- Local Anesthesia Part 3: Anatomy & Maxillary Tec...
- Local Anesthesia Part 2: Armamentarium, Patient ...
- Local Anesthesia Part 1: Introduction & The Drug...
- Multiple opioid prescriptions among privately in...
- Cohort study of HIV-positive and -negative metha...
- Periodontitis in US Adults
- Trends in annual dental visits among US dentate ...
Local Anesthesia Part 3: Anatomy & Maxillary Techniques
Local anesthetic techniques providing pain control in the maxillary arch are described in this program following a review of the anatomy of the trigeminal nerve. Techniques include infiltration (supraperiosteal), anterior superior alveolar nerve block; middle superior alveolar nerve block; posterior superior alveolar nerve block; anterior superior alveolar nerve block; and palatal injection techniques.
Local Anesthesia Part 2: Armamentarium, Patient Evaluation & Basic Injection Technique
The basic armamentarium for the administration of local anesthetics includes the syringe, cartridge and needle. Proper assembly and use of these items minimizes the risk of complications arising during injection, such as shattering of cartridges and needle breakage. Prior to the administration of drugs the doctor is expected to have knowledge of the health status of the patient receiving the injection. The medical history questionnaire is reviewed with an emphasis on local anesthetic-related concerns. As the delivery of ‘painless’ injections is foremost on the patient’s list of dental desires, the basic local anesthetic injection technique is reviewed.
The basic armamentarium for local anesthetic delivery – the syringe, cartridge and needle – is reviewed in this program along with evaluation of the patient prior to receiving an injection. A step-by-step review of the basic local anesthetic injection technique is provided.
Local Anesthesia Part 1: Introduction & The Drugs
Local anesthetics, the most used drugs in dentistry, are the safest & most effective drugs for the prevention and management of pain. However the act of receiving an injection – the ‘shot’ – is the most fear-inducing part of the dental experience for most patients. 75% of all dental office medical emergencies are ‘stress’ related and therefore preventable in most situations. Techniques of managing fear including inhalation and oral sedation are reviewed. The pain reaction threshold (PRT) is introduced followed by a discussion of the effect of various clinical situations, e.g. pain, infection and fear, on the PRT. The currently available (in North America) local anesthetic formulations are discussed with an emphasis on their expected duration of clinical action.
This program reviews the development of local anesthetics and the drug formulations that are currently available in dentistry. The effect of fear & anxiety on local anesthetic effectiveness is discussed along with an introduction to sedation – a very important ally in the quest for effective pain control.
Multiple opioid prescriptions among privately insured dental patients in the United States
Multiple or high dosage opioid prescriptions increase the risk of experiencing drug misuse and overdose. The authors examine index (first) and follow-up opioid prescriptions for 1 year among privately insured dental patients in the United States from 2010 through 2015. The authors used the 2010 through 2015 Truven Health MarketScan Research databases and the Prescription Drug Monitoring Program Training Technical Assistance Center conversion data set. The authors analyzed index prescriptions, repeat prescriptions over 1 year, same-day multiple prescriptions, and concurrent prescriptions among dental patients. Descriptive analyses were conducted for days’ supply, quantity of opioids, daily morphine milligram equivalent (MME) dose, and total MME dose.
Key Words. Opioids; concurrent prescriptions; repeat prescriptions; dentists.
Cohort study of HIV-positive and -negative methamphetamine users
The effects of methamphetamine (MA) on caries have been well documented. Little, however, is known about its effects on the periodontium. The authors conducted this study to determine the prevalence and severity of periodontal disease in an urban population of HIV-positive MA users. This cross-sectional survey was conducted in one of the most populous urban areas of Los Angeles County, California, beset with high rates of MA use. Participants were recruited by a combination of street outreach methods, referral from drug treatment centers, and word of mouth. Participants were eligible if they were older than 18 years, spoke English or Spanish, used MA in the past 30 days, were willing to undergo a dental examination and psychosocial assessments, and were willing to provide a urine sample. Periodontal assessments were completed for 541 participants by 3 trained and calibrated dentists.
Key Words. Attachment loss; pocket depth; HIV; methamphetamine use; periodontal disease; epidemiology.
Periodontitis in US Adults
This report presents weighted average estimates of the prevalence of periodontitis in the adult US population during the 6 years 2009-2014 and highlights key findings of a national periodontitis surveillance project. Estimates were derived for dentate adults 30 years or older from the civilian noninstitutionalized population whose periodontitis status was assessed by means of a full-mouth periodontal examination at 6 sites per tooth on all nonethird molar teeth. Results are reported according to a standard format by applying the Centers for Disease Control and Prevention/American Academy of Periodontology periodontitis case definitions for surveillance, as well as various thresholds of clinical attachment loss and periodontal probing depth.
Key Words. Adults; epidemiology; NHANES; periodontal diseases; periodontitis; population surveillance; United States.
Trends in annual dental visits among US dentate adults with and without self-reported diabetes and prediabetes, 2004-2014
The authors assessed the trends of annual dental visits in dentate adults with diabetes or prediabetes or no diabetes, and assessed whether the racial and ethnic disparities in dental visits changed from 2004 through 2014. Data for this analysis came from the Behavioral Risk Factor Surveillance System, a US health survey that looks at behavioral risk factors that was developed by the Centers for Disease Control and Prevention in cooperation with state health departments. Respondents indicated whether they had a dental visit in the past 12 months. Weighted proportions were calculated for annual dental visits in adults by diabetes status, and trends were assessed by racial and ethnic groups.
Key Words. Dental visits; diabetes; racial disparity.
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.
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