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The recent study published in BDJ (Nov 2014) demonstrated that sevoflurane (gas uses for GA induction and maintenance) was found to be as effective as an inhalation sedation agent as the standard dose of nitrous oxide used in normal inhalation sedation in the treatment of adult anxious dental patients. Sevoflurane in low concentrations is equivalent in effect to near equipotent concentrations of nitrous oxide. There is scope to explore the development of equipment specifically designed to deliver sevoflurane as an inhalation sedation agent in future.

(Allen M, Thompson S. “An equivalence study comparing nitrous oxide and oxygen with low-dose sevoflurane and oxygen as inhalation sedation agents in dentistry for adults”. British Dental Journal 217, E18 (2014).

A protocol for patients undergoing dental treatment and taking new oral anticoagulants: dagibatran, rivaroxaban, apixaban:  excessive bleeding risk assessment,  new oral anticoagulants discontinuation 24 hours prior planned eg. extraction, advice from medical practitioner or local haematology team is recommended, use of local measures to prevent post-op bleeding. (E. Sherwin, N. Curry. Oxford Health NHS Foundation Trust)

Cochlear implants and radiation for dental purposes. Congenitally deaf patient treated with cochlear implants and speech processors.  Speech processors should be kept at least 50 cm away and preferably out of the room when radiographic examinations are undertaken ( Harrison; Patient safety: Cochlear implants; British Dental Journal 219, 98 (2015)

Cimetidine, a well known drug used for the treatment of stomach ulcers as an H2 inhibitor, can be effective as a therapeutic agent for selected forms of aphthous stomatitis.When used regularly it may prevent future episodes aphthous ulcerations associated with PFAPA syndrome and has immunomodulatory effects that include blocking suppressor T-cells and facilitating cell-mediated immunity.

(A.Dziedzic; Ulceration: More on aphthous ulceration; British Dental Journal 218, 663 (2015)

Since August 2015 recommendations by the Scottish Dental Clinical Effectiveness Programme (SDCEP) in relation to combined antiplatelet and NOACs dual therapy do not advise a specific course of action and they only indicate a need for consultation with a general medical practitioner or specialist. Consultation with an anticoagulation clinic or clinical haematologist is always necessary prior to dental surgery for patients in combined dual anticoagulant therapy due to considerably higher risk of bleeding. Due to the more stable and predictable effects, temporary discontinuation and restarting the NOACs causes less risk than warfarin. When restarting the NOACs, a desirable anticoagulant effect reaches its targeted level within a few hours following administration. (A. Dziedzic. British Dental Journal 220, 45 (2016) Pharmacology: Dual therapy   guidance)

Patients with BMI of 30-34.9 and no significant co-morbidities/anatomical contraindications are still suitable for day procedure unit and have a moderate airway risk. Limiting BMI to 30 for day surgery is outdated and not (McKenna and S. Stevens, JDOH, 17/2, 2016)

Hematopoietic cell transplantation (HCT) is of the frequent procedures used for treatment of malignant and non-malignant blood diseases, autoimmune disorders, and certain solid tumors.  HCT still carries a high risk of non-relapse mortality due to early and late complications. Side effects of the therapy regimen frequently occur in the oral cavity and often significantly decrease the patients’ quality of life. The complications may result from or may be exacerbated by improper oral preparation of the patient before transplantation. It is mandatory that all patients referred to HCT undergo thorough dental examination and receive appropriate treatment before the procedure. It is also very important to develop an individual post-transplantation oral care protocol with special concerns to oral hygiene. This paper presents a review of dental management methods intended for patients before HCT proposed in literature as well as recommendations and pays special attention to the problem of potential foci of infection and bleeding. It also presents protocol of oral hygiene in post-transplantation period. (Annals of Hematology · February 2017, DOI: 10.1007/s00277-017-2932-y).

Hypokalemic sensory overstimulation – is characterized by a subjective experience of sensory overload and a relative resistance to lidocaine local anesthesia.