Pulpitis – How effective are diagnostic tests?

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This review of clinical tests for the diagnosis of the condition of the dental pulp included 28 studies from 29 publications. The quality of the included studies was low providing limited scientific evidence regarding the accuracy and reproducibility of diagnostic tests.

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Top Dental Elf Blogs: Jul – Sep 2021

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Treatments for cavitated dentine caries, topical anaesthetics to reduce injection pain and vital pulp therapy for permanent teeth were out most popular blogs duing July, August and September 2021.

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Vital pulp therapy in permanent teeth

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This review aimed to evaluate the association of preoperative factors or intraoperative factors with treatment outcomes of vital pulp therapy. 14 RCTs were included with the findings indicating a 93.2% (95%CI; 91-6% to 94.9%) success rate using contemporary bioceramic material based on low certainty evidence.

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Pulpotomy for permanent teeth

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This review of the efficacy and cost-effectiveness of pulpotomy and associated medicaments in permanent teeth with pulp exposure included 17 RCTs some os which are still ongoing. The findings suggest that pulpotomy may be a potential treatment option for permanent teeth but more research is needed.

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Dexamethasone for post endodontic pain

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This review of dexamethasone for controlling pain following endodontic treatment included 5 relatively small RCTs . The findings suggest statistically significant reduction of pain in patients receiving dexamethasone at 8,12, and 24 hours.

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Inferior alveolar nerve block: can NSAIDs improve anaesthetic success?

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This review of the efficacy of non-steroidal anti-inflammatory drugs (NSAIDs) as premedication on the success of inferior alveolar nerve block includes 13 RCTs suggesting NSAIDs have a positive impact on success.

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Primary molars: Hall technique most effective caries management option

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3 caries management options [conventional restorations (CR), the hall technique (HT), and non-restorative caries treatment (NRCT)] were investigated in this RCT. A 93% success rate was seen for the HT at 2.5 years compares with 70% for NRCT and 67% for CR.

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Little evidence for antibiotic use in irreversible pulpitis

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This is the latest update of this Cochrane review of the effectiveness of antibiotics for irreversible pulpitis. Only 1 small RCTs is available which provides insufficient evidence to determine whether antibiotics reduce pain or not compared to not having antibiotics

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Is this toothache or am I having a heart attack?

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Pain from cardiac ischaemia can have a range of presentations. This can include chest, arm, shoulder pain, face or jaw pain.  While sudden chest pain that may travel down the arm is a typical presentation classic teaching is that cardiac ischemia can present with tooth, jaw, or facial pain as its sole symptom.  The aim [read the full story…]

Guidance on the management of acute dental problems from SDCEP

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The Scottish Dental Clinical Effectiveness Programme (SDCEP) has recently launched guidance for the management of patients with acute dental problems. The scope of the guidance is to:- Encourage a consistent approach to the management of acute dental problems to reduce avoidable variation in practice Improve the quality of unscheduled clinical care for patients with acute [read the full story…]