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Despite tlie attention it has garnered in recent years, the opioid epidemic in the United States has remained a challenge to healthcare professionals, prescribers. families, and patients alike. A recent publication in the dental literature urged oral healthcare practitioners (OHCPs) to take a leadership role in the face of this epidemic ariel consider carrying naloxone, a drug designed to rapidly reverse opioid overdose, in the dental o mee as the eighth essential medication in the minimal dental emergency kit. In 2023, the US Food and Drug Administration deregulated naloxone 4-mg nasal spray to nonprescription status to increase its availability and access. Given the anticipated expanded availability of naloxone, it is important for OHCPs to be knowledgeable about this potentially lifesaving therapy. This article - is intended to serve as a primer for dentists on the history, pharmacology, appropriate appropriate use, and administration of this critical niedication. [ABSTRACT FROM AUTHOR]

Studies have found that the use of prescription drugs during pregnancy is common and has been increasing over time. with some researchers showing that two-thirds of women take prescription medications while they are pregnant. Additionally, it is generally accepted that breastfeeding women take significantly more medications per month than pregnant women. Within the context of the recent opioid epidemic and renewed concerns for appropriately addressing patients' pain. along with the publication of recent guidelines and updated safely concerns for certain pain medications such as acetaminophen. some uncertainty may exist regarding the safe analgesic prescribing for pregnant and/or breastfeeding women. The purpose of this article is to provide an organized source of information about analgesic use for the pregnant or breastfeeding dental patient. With data regarding commonly used medications and pregnancy categories established by the US Food and Drug Administration, oral healthcare providers that are prepared with evidence-based information about the safety of medication use during pregnancy and breast feeding can effectually advise their patients regarding medication therapy, helping to ensure healthy outcomes for both mother and child. [ABSTRACT FROM AUTHOR]

Acetaminophen is a popular, universally used, over-the-counter pain medication contained in more than 600 different products and available in a plethora of dosage forms. Acetaminophen is an important adjunct to manage postoperative dental pain in combination with a nonsteroidal anti-inflammatory drug such as ibuprofen. For the treatment of more severe pain, acetaminophen is often formulated with non-opioid and opioid agents. Because of the accessibility of acetaminophen und its widespread use, dental practitioners need to be cognizant of any significant safety concerns that may be associated with this drug. including acetaminophen toxicity. This article discusses the history of acetaminophen, its pharmacology, metabolism, and toxicity, as well as strategies to help address some of the potential safety issues with this medication, including unintentional overdosing. [ABSTRACT FROM AUTHOR]

The importance of effective local anesthesia delivery in dentistry cannot be overstated, as many dental procedures could not be performed without it. Despite the availability to oral healthcare professionals of various successful local anesthetics, the administration of local anesthesia continues to provoke anxiety among dental patients and remains an often unpleasant experience. A number of techniques maybe utilized to help mitigate injection pain and improve the patient experience. This article reviews four strategies clinicians may consider to increase the effectiveness of their delivery of local anesthesia: warming or cooling of local anesthetic solutions, vibration and distraction techniques, liposomal encapsulation, and buffering or alkalinization of dental local anesthetics. [ABSTRACT FROM AUTHOR]

Methamphetamine is not a new drug. It has a long and storied history of legitimate clinical use and recreational abuse. Unfortunately, abuse of methamphetamine is increasing with alarming frequency in the United States and leads to appalling destruction of dentition. The pathognomonic effects of methamphetamine abuse on teeth have led to the term "meth mouth." This term, while descriptive of the clinical appearance of patients, is a misnomer. A review of available information on methamphetamine abuse is presented and discussed. A clinical case is documented to help clinicians recognize and manage patients who may be abusing methamphetamines. [ABSTRACT FROM AUTHOR]

Background: Alkalinization or buffering of dental local anesthetics to raise the pH of these acidic solutions is a well-documented technique that results in clinical benefits such as decreased injection pain, reduced onset time, and the need for less overall volume of local anesthesia.Objective: In a previous study, two options available for buffering local anesthetics in dentistry were compared, one using the Onpharma® mixing system (Onpharma), and the other by hand mixing with 8.4% sodium bicarbonate using a "remove and replace" technique. The results of that study showed no statistically significant difference in buffering outcomes between the two methods. This follow-up in vitro study introduces and examines a less complex, direct injection, chairside hand-mixing approach using four commercially available dental local anesthetic preparations.Materials and Methods: The authors prepared multiple buffered samples of four different commercially available local anesthetic solutions. The buffered samples were mixed to 9:1, 19:1, and 18:1 ratios (local anesthetic to 8.4% sodium bicarbonate). Sample pH was recorded using a pH meter. Two samples of each local anesthetic at each ratio were prepared and sequentially pH tested. The pH was recorded via the same pH meter, which was cleaned between each test.Results: The pH change between unbuffered solutions and all buffered samples was statistically different (P < .01, CI 99%). There was no final pH difference between the 9:1 and 19:1, and 19:1 and 18:1 buffering ratios (P > .01); however, a statistical difference was seen between the final pHs of the solutions resulting from the 9:1 and 18:1 buffering ratios (P = .006, CI 99%). After correction for multiple comparisons, the difference between the 9:1 and 18:1 ratio was marginally significant (P = .048).Conclusions: Each of the buffering ratios tested can be used to alkalinize dental local anesthetic solutions. For practical purposes, a direct injection chairside of 0.1 mL of 8.4% sodium bicarbonate into any of the four local anesthetics tested is easy, simple, and safe compared to the more complex remove and replace method. Further studies are needed to evaluate if a clinically significant difference exists between the 9:1, 19:1, and 18:1 ratio solutions.Clinical Implications: The potential benefits of buffering local anesthetic solutions prior to injection, such as decreased injection pain, faster onset, and greater depth of anesthesia, may be particularly advantageous in patients who have difficulty achieving profound anesthesia for clinical dentistry, and for anesthetizing infected areas. Dentists can effectively buffer local anesthetic preparations using commercially available mixing systems or by utilizing a hand-mixing technique. Rather than using a remove and replace technique, practitioners may consider a direct injection technique, adding 0.1 mL of 8.4% sodium bicarbonate directly into any local anesthetic cartridge regardless of local anesthetic concentration. [ABSTRACT FROM AUTHOR]

Bisphosphonates have been implicated in the induction of medication-related osteonecrosis of the jaw (MRONJ) since 2004. Since then, the spectrum of drugs implicated in the onset of MRONJ has broadened to include other antiresorptive and antiangiogenic drugs. Denosumab is an antiresorptive drug that has been on the market since 2010. Denosumab inhibits osteoclast formation, function, and survival and increases bone mineral density. As a result, denosumab is indicated for the treatment of osteoporosis and bone metastases. This article reports 2 cases of MRONJ associated with denosumab use. The characteristics and progression of MRONJ in patients who take denosumab are reviewed, and therapeutic measures are discussed. [ABSTRACT FROM AUTHOR]

Dry mouth is a pervasive oral health problem, with 5% to 46% of the population experiencing this condition. Patient factors such as age, gender, systemic diseases, and medication use play significant roles in correctly diagnosing this presentation. The subjective feeling of dry mouth is often referred to as xerostomia but may be more correctly diagnosed as salivary gland dysfunction: a reduced volume of saliva secretion or a change in salivary composition. Symptoms of dry mouth may range from mild oral discomfort to significant oral disease that can negatively impact patients' health, dietary intake, and quality of life. Despite the significant prevalence of xerostomia in the general population, however, no standard treatment guidelines exist. Successful treatments are typically individualized for the specific patient and should be targeted at the underlying pathophysiology of the disease. For these reasons, an accurate diagnosis of xerostomia is paramount so that patients may be offered the best treatment possible, and this treatment often involves a multimodal approach. [ABSTRACT FROM AUTHOR]