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AbstractSince 1997, the appetite suppressant drugs fenfluramine‐phentermine (fen‐phen) and dexfenfluramine have been associated with the development of valvular heart disease. As a result, the drugs have been withdrawn from the market and interim recommendations for evaluation and treatment of exposed patients were issued. However, subsequent studies showed lower prevalence rates for valve abnormalities than were initially reported, and the possibility of such drug‐induced lesions resolving has been raised. This article reviews relevant evidence and discusses concerns for the dental practitioner.

ABSTRACTThe prevalence of diabetes mellitus in the general population has been increasing sharply. Currently, much is feared but little is known about postoperative complications of oral surgery among persons with diabetes. Existing dental education and practice guidelines cite excess infectious risk among patients with diabetes; however, empiric evidence to support such concerns is lacking. In fact, dentists commonly prescribe antibiotics when dental surgical procedures involve bone. This practice may contribute to the rising problem of microbial resistance and may increase overall healthcare costs. The growing number of dental patients with diabetes warrants strengthening the evidence base to guide their dental care and prevent possible morbid complications.

ABSTRACTThis paper reports the case history of a patient who had bisphosphonate‐associated osteonecrosis of the jaw (ONJ) in which adjunctive treatment with teriparatide was used. The patient was treated for 5 years with alendronate for osteoporosis and developed ONJ after extraction of maxillary teeth. An implant was placed at the site of the extracted teeth. The pathology report confirmed the clinical diagnosis of ONJ; treatment was changed from alendronate to teriparatide and the ONJ resolved. To our knowledge, this is the third case history reported in the literature in which teriparatide was successfully used as adjunct therapy in ONJ because it has an anabolic effect and presumed role in accelerating bone healing. ONJ is a serious but infrequent condition that has been recently associated with nitrogen‐containing bisphosphonate therapy. Teriparatide may be a useful adjunctive therapy when ONJ develops.

ABSTRACTWe investigated disparities in the prescription of analgesics following dental procedures that were expected to cause acute postoperative pain. Patients over the age of 19 years who had been treated by surgical and/or endodontic dental procedures were included in this study. We reviewed 900 consecutive charts and abstracted data on procedures, patients, and providers. We used chi‐square and logistic regression models for analyses. There were 485 White subjects, 357 African American subjects included in this review; 81% of the African American and 78% of White patients received a postoperative narcotic prescription (p= .56). In multivariate regression models, patients over age 45 (p= .003), those with insurance that covered medication and those with preexisting pain (p= .004) were more likely to receive narcotic analgesics. Students prescribed more narcotics than residents (p= .001). No differences were found by race in prescribing analgesics.