JADA September 2018

The authors’ aim in this systematic review was to evaluate to what extent impacted canines are associated with root resorption (RR) of the adjacent tooth by using cone-beam computed tomography.

Key Words: Root resorption; impacted tooth; ectopic tooth; systematic review.

JADA September 2018

Although sealants are highly effective in preventing caries in children, placement rates continue to be low. The authors’ goals were to implement and assess the performance of 2 existing sealant quality measures against a manual audit of charts at 4 dental institutions and to identify measurement gaps that may be filled by using data from electronic health records.

Key Words: Dental sealants; oral health; quality of care; caries risk assessment; caries.

Learn why your organization must embrace change from Dr. Kathy O'Loughlin, Executive Director of the American Dental Association.  In this course, Dr. O'Loughlin discusses the need for leaders to be champions of change and tactics to lead your teams through modern transitions.

Updated for 2018

Though local anesthetics are safe and effective, considerable research is on-going to make them even more effective. Computer-controlled local anesthetic delivery systems (C-CLAD) and buffered local anesthetic solutions promise to allow painless injections to be delivered to dental patients almost anywhere in the oral cavity. Fear of injections is primarily based on the needle. The development of an intranasal local anesthetic mist has been shown to provide successful pulpal anesthesia of maxillary teeth – without a needle. Epinephrine is added to injectable local anesthetics to increase their effectiveness, duration and safety. However the duration of residual soft tissue anesthesia – usually unnecessary and occasionally a potential danger – is extended when epinephrine is used in the anesthetic solution. Self-inflicted soft tissue injury is a real problem associated with this anesthesia in all patient age groups but especially pediatric and geriatric patients. Phentolamine mesylate – an alpha adrenergic antagonist – has been shown to significantly reduce the duration of residual soft tissue anesthesia when administered at the conclusion of the traumatic part of dental treatment.

Learning Objectives: 

1. Discuss the current research on intranasal local anesthesia in dentistry
2. Describe the effect of pH on the onset, depth & comfort of anesthesia with local anesthetics
3. Describe the mechanism of action of the buffering agent sodium bicarbonate on local anesthetics
4. List the benefits of local anesthetic buffering in dentistry
5. Discuss the local anesthetic reversal agent - phentolamine mesylate
6. Describe the advantages & disadvantages of Computer-Controlled Local Anesthetic Delivery (C-CLAD)
7. Describe the clinical effects of the intranasal local anesthetic mist

Updated for 2018

Articaine HCl was introduced in the USA in 2000 and has become a very popular anesthetic agent. Though classified as an amide local anesthetic it is actually a hybrid molecule, possessing both ester and amide characteristics. With epinephrine, articaine provides approximately 60 minutes of pulpal anesthesia and between 3 to 5 hours of soft tissue anesthesia. Its unique molecular characteristics make articaine a preferred anesthetic in the pregnant and the nursing patient as well as the lighter weight (<30kg) pediatric patient. However, articaine is used as a 4% solution and there has been some concern about the possibility of 4% anesthetics possessing a greater risk of producing paresthesia than local anesthetics used in lesser concentrations.

This program provides an in-depth look at articaine, its advantages and disadvantages when compared with other commonly used dental local anesthetics. We also discuss the ‘controversy’ alleging an increased risk of paresthesia following administration of 4% local anesthetics.

Learning Objectives:

1. Describe the clinical characteristics that make articaine HCl ‘different’
2. Compare articaine HCl clinically to other dental local anesthetics
3. Discuss the use of articaine HCl in pediatrics; (2) pregnancy and (3) nursing
4. Discuss the use of articaine HCl in (1) pregnancy and (2) nursing
5. Discuss the ‘controversy’ over prolonged anesthesia (paresthesia) as related to injectable local anesthetics in dentistry

Updated for 2018

Complications associated with local anesthetic administration are rare. This program discusses complications occurring in and around the site of local anesthetic drug administration - facial nerve paralysis, hematoma, paresthesia, trismus and needle breakage, their prevention, recognition and management as well as the two systemic adverse drug reactions – allergy and overdose – are reviewed as each relates to the administration of local anesthetic drugs.

Learning Objectives:

1. Name 5 localized complications associated with administration of dental local anesthetics
2. Discuss the mechanism of and signs & symptoms associated with multiple complications
3. Name the three systemic adverse drug reactions (ADRs)
4. Discuss the differences between allergy & overdose
5. List the components of a local anesthetic cartridge and potential allergic reactions
6. Describe the signs & symptoms of local anesthetic overdose

JADA November 2017
This six article annual JADA supplement explores the benefits of baking soda and oral health. This supplement has been sponsored by Church & Dwight Co., Inc. All content has been peer reviewed by the designated editors of The Journal of the American Dental Association (JADA). The opinions or views expressed in this supplement are those of the authors, and do not necessarily reflect the opinions or views of The Journal, Church & Dwight Co., Inc., or those of the American Dental Association.

JADA November 2017
Objectives were to determine the likelihood that a clinician accepts an impression for a single-unit crown and document crown remake rates. The authors developed a questionnaire that asked dentists about techniques used to fabricate single-unit crowns. The authors showed dentists photographs of 4 impressions and asked them to accept or reject each impression. The authors correlated answers with dentist and practice characteristics. Other questions pertained to laboratory use and crown remake rates.

Abstract:

Part 4: Leading Your Patients- In this webinar, the dentist and team will discover the keys to converting a tenuous new patient inquiry to a committed first appointment and beyond. Patients will pay any fee if they like you, understand why treatment is being diagnosed and are committed to their care, because they felt partnered with and listened to!

JADA November 2017
The authors examined the relationship between education debt and career choice, particularly dentists’ decisions to specialize, participate in public health insurance programs, and join dental management service organizations (DMSOs). The authors used data from the American Dental Association 2015 office database, which contains dentist demographic information and identifies dentists who participate in public health insurance programs for pediatric dental care services. The authors merged this database with the 2002-2015 American Dental Association Survey of Dental Graduates, which contains information about education debt, to assess the relationship between education debt and career choices. The authors used probit and multinomial logit models to determine the relationships among education debt, demographic characteristics, and dentist career choices.

JADA July 2017
Sugar-sweetened beverages (SSBs) are dietary sources of sugar that are factors in caries development and tooth loss. Dietary sugar also is linked to diabetes mellitus (DM). There is limited research related to SSBs and tooth loss in people with DM. The authors investigated the association between SSBs and tooth loss as it related to the presence or absence of DM. The authors used a cross-sectional design with data reported by adults (18 years and older) who responded to the 2012 Behavior Risk Factor Surveillance System questionnaire, which was used in 18 states (N = 95,897; 14,043 who had DM and 81,854 who did not have DM). The authors conducted c2 and logistic regression analyses to determine associations related to DM status.

JADA August 2017
Except for a small increase in caries prevalence in young children from 1999 through 2004, the prevalence of pediatric caries in the United States has remained consistent for the past 3 decades. The authors used data from the National Health and Nutrition Examination Survey (NHANES) (from 1999 through 2004 and from 2011 through 2014) to ascertain changes in caries prevalence in youth aged 2 to 19 years. The authors evaluated changes in the prevalence of caries experience, untreated caries, and severe caries (3 or more teeth with untreated caries) in the primary, mixed, and permanent dentition according to poverty status.

JADA December 2017
A lesion on an occlusal tooth surface with no cavitation and no radiographic radiolucency but in which caries is suspected owing to surface roughness, opacities, or staining can be defined as a suspicious occlusal carious lesion (SOCL). The authors’ objective was to quantify the characteristics of SOCLs and their relationship to lesion depth and activity after these lesions were opened surgically. Ninety-three dentists participated in the study. When a consenting patient had an SOCL, information was recorded about the tooth, lesion, treatment provided, and, if the SOCL was opened surgically, its lesion depth. The Rao-Scott cluster-adjusted c2 test was used to evaluate associations between lesion depth and color, roughness, patient risk, and luster.

Key Words: Evidence-based dentistry; carious lesions; dentin.

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