RESUMO
Complications associated with various local anesthetic techniques have been recorded in case reports and reviews. This current case reports a transient incident of blurred, double vision (diplopia) following a Gow-Gates mandibular block injection. There is descriptive discussion on possibilities associated with intra-arterial injection, intravenous injection, diffusion through tissue planes, and the autonomic nervous system pathway to lend credence suggesting the etiology of the complication. For practitioners, recognizing when a complication arises from anesthesia delivery and managing the patient in an appropriate manner is essential to an overall agreeable outcome.
Assuntos
Anestesia Dentária/efeitos adversos , Diplopia/etiologia , Nervo Mandibular , Bloqueio Nervoso/efeitos adversos , Adulto , Humanos , Injeções , MasculinoRESUMO
The Pacific Center for Special Care at the University of the Pacific, Arthur A. Dugoni School of Dentistry has developed the virtual dental home (VDH) system, which uses allied dental professionals trained to place interim therapeutic restorations (ITR) under the general supervision of dentists. This paper reviews the scientific basis for the ITR, as used in the VDH system, in managing caries lesions and delivering oral health care to underserved and vulnerable populations.
Assuntos
Tratamento Dentário Restaurador sem Trauma , Auxiliares de Odontologia/estatística & dados numéricos , Cárie Dentária/terapia , Restauração Dentária Temporária , Populações Vulneráveis , California , Difusão de Inovações , Cimentos de Ionômeros de Vidro , Humanos , TelemedicinaRESUMO
Many people in California face significant barriers to obtaining dental care. Creation of a community-based oral health delivery system that could deliver preventive and simple therapeutic oral health services in community settings where these populations live or receive social and/or general health services has been one of the proposed strategies for improving access to oral health care. Two of the newer techniques are caries management by risk assessment and interim therapeutic restoration.
Assuntos
Serviços de Saúde Comunitária , Tratamento Dentário Restaurador sem Trauma/métodos , Assistência Odontológica/organização & administração , Cárie Dentária/prevenção & controle , Diagnóstico Precoce , Intervenção Médica Precoce , California , Acessibilidade aos Serviços de Saúde , Disparidades em Assistência à Saúde , Humanos , Medição de RiscoRESUMO
The decision to inject local anesthetic agents to achieve profound anesthesia is dependent upon many factors, particularly the depth and duration of anesthesia required, and the possible need for hemostasis. To maximize the safety of local anesthetic injections, it is necessary to weigh the risks against the benefits for each patient, for each anesthetic agent, for use of a vasoconstrictor, and for the delivery technique for the selected agent.
Assuntos
Anestesia Dentária/métodos , Anestesia Local/métodos , Anestésicos Locais/administração & dosagem , Anestésicos Locais/classificação , Assistência Odontológica/métodos , Quimioterapia Combinada , Humanos , Vasoconstritores/administração & dosagem , Vasoconstritores/classificaçãoRESUMO
This article seeks to provide a practical, everyday clinical guide for managing dental caries based upon risk group assessment. It is based upon the best evidence at this time and can be used in planning effective caries management for any patient. In addition to a comprehensive restorative treatment plan, each patient should have a comprehensive caries management treatment plan. Some sample treatment plans are included.
Assuntos
Cárie Dentária/terapia , Guias de Prática Clínica como Assunto , Adolescente , Adulto , Anti-Infecciosos Locais/uso terapêutico , Cariostáticos/uso terapêutico , Criança , Assistência Odontológica Integral , Cárie Dentária/diagnóstico , Cárie Dentária/prevenção & controle , Suscetibilidade à Cárie Dentária , Fissuras Dentárias/diagnóstico , Fissuras Dentárias/terapia , Restauração Dentária Permanente , Comportamento Alimentar , Humanos , Lasers , Higiene Bucal , Planejamento de Assistência ao Paciente , Radiografia Interproximal , Medição de Risco , Fatores de Risco , Cárie Radicular/terapia , Remineralização DentáriaAssuntos
Anestesia Dentária/métodos , Anestesia Local/métodos , Anestésicos Locais/administração & dosagem , Injeções/métodos , Vasoconstritores/administração & dosagem , Carticaína/administração & dosagem , Epinefrina/administração & dosagem , Humanos , Mepivacaína/administração & dosagem , Nordefrin/administração & dosagemRESUMO
In fall 2002, the ADEA Section on Comprehensive Care and General Dentistry conducted a survey of the predoctoral clinical curriculum models at sixty-four North American dental schools. Fifty-eight percent of the schools reported that most patient care is provided in a comprehensive care clinic setting, 22 percent reported that most patient care is provided in discipline-specific settings, and 20 percent reported a hybrid of comprehensive care and discipline-specific settings. While ten Primarily Discipline-Based (PD) schools have instituted new Primarily Comprehensive Care (PCC) or Hybrid clinical curricula since 1997, one PCC school has converted to a Hybrid model, and one PCC school has converted to a PD model. PCC curriculum models were frequently associated with the following institutional factors: more densely populated metropolitan areas; private institutional sponsorship; location within a university medical center; larger class size; and more students enrolled in advanced training at the school. Curriculum factors frequently associated with PCC models included the following: increased use of simulation technology: higher proportion of clinical/teaching track faculty; higher proportion of part-time faculty; higher proportion of generalist faculty; same faculty supervising both treatment planning and patient treatment; and use of competency exams as the main requirement for completion of the curriculum.
Assuntos
Competência Clínica/normas , Assistência Odontológica Integral/normas , Currículo/estatística & dados numéricos , Educação em Odontologia/organização & administração , Faculdades de Odontologia/normas , Canadá , Educação Baseada em Competências/normas , Educação em Odontologia/estatística & dados numéricos , Humanos , Modelos Educacionais , Faculdades de Odontologia/estatística & dados numéricos , Estados UnidosRESUMO
Local anesthetics have been in use in dental practice for more than 100 years. The advent of local anesthetics with the development of nerve blockade injection techniques heralded a new era of patient comfort while permitting more-extensive and invasive dental procedures. A brief history and summary of the current local anesthetics available in the United States is provided, and some of the newest techniques for delivering local anesthetics are reviewed. General guidelines for addressing difficulties encountered in anesthetizing patients are also discussed.
Assuntos
Anestesia Dentária , Anestésicos Locais , Anestesia Dentária/métodos , Anestésicos Locais/administração & dosagem , Humanos , Injeções , Nervo Mandibular , Nervo Maxilar , Bloqueio Nervoso/métodos , Terapia Assistida por ComputadorRESUMO
Escalating student debt for dental education has led some to speculate that beginning practitioners may undertake procedures that are beyond their competence in an effort to augment practice income. This hypothesis was tested directLy using a data set containing self-reports of practice profiles across a wide range of procedures and debt for education, practice, and personal purposes. Respondents were 113 individuals who had graduated from a private dental school from 1986 to 1997. Conservative dental practice was measured by comparing frequency of commonly and uncommonly performed procedures in the group as a whole against the profile for each respondent. There was no association between educationaL debt and propensity to engage in unconventional procedures. Older dentists and those who felt more competent at the time of graduation were less conservative. Amount of practice debt was a better predictor of unconventional practice than was educational debt.