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List Currently Showing Topic: Pharmacology

Anesthetic Buffering: New Advances for Use in Dentistry
AGD Subject Code(s): 132 CE credits: 1 Cost: $20.00
Faculty: Demetra Daskalos Logothetis, RDH, MS
14998

´╗┐´╗┐Local anesthetics are the safest drugs used in dentistry for pain management, but cause undesirable qualities such as stinging and burning upon injection, relatively slow onset of action, and unreliable or no anesthesia when injected into infected tissues. Buffering of local anesthetics has been demonstrated to counteract these undesirable qualities of local anesthetics. Recent advances in technology have made buffering of local anesthetics practical for use to alkalinize dental local anesthetic cartridges chairside immediately prior to injection, making the anesthetic’s onset quicker, more reliable, and more comfortable for the patient. This article provides an overview of neurophysiology, pharmacology of local anesthetics, and the role and benefits of local anesthetic buffering.

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Antibacterial Agents in Dental Hygiene Care
AGD Subject Code(s): 016 CE credits: 1 Cost: $20.00
Faculty: Howard M. Notgarnie, RDH, EdD
15062

Dental hygiene care incorporates antimicrobial agents as ad¬junct services with nonsurgical periodontal therapy, and as a measure to reduce the risk of hematogenous infection subse¬quent to oral tissue manipulation. Knowledge of antimicrobial properties provides practitioners the ability to make sound de¬cisions when diagnosing conditions treated by dental hygiene intervention and choosing antibiotics dentists prescribe for administration. Antimicrobial agents inhibit structural or metabolic functions of microorganisms, but also render adverse effects to patients. Bacterial mutation and acquisition of genetic material enables development of strains resistant to antibiotics. Understanding the interplay of host, microorganism, and anti¬microbials fosters advances in therapeutic choices and delivery systems when treating periodontal disease, as well as when re¬sponding to the risk of hematogenous infection of endocardium or prosthetic joints.

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Antibiotic Interference with Oral Contraceptives: Can a Dental Visit Make you Pregnant?
AGD Subject Code(s): 016, 134 CE credits: 2 Cost: $49.00
Faculty: Michael Wahl, DDS
15307

Oral contraceptives are a safe and effective form of birth control used by millions of women in the United States and around the world. There have been anecdotal reports of unintended pregnancies after antibiotics were prescribed to women on oral contraceptives. Dentists and physicians have therefore been advised to warn female patients on oral contraceptives of a potential interaction and to advise additional forms of contraception when prescribing antibiotics. This issue has caused consternation among dentists, physicians, and patients, coming to a climax in the lay media with the headline “A Dentist Visit Can Make You Pregnant” in a supermarket tabloid. Fortunately, scientific studies have failed to show any decrease in oral contraceptive efficacy with any antibiotics except for one: rifampin, which is not typically used in dentistry. It is therefore not necessary to warn patients of a potential interaction between antibiotics used in dentistry and oral contraceptives when scientific evidence has consistently and repeatedly failed to support such an interaction.

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Anticoagulants and Antiplatelet Drugs in Dentistry: Stop the Interruption
AGD Subject Code(s): 016, 735 CE credits: 2 Cost: $49.00
Faculty: Michael Wahl, DDS
15077

Antithrombotic medications including anticoagulants like warfarin (Coumadin®) and antiplatelet agents like aspirin are used by millions of dental patients to prevent various thrombotic complications including stroke or heart attack. Dentists must weigh the risks of postoperative bleeding in patients whose antithrombotic medications are continued versus the risk of thromboembolic complications if antithrombotic medications are interrupted for dental procedures. The dental and medical literature shows only minimal risk for bleeding complications in patients whose anticoagulation or antiplatelet medication is continued for dental surgery, and if bleeding complications occur, they can usually be easily controlled with local measures for hemostasis. The literature also shows a small but significant risk of catastrophic or fatal embolic complications in patients whose anticoagulation or antiplatelet medications are interrupted for dental procedures. There is usually no valid reason to interrupt therapeutic levels of continuous anticoagulation or antiplatelet medications for dental surgery with local measures available for hemostasis.

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Pradaxa and Xarelto: Coming Soon to Your Practice!!
AGD Subject Code(s): 016 CE credits: 1 Cost: $20.00
Faculty: Leslie F.T. Fang, MD, PhD
15181

Pradaxa® (dabigatran) and Xarelto® (rivaroxaban) are two new oral anticoagulants that are striving to replace Coumadin ® in the management of patients with non-valvular atrial fibrillation. The drugs have rapid onset of action, are taken in a fixed dose, do not require PT/INR monitoring and there are no dietary restrictions for the patients on these agents. This has led to a rapid adoption by physicians. It is therefore important for the dental professional to understand the mechanism of action of these drugs in order to intelligently manage these patients when they need dental intervention. The pros and cons of interruption of therapy are discussed as they apply to patients needing simple and complex dentistry. Medical consultation is mandatory prior to interruption of anticoagulant therapy.

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Prosthetic Joints and Antibiotic Prophylaxis
AGD Subject Code(s): 016 CE credits: 1 Cost: $20.00
Faculty: Frieda Atherton Pickett, RDH, MS
15061

In 2009 the American Academy of Orthopaedic Surgeons (AAOS) website published a statement calling for universal antibiotic prophylaxis (AP). This statement was in conflict with the former joint guidelines published by the American Dental Association (ADA) and the AAOS. The ADA was not consulted prior to publishing the 2009 statement on the AAOS website. The event led to a call from many organizations to conduct a systematic review of the literature to establish evidence-based guidelines regarding the efficacy of AP to prevent prosthetic joint infection (PJI). Those guidelines were published December 2012 on the AAOS website and suggested practitioners reconsider the decision to call for AP in patients with hip and knee joint replacements. They are also available on the ADA Clinical Recommendations website at http://ebd.ada.org/ClinicalRecommendations.aspx. Maintenance of oral health was recommended as a measure to reduce the magnitude (number of microorganisms) of bacteremia.

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