Silver Diamine Fluoride: a critical review and treatment recommendations

Dental Update ◽  
2019 ◽  
Vol 46 (7) ◽  
pp. 626-632
Author(s):  
Jilen Patel ◽  
Robert P Anthonappa ◽  
Nigel M King
Keyword(s):  
High Risk ◽  
Current Evidence ◽  
Evidence Based ◽  
Dental Practice ◽  
Silver Diamine Fluoride ◽  
Disadvantaged Populations ◽  
Carious Lesions ◽  
Caries Management ◽  
High Risk Populations ◽  
High Risk Children

Over the last decade there has been a renewed interest in the use of Silver Diamine Fluoride (SDF) as an adjunctive modality in the management of caries among high-risk populations. This review presents the current evidence behind the use of SDF and recommendations for its use in caries management dental practice. CPD/Clinical Relevance: Silver diamine fluoride is an effective, evidence-based modality that can contribute towards arresting carious lesions among high-risk children and disadvantaged populations.

scholarly journals Infection Control Policy for Dental Practice: An Evidence-based Approach

2013 ◽  
Vol 3 (2) ◽  
pp. 82-86
Author(s):  
Ashwin Muralidhar Jawdekar
Keyword(s):  
Infection Control ◽  
Control Policy ◽  
Current Evidence ◽  
Successful Implementation ◽  
Evidence Based ◽  
Dental Practice ◽  
Control Policies ◽  
Adequate Knowledge ◽  
Infection Control Policy ◽  
Dental Staff

ABSTRACT Having a policy on infection control based on current evidence and guidelines is essential for all dental practices. The evidence shows that all the members of the dental team may not possess adequate knowledge of all relevant aspects related to infection control, such as the transmission of infectious diseases, current regulations, etc. Moreover, there exists evidence to support the value of education and certified training the dental professionals in improving their understanding of infection control policies and procedures. The training must be provided by an expert team comprising of an academician with suitable clinical experience and demonstrable expertize in dentistry, and a microbiologist who understands the needs of dental settings. Evidence suggests that a training over 10 hours is associated with maximal benefits; and the CDC and BDA guidelines recommend training to all dental staff (clinical as well as nonclinical) for optimal benefits. Successful implementation of the infection control policies depends on the adequate provision of time and facilities for the same. How to cite this article Jawdekar AM. Infection Control Policy for Dental Practice: An Evidence-based Approach. J Contemp Dent 2013;3(2):82-86.

scholarly journals Intra-aortic balloon counterpulsation: current evidence-based and unresolved issues

2020 ◽  
Vol 24 (3S) ◽  
pp. 18
Author(s):  
Yu. N. Neverova ◽  
T. S. Golovina ◽  
R. S. Tarasov
Keyword(s):  
Acute Coronary Syndrome ◽  
High Risk ◽  
Conflict Of Interest ◽  
Current Evidence ◽  
Evidence Based ◽  
Coronary Syndrome ◽  
Myocardial Revascularisation ◽  
Percutaneous Coronary ◽  
Intra Aortic Balloon Counterpulsation ◽  
Balloon Counterpulsation

<p>This literature review provides the current evidence-based research regarding the role of intra-aortic balloon counterpulsation in the treatment of patients in various clinical situations. These include patients with acute coronary syndrome, complicated or uncomplicated by cardiogenic shock, accompanied by high-risk percutaneous coronary interventions, accompanying patients in need of coronary artery bypass surgery in various conditions as a ‘bridge’ to decision-making or treatment. Because the introduction of intra-aortic balloon counterpulsation into clinical practice, it has been the most common method of hemodynamic support in high-risk patients. The classical strategy for the treatment of acute myocardial infarction has evolved over the last decade from a thrombolysis scenario to a primary coronary revascularisation scenario, which resulted in a larger patient cohort. The currently available data, however, do not support the routine use of intra-aortic balloon counterpulsation by most of this population. Current studies have shown that the use of intra-aortic balloon counterpulsation did not lead to a decrease in 30-day mortality in patients with acute coronary syndrome and cardiogenic shock who received therapy with the strategy of early myocardial revascularisation as the planned primary goal. The expediency of using high-risk percutaneous coronary intervention as an accompanying method is ambiguous, whereas the use of the method as a ‘bridge’ to surgical myocardial revascularisation may be justified and requires additional research. The article provides the current recommendations for the treatment of patients. Research results and unresolved issues are being discussed.</p><p>Received 3 June 2020. Revised 4 August 2020. Accepted 24 August 2020.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> Authors declare no conflict of interest.</p>

scholarly journals Evidence-based Recommendations on Periodontal Practice and the Management of Periodontal Patients During and After the COVID-19 Era: Challenging Infectious Diseases Spread by Airborne Transmission

2021 ◽  
Vol 15 (1) ◽  
pp. 325-336
Author(s):  
Federica Di Spirito ◽  
Vincent J Iacono ◽  
Iandolo Alfredo ◽  
Amato Alessandra ◽  
Ludovico Sbordone ◽  
...  
Keyword(s):  
High Risk ◽  
Infectious Diseases ◽  
Population Based ◽  
Economic Resources ◽  
Assessment Tools ◽  
Current Evidence ◽  
Evidence Based ◽  
Contamination Control ◽  
Treatment And Prevention ◽  
Time Space

Background: Periodontal care, which was completely suspended during the peak of the SARS-Cov-2 pandemic and was delayed and recurrently discontinued during the succeeding waves, must be safely provided in the COVID-19 era. Objectives: The study aimed to provide recommendations on periodontal practice, optimizing safety, ergonomics, and economic resources, and the management of periodontal patients, ensuring continuity, timing, and effectiveness of periodontal care in the COVID-19 era. Methods: Reported protocols for the dental practice in the context of the COVID-19 and current evidence on periodontitis treatment and prevention were reviewed. Results: Evidence-based recommendations on contamination control and ergonomic improvements for periodontal practice and the management of periodontal patients challenging COVID-19 and airborne infectious diseases have been provided. Conclusion: Due to the economic, ergonomic, and ethical concerns raised by limited periodontal care due to the SARS-Cov-2 pandemic, and awareness of other emerging airborne transmitted infections, the periodontal practice should integrate measures minimizing airborne cross-infections and optimizing time-space and economic resources. The management of periodontal patients in the COVID-19 era should comprise less complex treatments and more comprehensive and definitive approaches, reducing emergencies, session length and number, and, concurrently, extending the recall and maintenance intervals. Moreover, it should implement prevention strategies through teledentistry tools and apps, improving periodontal awareness and self-care, and also through the self-reporting of periodontitis and periodontal risk assessment tools, performing both “population-based” and “high-risk” surveillance of periodontitis. Finally, it should enhance inter-professional collaboration, through telehealth networks, especially targeting subjects at high-risk of both periodontitis and systemic disorders, each of the two variously linked to COVID-19 onset and worsening.

scholarly journals Current Evidence-based Management of Patients on Antiplatelets and Anticoagulants in Dental Practice: A Questionnaire-based Survey of Interns and Staff

2014 ◽  
Vol 4 (1) ◽  
pp. 22-26 ◽  
Author(s):  
Sunil Sidana ◽  
Shazneen Firdosh Daruwalla
Keyword(s):  
Blood Flow ◽  
Standard Of Care ◽  
Current Evidence ◽  
Evidence Based ◽  
Dental Practice ◽  
Thromboembolic Complications ◽  
Flow Mechanism ◽  
Excessive Bleeding ◽  
Dental Patients ◽  
Dental Procedures

ABSTRACT An increasing number of dental patients are taking ‘blood thinner’ medications for various medical conditions. These drugs interfere with the body's normal clotting (stopping blood flow) mechanism. The standard of care has been to stop the aspirin and warfarin prior to dental procedures involving bleeding since these drugs are known to affect clot formation and coagulation. However, the patient is at a greater risk of developing thromboembolic complications and reinfarcts if these drugs were discontinue than occurence of excessive bleeding if they were continued. Bleeding can be effectively managed by local hemostatic measures. How to cite this article Daruwalla SF, Sidana S. Current Evidence-based Management of Patients on Antiplatelets and Anticoagulants in Dental Practice: A Questionnaire-based Survey of Interns and Staff. J Contemp Dent 2014;4(1):22-26.

scholarly journals Use of Fluoride and Silver Ion Compounds in Three International School Based Oral Health Programs – A Case Report

2020 ◽  
Vol 3 (2) ◽  
pp. 1-11
Author(s):  
Steven R. Duffin ◽  
Marcus L. Duffin
Keyword(s):  
Silver Nitrate ◽  
Sodium Fluoride ◽  
Treatment Protocol ◽  
Management Program ◽  
Fluoride Varnish ◽  
Initial Assessment ◽  
Silver Diamine Fluoride ◽  
School Based ◽  
Carious Lesions ◽  
Caries Management

Untreated dental caries in children is one of the most common diseases and largest public health problems in the world. A novel caries management program, using 50% silver nitrate, 38% silver diamine fluoride, and 5% sodium fluoride varnish, was developed at Shoreview Dental, LLC, a private dental practice in Oregon USA, and then introduced into schools in Ecuador, Ghana, and Bolivia. Cavitated carious lesions were treated with 50% silver nitrate, followed by covering with 5% sodium fluoride varnish, three times over two weeks for 165 children in Ecuador at initial assessment, 3 months, and 6 months. This protocol was repeated for 271 children in Ghana at initial assessment and 12 months. In Bolivia, 130 children were treated with 38% silver diamine fluoride, followed by covering with 5% sodium fluoride varnish, once per visit at initial assessment, 6, 12, 18, 24, 30, and 36 months. The percentage of children with active cavitated carious lesions at initial evaluation was 92.7% (Ecuador), 55.4% (Ghana), and 92.3% (Bolivia). The final arrest rate of treated surfaces was 98.8% (Ecuador), 67.6% (Ghana), and 90.2% (Bolivia). Effectiveness of cavitated caries lesion arrest is increased when it is thoroughly cleaned and dried before the treatment protocol. Further optimization is obtained when this protocol is repeated multiple times.

scholarly journals Multidisciplinary, evidence-based consensus guidelines for human papillomavirus (HPV) vaccination in high-risk populations, Spain, 2016

2019 ◽  
Vol 24 (7) ◽  
Author(s):  
Xavier Martínez-Gómez ◽  
Adrian Curran ◽  
Magda Campins ◽  
Laia Alemany ◽  
José Ángel Rodrigo-Pendás ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
High Risk ◽  
Bone Marrow Failure ◽  
Hpv Vaccination ◽  
Evidence Based ◽  
Solid Organ ◽  
Hematopoietic Stem ◽  
Associated Lesions ◽  
Vaccination Recommendations ◽  
High Risk Populations

Introduction: Although human papillomavirus (HPV) routine vaccination programmes have been implemented around the world and recommendations have been expanded to include other high-risk individuals, current recommendations often differ between countries in Europe, as well as worldwide. Aim: To find and summarise the best available evidence of HPV vaccination in high-risk patients aiding clinicians and public health workers in the day-to-day vaccine decisions relating to HPV in Spain. Methods: We conducted a systematic review of the immunogenicity, safety and efficacy/effectiveness of HPV vaccination in high-risk populations between January 2006 and June 2016. HPV vaccination recommendations were established with levels of evidence according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Results: A strong recommendation about HPV vaccination was made in the following groups: HIV infected patients aged 9–26 years; men who have sex with men aged 9–26 years; women with precancerous cervical lesions; patients with congenital bone marrow failure syndrome; women who have received a solid organ transplant or hematopoietic stem cell transplantation aged 9–26 years; and patients diagnosed with recurrent respiratory papillomatosis. Conclusions: Data concerning non-routine HPV vaccination in populations with a high risk of HPV infection and associated lesions were scarce. We have developed a document to evaluate and establish evidence-based guidelines on HPV vaccination in high-risk populations in Spain, based on best available scientific evidence.

The development of allergy in high-risk children

1997 ◽  
Vol 27 (11) ◽  
pp. 1247-1253 ◽  
Author(s):  
M. L. BURR ◽  
T. G. MERRETT ◽  
F. D. J. DUNSTAN ◽  
M. J. MAGUIRE
Keyword(s):  
High Risk ◽  
High Risk Children
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