Dental unit waterline infection control practice and knowledge gaps.

BACKGROUND: Dental unit waterline (DWL) infection control is critical to infection prevention. Identifying challenges and barriers to its implementation is a first step toward understanding how to improve engagement. METHODS: A survey was distributed to dentists, dental hygienists, and dental assistants via the Qualtrics XM platform (Qualtrics). Responses were analyzed to quantify engagement in practices contrary to Centers for Disease Control and Prevention guidance and identify avenues to improve engagement. RESULTS: Although oral health care providers recognized DWL infection control was important, there was a lack of clarity about appropriate routine engagement (eg, what lines should be tested), what should be noted in practice infection control records, and steps to be taken in response to a failed test result (ie, ≥ 500 colony-forming units/mL), such as taking a chair out of service. CONCLUSIONS: Survey results showed there were considerable gaps in knowledge and practice that could lead to patient harm. Oral health care provider training may not prepare personnel adequately to engage in, let alone supervise, DWL infection control. DWL infection control, like other aspects of infection control, requires action informed via an understanding of what needs to be done. Although good intentions are appreciated, better approaches to DWL infection control information dissemination and strategies to engage dental assistants, dental hygienists, and dentists in best practices are needed. PRACTICAL IMPLICATIONS: Evolving standards of care, including infection control, should be reflected in the provision of dental treatment. Improvements in communicating and ensuring engagement in best practices are needed when it comes to DWL infection control.

Teledentistry: An Adjunct for Delivering Dental Care in Crises and Beyond.

Teledentistry can play a viable role both during a public health emergency and in everyday practice, contributing to sustaining, building, and improving dental practices as well as addressing health inequities. In light of the COVID-19 pandemic, which has caused widespread disruptions in the delivery of dental care, Oregon Health and Science University (OHSU) and the University of Washington (UW) implemented virtual care programs to help mitigate challenges associated with access to care. This article outlines a practical workflow for dentists to embark on teledentistry.

General anesthesia for a child with Landau-Kleffner syndrome, a case report.

Landau-Kleffner syndrome is a rare, epileptiform disorder with a pathognomonic sudden aphasia, epilepsy, and electroencephalographic abnormalities. It was first described in 1957. No case reports are included in the anesthesia literature. This case report describes a 9-year-old male who was treated for dental caries while under intubated general anesthesia. The case was successful and uneventful, with multiple precautions taken to prevent seizures or other complications. The authors hope that this report will provoke communication and additional case reports.

Successful shade matching--what does it take?

Dental practitioners can avoid expensive and embarrassing shade matching errors by learning about the structure and function of the eye and how to control the external and internal factors that affect human vision. The color of objects is identified by the visible light that they reflect; objects can reflect only the light that shines upon them. Eyes sense the hue, intensity, and saturation of light, so lighting of proper intensity and color balance is necessary for consistent, correct shade-matching. Although sunlight is the most common standard for good lighting, in everyday practice, it cannot be used for shade matching because of its extreme variability with weather conditions, time of day, and season of the year. In addition to external factors such as lighting, conditions internal to the observer also play a role in accurate color perception. Color vision confusion (CVC), often called "color blindness," is a serious handicap for dental professionals. The popular assumption is that very few people are afflicted; in fact, all people suffer from some level of color vision confusion. This distortion of visual information can be permanent or transitory. Therefore, controlling these variables can lead to color matching success.

Local anesthetic use in the pregnant and postpartum patient.

The use of systemically absorbed drugs in the gravid and in the lactating patient is of concern to the dentist. This article reviews concerns for the health and safety of the mother, developing fetus, and neonate involving local anesthetics. The available literature on the use of local anesthetics for dentistry in the pregnant and postpartum patient is also reviewed. In addition, the physiology of the pregnant and postpartum woman is discussed because this is essential to understanding potential interplay with local anesthesia and the stress of a dental appointment.