savings would be equivalent to roughly 364,000 dental check-ups. Sugar free gum can be an easy and effective addition to oral health routines. The British Dental Health Foundation recommends brushing for two minutes, twice a day and for children over the age of seven, chewing sugar-free gum during the day. This can be effective in breaking down lingering food, neutralising harmful plaque acids, and reducing the risk of decay. Chewing sugar free gum after eating and drinking leads to increases in the production of saliva, which can help wash away food particles and neutralise harmful plaque acids. In addition, it promotes the remineralisation of tooth enamel. The benefits of sugar-free gum on […]

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It may be impossible to remove all bacteria from dental equipment

A few stories have appeared in articles in recent years where someone has gotten an infection at an oral surgeon or dentists office due to unsafe practices. See for example http://blog.teethremoval.com/unsafe-injection-practices-plaque-u-s-outpatient-facilities/. This has occurred when a lapse in following proper infection control practices has occurred. However, even when proper protocols are being followed at dental offices it may still be possible to come down with an infection (although rare). This is supported by a new study in the Journal Water Research titled “Efficacy of dental unit waterlines disinfectants on a polymicrobial biofilm.” The study reveals that disinfectants recommended by companies that manufacture dental unit water lines don’t actually shift all the bacteria in the lines, which means the water lines are never completely clean. The dental water lines are used by dentists to keep their dental equipment, which is always coming in contact with people’s mouths, clean. In the study by researchers from the Université de Poitiers in France they analyzed three disinfectants used by some European dentists to control biofilms in dental water lines: Calbenium®, Oxygenal 6® and Sterispray®. The researchers tested how well the disinfectants removed biofilms from dental water lines. If the disinfectants are not completely effective […]

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Will There Be No More Needles at the Dentist Soon?

A new study reveals how a dentist could give you an anesthetic using a tiny electric current instead of a needle.  The study was published in Colloids and Surfaces B: Biointerfaces and reveals how a dentist could give you anesthetic using a tiny electric current instead of a needle. The researchers from the study are from the University of São Paulo and believe their findings could help improve dental procedures and bring relief to millions of people who are scared of needles. Dentists commonly currently use anesthetics that block pain administered using needles. Many patients are afraid of these injections, and this can result in them postponing and canceling visits to the dentist. For patients who do not like needles, dentists can give them a topical painkiller to reduce their pain and fear. This can come in the form of a hydrogel which can contain lidocaine and prilocaine. In the study, the researchers explored a way of getting topical anesthetics into the body more effectively. They found that applying a tiny electric current known as iontophoresis, made the anesthetics more effective. The researchers first prepared the anesthetic hydrogels with a polymer to aid in it sticking to the lining of […]

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Diseases that causes rashes on the skin can trigger neurological problems

An interesting chapter titled “Acquired neurocutaneous disorders” which appeared last year discusses how diseases that cause rashes and skin problems can trigger neuroglical conditions such as migraine headaches and strokes. The article was published in Handbook of Clinical Neurology by three authors affiliated with the Department of Neurology of Loyola University Chicago Stritch School of Medicine. The authors say that a variety of neurological diseases have skin related manifestations that precede, coincide with or follow neurologic findings. A few of the diseases described in the article that cause both skin and neurological problems are: Sjögren syndrome. Sjögren syndrome is an autoimmune disease where the body attacks its own tissues. The most common skin problem Sjögren syndrome causes is xerosis which causes dull, itchy skin with a fine, white bran-like scale. Neurologic problems caused by Sjögren syndrome include aphasia (inability to talk or understand speech), hemiparesis (paralysis on one side of the body), and chorea (jerky, involuntary movements). Lupus. Lupus can affect multiple organs and can cause a range of neurologic and psychiatric problems, including stroke, migraine headaches, and anxiety. Women are 10 times more likely than men to have lupus and it occurs a lot during the reproductive years. Around 70% […]

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