Tranexamic acid for minor oral surgery in anticoagulated patients

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5 good but small RCTs were identified for this review of topical tranexamic acid (TXA) for minor oral surgery in patients on anticoagulants. The findings suggest that TXA irrigation and mouthwash may reduce the risk of bleeding.

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Tooth extraction: factors affecting anxiety and fear

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This review of factors affecting fear and anxiety in adult patients undergoing tooth extraction included 16 studies and identified a number of factors associated with anxiety although there are concerns over the quality of the available studies.

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Third molars: insufficient evidence for removal of impacted asymptomatic disease-free teeth

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This update of an earlier Cochrane review comparing retention or extraction of of asymptomatic disease-free impacted third molars only identified 2 studies of low to very low quality evidence providing insufficient evidence to inform practice.

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Anticoagulant therapy and dental extractions

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This review the bleeding risk of patients continuing or discontinuing oral anticoagulant therapy found no increase bleeding risk in those continuing anticoagulant therapy.

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Do analgesics before dental treatment reduce post treatment pain in children?

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This Cochrane review found 5 RCTs of pre-op analgesics prior to dental treatment for children under local anaesthetic. The evidence as insufficient to determine a benefit but there may be a benefit prior to orthodontic band placement. Further high quality studies are needed.

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Palatal injections for maxillary extractions: are they needed?

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This review of the use of palatal injections for maxillary extractions included 15 studies. While the findings suggest that they may not be needed further high quality studies are needed to confirm the findings.

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Prolonged bleeding after tooth extraction – no evidence on treatment from trials

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This Cochrane review did not identify any randomised controlled trials that evaluated the effects of different interventions for the treatment of post-extraction bleeding. Clinicians must use their clinical experience to determine the most appropriate means of treating this condition, depending on patient-related factors.

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Tooth extraction: no need to stop long-term aspirin before suggests review

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This review considers whether patients on long-term aspirin therapy should stop aspirin before tooth extraction. The review found 10 studies (3 RCTs). No significant increase in bleeding time was found and although there was an increased risk of haemorrhage, the authors recommended not stopping aspirin therapy.

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Trial suggests that post extraction use of warm saline mouth rinse reduces complications

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The use of warm salt water mouthrinses as part of a post extraction regimen is a commonly taught, yet as the authors of this trial found there seems to be little objective evidence for its effectiveness.  The aim of this study was to determine the beneficial effect of different warm saline rinse regimens on the [read the full story…]