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


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


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…]

No randomised controlled trials to support or refute the extraction or non-extraction of teeth prior to radiotherapy of head and neck


Globally about 3% of cancers are head and neck cancers.  Dental examination and completion of any necessary treatment is recommended prior to any radiotherapy required for patients with head and neck cancer. The aim of this Cochrane review was to assess whether the pre-radiation extraction of diseased or non-diseased molars compared to conservative treatment reduced [read the full story…]

No reliable evidence of benefit from extracting primary canine teeth for correcting poorly aligned permanent canines

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In a small proportion of children (1-3%) the upper permanent canine tooth is diverted into the roof on the mouth.  Treatment of this displacement can be complex and it is considered that the early removal of the primary canine tooth may improve the position f the developing permanent successor. The aim of this Cochrane review [read the full story…]

Moderate evidence that chlorhexidine rinse or gel provides a benefit in preventing dry socket


Teeth are extracted every day in dental surgeries throughout the world because of tooth decay and periodontal (gum) disease. Alveolar osteitis (dry socket) is a complication that can follow an extraction with estimates of its incidence ranging from <1-37.5%.  Typically a blood clot is absent in the socket and the patients have pain in and [read the full story…]

Intravenous bisphosphonates and osteonecrosis of the jaw


Bisphosphonates (BPs) are used for the treatment of a range of bone problems, e.g., osteoporosis, or bone metastases of malignant cancer. In 2003 the condition of bisphosphonate related osteonecrosis of the jaw (BONJ) was reported.  The aim of this retrospective cohort study was to estimate the cumulative incidence and risk ratio for ONJ (osteonecrosis of [read the full story…]

Some limited evidence to support the use of chlorhexidine to prevent dry socket


Dry socket (alveolar osteitis) socket is a painful complication of  tooth extraction that occurs in about  5%  of  extractions of permanent tooth. It is more common following the extraction of wisdom teeth. That aim of this review was to assess whether chlorhexidine, when compared to placebo and/or other interventions, reduced the incidence of alveolar osteitis [read the full story…]

Traumatic extraction carries a high risk of a painful dry socket

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Alveolar osteitis or dry socket is a common and painful complication of tooth extraction, occurring following about 5% of all tooth extractions.  The aetiology of this complication is unclear and it has been associated with a wide range of risk factors. the aim of this study was to assess the relation between 8 risk factors [read the full story…]

Limited evidence that extraction of deciduous canines prevents impaction of palatally displaced permanent canines

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This ADA Centre for Evidence-based Dentistry critical summary of  a systematic review  published in 2011. The original review was asked whether interceptive treatment involving the early extraction of the deciduous canine prevents impaction of palatally displaced canines (PDC) [ see Dental Elf 28th July ]. The ADA noted that while the review was generally well [read the full story…]

Topical use of chlorhexidine may prevent dry socket

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This review was first published in 2009 . The American Dental Association Centre for Evidence-based Dentistry has now published a critical summary of this review. The original review included 12 clinical trials involving 1818 patients and concluded that a twice-daily regimen of Chlorhexidine gel (0.2 percent) applied every 12 hours for seven consecutive days can [read the full story…]