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Clinical Decision-Making Resources for Dentistry

Key Journal Articles

Special thanks to Dr. Daniel Haas for his contribution to this section!

Journal Articles

Ashley PF, Williams CE, Moles DR, Parry J. Sedation versus general anaesthesia for provision of dental treatment in under 18 year olds. Cochrane Database of Systematic Reviews 2009;(1).

Becker DE, Haas DA. Management of complications during moderate and deep sedation: Respiratory and cardiovascular considerations. Anesthesia progress. 2007 Summer;54(2):59,68; quiz 69.

Chanpong B, Haas DA, Locker D. Need and demand for sedation or general anesthesia in dentistry: A national survey of the canadian population. Anesthesia progress. 2005;52(1):3-11.

Dionne RA, Yagiela JA, Cote CJ, Donaldson M, Edwards M, Greenblatt DJ, Haas D, Malviya S, Milgrom P, Moore PA, Shampaine G, Silverman M, Williams RL, Wilson S. Balancing efficacy and safety in the use of oral sedation in dental outpatients. Journal of the American Dental Association. 2006 Apr;137(4):502-13.

Haas DA. An update on local anesthetics in dentistry. Journal of the Canadian Dental Association. 2002 Oct; 68(9): 546-51.

Haas DA. Emergency drugs. Dental Clinics of North America. 2002 Oct; 46(4): 815-30.

There is universal agreement that dentists require emergency drugs to be readily available. Opinions differ as to the specific drugs that should comprise an emergency kit. This article has provided one opinion. Oxygen, epinephrine, nitroglycerin, injectable diphenhydramine or chlorpheniramine, albuterol, and aspirin should be readily available in a dental office. Other drugs such as glucagon, atropine, ephedrine, hydrocortisone, morphine or nitrous oxide, naloxone, midazolam or lorazepam, and flumazenil should also be considered. There are differences in the level of training of dentists in the management of medical emergencies [25]. Therefore the final decision should be made by the individual dentist who is in the best position to determine the appropriateness of these agents for the particular practice. Despite the best efforts at prevention, emergencies may still arise. Plans to manage these events are needed and there is the possibility that the drugs discussed above may be required. Their presence may save a life.

Haas, DA. Oral and inhalation conscious sedation. Dental Clinics of North America. 1999 Apr; 43(2): 341-59.

Many patients can benefit by having dental procedures carried out with conscious sedation administered by the oral or inhalation routes. Dentists who employ these techniques must be familiar with the pharmacology of the agents selected, cognizant of the risks and benefits of the technique employed, and able to manage adverse events that may arise with its use. Careful patient selection and prudent administration of one of the drugs described here is the basis for successful use of these techniques.

Matharu LM, Ashley PF. Sedation of anxious children undergoing dental treatment. Cochrane database of systematic reviews 2006;(1).

Yarascavitch C. Hugs with drugs. Empathy and sedation.  Ontario Dentist. 2009; 86(7):19-21.

Wong EW. Taking blood pressure in the dental office. Ontario Dentist. 2006; 83(4):28-31.

British Dental Journal

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Anesthesia Progress

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Journal of American Dental Association

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Cochrane Reviews

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