Tag Archives | anesthesia

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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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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Should bilateral inferior alveolar and lingual nerve blocks be given for wisdom teeth surgery?

An interesting article titled “Should we be giving bilateral inferior alveolar and lingual nerve blocks for third molar surgery,” appears in the British Journal of Oral and Maxillofacial Surgery and written by J. Jabbar and et al. (2014, vol. 52, pp. 16-17). The article discusses how when someone is having their wisdom teeth extracted they are usually given general anesthesia and 2 inferior alveolar nerve blocks or local anesthesia in one or two visits. The authors feel there is controversy over whether 2 inferior alveolar nerve blocks should be given to patients in a single visit. The authors say the most common complications thought to be associated with bilateral inferior alveolar nerve blocks are injury to the tongue during anesthesia, unpleasant effects, loss of control of the tongue, and bilateral anaesthesia of the tongue, which can lead to collection of fluid in the oral cavity and aspiration. The authors mention a few past studies that have been conducted to look at lingual movement from bilateral anesthesia. Possible speech and articulation problems can arise. It is also possible the delay of lingual movement can cause a week bolus propulsion during swallowing. The author state that as of the study being published there is only anecdotal evidence on the incidence and complications that can happen from bilateral inferior alveolar nerve […]

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How safe is deep sedation or anesthesia in dentistry?

An interesting article titled “How safe is deep sedation or general anesthesia while providing dental care?” appears in the Sept. 2015 issue of JADA (volume 146, issue 9, Pages 705–708) and written by Jeffrey D. Bennett and et al. The article discusses how deep sedation and general anesthesia are given daily in dental offices or practices and this is usually done by oral and maxillofacial surgeons and dentist anesthesiologists. Sedation and anesthesia is given to patients to be able to more easily perform procedures and keep the patient safe and comfortable. Unfortunately in rare cases problems can happen and hence the authors were interested in exploring this. The authors state “Using the available data and informational reports, the authors estimate that the incidence of death and brain injury associated with deep sedation or general anesthesia administered by all dentists most likely exceeds 1 per month.” The authors feel that a patient safety database for anesthetic management in dentistry would provide a more complete assessment of the mortality and morbidity involved. This would be beneficial to developer safer anesthetic care. The authors further state “Optimization of patient care requires appropriate patient selection, selection of appropriate anesthetic agents, utilization of appropriate monitoring, and a highly trained […]

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Pediatric Dental Death in Cambridge, Ontario, Canada Spurs Comments on Dental Anesthesia

Recently, a death has occurred in Cambridge, Ontario, Canada, in a dental office. Details of the case have not yet been released, but a boy died after getting anesthetic and had a previously undetected heart condition. It seemed to have occurred sometime around late April, 2014, but the date may be off a bit. It appears that in this case the boy was brought to a hospital after the dental office in an attempt to save his life. An interesting article over in the Cambridge times published June 27, 2014, by Gordon Paul, titled “Pediatric dental surgery with anesthesia should be done in hospitals, dentist says,” provides some comments on this case. See http://www.cambridgetimes.ca/news-story/4605070-pediatric-dental-surgery-with-anesthesia-should-be-done-in-hospitals-dentist-says/. In this article comments by Dr. Hanover who is on the political action committee of the Ontario Dental Association are provided. He says “I think every pediatric dentist is most comfortable in a hospital. You’ve got the anesthetist, you’ve got a whole team of nurses, you’ve got crash carts, you’ve got ICUs … and in a dental office, you’ve got the dental anesthetist and maybe an RN. That’s the big difference.” Dr. Hanover, says that he has performed dental surgery on thousands of children under general anesthesia, but […]

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