- Assessment of inappropriate antibiotic prescribi...
- Opioid prescribing and risk mitigation implement...
- Mission of Mercy patient characteristics and den...
- Influence of 2 caries-detecting devices on clini...
- Effect of an experimental desensitizing agent on...
- Opioid prescribing practices from 2010 through 2...
- Outbreak of bacterial endocarditis associated wi...
Assessment of inappropriate antibiotic prescribing among a large cohort of general dentists in the United States
The purpose of this study was to assess dental antibiotic prescribing trends over time, to quantify the number and types of antibiotics dentists prescribe inappropriately, and to estimate the excess health care costs of inappropriate antibiotic prescribing with the use of a large cohort of general dentists in the United States. We used a quasi-Poisson regression model to analyze antibiotic prescriptions trends by general dentists between January 1, 2013, and December 31, 2015, with the use of data from Express Scripts Holding Company, a large pharmacy benefits manager. We evaluated antibiotic duration and appropriateness for general dentists. Appropriateness was evaluated by reviewing the antibiotic prescribed and the duration of the prescription.
Key Words. Antibiotics; dentistry; prophylaxis; treatment; epidemiology; public health.
Opioid prescribing and risk mitigation implementation in the management of acute pain
Minimal information exists regarding the consistency and correlates of dentists’ implementation of risk mitigation strategies when prescribing opioids, including risk screening, prescription drug monitoring program (PDMP) use, and patient education. The authors conducted a Web-based, cross-sectional survey among practicing dentist members of The National Dental Practice-Based Research Network. The authors used the survey to assess pain management prescribing practices and risk mitigation implementation. The authors linked survey data with network enrollment questionnaire data to include practitioner demographic and practice characteristics.
Key Words. Pain; patient education; prescriptions; drug.
Mission of Mercy patient characteristics and dental-related emergency department use
Although dental Mission of Mercy (MOM) events have existed for more than 2 decades and are held in more than 30 states, systematic data collection and reporting on patient characteristics, oral health care use patterns, and oral health care needs are lacking. The authors surveyed patients attending the 2016 Florida MOM, asking about their reasons for seeking oral health care, oral health care use, and dental-related emergency department (ED) use. The authors conducted descriptive and multivariable analyses of survey and patient registration data to describe patient characteristics and examine associations between patient characteristics, time to last dental visit, and ED use.
Key Words. Access to oral health care; emergency services; oral health; vulnerable populations; Mission of Mercy.
Influence of 2 caries-detecting devices on clinical decision making and lesion depth for suspicious occlusal lesions
A suspicious occlusal carious lesion (SOCL) can be defined as a lesion with no cavitation and no radiographic radiolucency but for which caries is suspected. The authors evaluated whether using a device changed the percentage of SOCLs that were opened surgically and, among those SOCLs that were opened, the proportion that had penetrated into dentin. Eighty-two dentists participated. In phase 1 of the study, dentists identified approximately 20 SOCLs, obtained patient consent, and recorded information about the lesion, treatment or treatments, and depth, if opened. Dentists were then randomly assigned into 1 of 3 groups: no device, DIAGNOdent (KaVo), and Spectra (Air Techniques). In phase 2, dentists enrolled approximately 20 additional patients and recorded the same phase 1 information while using the assigned device to help make their treatment decisions. A mixed-model logistic regression was used to determine any differences after randomization in the proportion of lesions opened and, if opened, the proportion of lesions that penetrated into dentin.
Key Words. Evidence-based dentistry; caries; dentin.
Effect of an experimental desensitizing agent on reduction of bleaching-induced tooth sensitivity
In this randomized study, split-mouth, triple-blind clinical trial, the authors evaluated the efficacy of a desensitizing gel that contained 5% potassium nitrate and 5% glutaraldehyde applied before in-office bleaching with 35% hydrogen peroxide (HP). Treatment with the desensitizing or placebo control gels was randomly assigned to one-half of the maxillary teeth of 42 patients in a split-mouth design. The desensitizing gels were applied and maintained in contact with the tooth enamel for 10 minutes, followed by 2 HP bleaching sessions separated by 1 week. The primary outcome variable was pain intensity assessed with a numeric rating scale and a visual analog scale. Color was evaluated by means of a digital spectrophotometer and a value-oriented shade guide.
Key Words. Tooth bleaching; dentin sensitivity; randomized controlled clinical trial; hydrogen peroxide.
Opioid prescribing practices from 2010 through 2015 among dentists in the United States
Dentists wrote 6.4% of all opioid prescriptions in the United States in 2012. The purpose of this study was to examine opioid prescription rates, dosage of opioids prescribed, type of opioid drug prescribed, and type of dental visit at which dentists prescribe opioids. The authors used the 2010 through 2015 Truven Health Marketscan Research databases and the Prescription Drug Monitoring Program (PDMP) Training and Technical Assistance Center conversion data set. The authors conducted descriptive analyses for days’ supply, quantity prescribed, and daily morphine milligram equivalent dose.
Key Words. Opioids; prescriptions; dentists.
Outbreak of bacterial endocarditis associated with an oral surgery practice
In October and November 2014, the New Jersey Department of Health received reports of 3 patients who developed Enterococcus faecalis endocarditis after undergoing surgical procedures at the same oral surgery practice in New Jersey. Bacterial endocarditis is an uncommon but lifethreatening condition; 3 patients with enterococcal endocarditis associated with a single oral surgery practice is unusual. An investigation was initiated because of the potential ongoing public health risk. Public health officials conducted retrospective surveillance to identify additional patients with endocarditis associated with the practice. They interviewed patients using a standardized questionnaire. An investigative public health team inspected the office environment, interviewed staff, and reviewed medical records.
Key Words. Endocarditis; Enterococcus faecalis; health careeassociated outbreak; infection control; injection safety.
About ADA CE Online
ADA’s Online CE platform provides trusted education to dental professionals at your convenience. Our ever-growing catalog of clinical, practice management, and personal development education offers peer-reviewed continuing education credits to fit your resources and schedule. Credits earned through this platform are maintained for all users in an online transcript that you can access when you need your verification letters.
The ADA is a CERP Recognized Provider. ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.