Dr Mark O'Donnell B.D.S
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News - November 2016
Combining dental, medical procedures may safely limit children's anaesthesia exposure
Children who require both dental and medical procedures should have them completed under one general anaesthetic whenever possible, which is ideal for both the patient and family, suggests research being presented at the Anesthesiology 2016 Annual Meeting.
"While surgery and anaesthesia are safer than they've ever been, limiting exposure is preferable, especially in children, because there may be sensitivities or a greater risk of anaesthesia-related complications," said Dr Vidya T. Raman, lead author of the study and director of pre-admission testing at Nationwide Children's Hospital, Ohio.
"In addition to improving patient safety, we believe combining procedures decreases costs and improves patient satisfaction”.
Every year, millions of children require surgery for dental and medical procedures. Dental procedures should be performed in combination with other surgical interventions requiring general anaesthesia. This enables the child to undergo multiple procedures in one visit rather than over several weeks or months.
In the study, 55 children had a dental procedure combined with another medical procedure under one anaesthetic. Nearly nine out of ten (87%) did not experience any complications. Seven (13%) had complications such as vomiting, pain, fever and pneumonia and of those, four (7%) required unplanned admission to the hospital. Most of those patients were at increased risk of hospitalisation because of severe systemic disease, said Dr Raman. Additionally, combining procedures saved an average of 30%, leading to savings of approximately $165,000 for 55 cases, researchers determined.
Study suggests benefits of laser treatments for dental problems
Researchers have developed computer simulations showing how lasers attack oral bacterial colonies, suggesting that using lasers could lead to better dental health.
In a study published in the journal Lasers in Surgery and Medicine, the researchers show the results of simulations depicting various laser wavelengths aimed at virtual bacterial colonies buried in gum tissue. In humans, actual bacterial colonies can cause gum inflammation. This can develop into periodontal disease, which involves a more serious infection that breaks down the bones and tissues that support teeth.
"The paper verifies or validates the use of lasers to kill bacteria and contribute to better health following periodontal treatments," said co-author Lou Reinisch, PhD of New York Institute of Technology.
Drawing on his background in physics, optics, and calculus, Reinisch, an expert in laser surgery, created mathematical models based on optical characteristics of gum tissues and bacteria. He then produced simulations of three different types of lasers commonly used in dentistry and their effects on two types of bacterial colonies of various sizes and depths within the gum models.
"One of the questions we asked is how deep could the bacteria be and still be affected by the laser light," said Reinisch. The simulations indicate that 810nm diode lasers, when set to short pulses and moderate energy levels, can kill bacteria buried 3mm deep in the soft tissue of the gums. Both lasers spare the healthy tissue, with the simulations showing minimal heating of the surrounding tissue. Minimising the thermal damage leads to faster healing.
New toothpaste reduces dental plaque and inflammation in the body
Research has already suggested a link between oral health and inflammatory diseases, in particular, heart attacks and strokes.
The results from a trial of a plaque identifying toothpaste (Plaque HD), show statistically significant reductions in dental plaque and inflammation throughout the body. Inflammation in the body is accurately measured by high sensitivity C-reactive protein (hs-CRP), a sensitive marker for future heart attacks and strokes. These results, published in the American Journal of Medicine, show that the toothpaste produced statistically significant reductions in dental plaque and inflammation throughout the body.
In this trial, all randomised subjects were given the same brushing protocol and received a 60-day supply of toothpaste containing either Plaque HD or an identical non-plaque identifying placebo.
"While the findings on reducing dental plaque extend a previous observation, the findings on decreasing inflammation are new and novel," said Dr Charles H. Hennekens, senior author on the study.
Dr Joseph S. Alpert, a cardiologist, noted the importance and timeliness of these findings and commented on how his father, a dentist, had told him even before he went to medical school, that dental health may affect heart attacks and strokes.
Plaque HD reveals plaque so that it can be removed with directed brushing. In addition, the product's proprietary formulation contains combinations and concentrations of cleaning agents that weaken the core of the plaque structure to help the subject see and more effectively remove the plaque.
Imaging method could enable dentists to detect and heal cavities earlier
Tooth decay is the most prevalent dental disease in the world. Left too long before treatment, the disease results in difficulty eating, infection and tooth loss. New research published by the international society for optics and photonics (SPIE), in the Journal of Biomedical Optics, describes a method enabling much earlier detection using inexpensive long-wavelength infrared imaging.
A cavity begins with a minute amount of mineral loss from the tooth enamel surface, resulting from the acidic environment of dental plaques. If cavities can be detected early enough, the progression can be stopped or even reversed.
Dentists currently rely on two methods to detect early cavities: x-ray imaging and visual inspection of the tooth surface, but both have limitations. Dentists can't see a cavity until it is relatively advanced, and x-rays can't detect early cavities on the biting surface of the tooth.
In the paper called ‘First step toward translation of thermophotonic lock-in imaging to dentistry as an early caries detection technology’, Ashkan Ojaghi, Artur Parkhimchyk, and Nima Tabatabaei of York University in Toronto describe a low-cost thermophotonic lock-in imaging (TPLI) tool that would allow dentists to detect developing cavities much earlier than x-rays or visual analysis.
The TPLI tool uses a long-wavelength infrared camera to detect the small amount of thermal infrared radiation emitted from dental cavities after stimulation by a light source.
Andreas Mandelis, professor of mechanical and industrial engineering at the University of Toronto, said: "This paper will have a high impact on the way dentists diagnose incipient caries”.