Under oath: content analysis of oaths administered in ADA-Accredited Dental Schools in the United States, Canada, and Puerto Rico.

This study reviews and analyzes the content of dental school oaths taken by students in the United States, Canada, and Puerto Rico in 2006. Each oath was qualitatively reviewed to determine its consistency with each of the five principles set forth in the American Dental Association (ADA)'s Principles of Ethics and Code of Professional Conduct. Fifty-eight oaths were received from sixty-one of sixty-six schools in response to information requests regarding use of oaths and manner of administration. Of these, thirty-nine employ one oath, administered at either graduation or ceremonies marking transition to clinical training; twelve employ an oath at both occasions, with five repeating the same oath; and ten have no formal oaths. Eighteen oaths follow the wording of "The Dentist's Pledge," nine follow the "Oath to the Profession/Professional Pledge," three follow the Modern Hippocratic Oath, and twenty-eight are idiosyncratic. All five of the ADA principles (autonomy, nonmaleficence, beneficence, justice, and veracity) are addressed in thirteen oaths, four principles in nine oaths, and three or fewer principles in thirty-six oaths. Eleven make reference to care for the underserved. As oath-taking is an opportunity to instill and reinforce to students dentistry's most important ethical obligations, recommendations are offered to make the content more meaningful and comprehensive.

Antibiotic prophylaxis and postoperative complications after tooth extraction and implant placement: a review of the literature.

OBJECTIVES: To assess published evidence regarding the use of preoperative antibiotic prophylaxis among children and adults undergoing dental extraction or implant placement. DATA: Research published between 12/31/97 and 6/30/07 in English. SOURCES: MEDLINE, PUBMED, EMBASE, EBM Reviews, and Cochrane Central Register for Controlled Trials using the following search terms linked with Boolean AND logic: prophylactic antibiotics, dentistry, tooth, third molar, extraction, implant, endosseous, prophylaxis, prophylactic, infective endocarditis, bacterial, infection, and bacteremia. STUDY SELECTION: Eight randomized clinical trials and one retrospective study was found involving preoperative use of antibiotics before tooth extraction. Four additional non-randomized intervention studies among patients undergoing implant placement were found. These 13 studies comprised all of the published research found that met our inclusion criteria. Overall, this body of literature was limited and of poor quality. In general, sample sizes were small and provided insufficient statistical power to avoid type II, or false-negative errors. In some studies no comparison group was included and/or it was difficult to determine the extent to which the intervention had actually been implemented. CONCLUSION: With the recent improvements in the current standards of antibiotic prophylaxis in dentistry, further monitoring of antibiotic use among dental practitioners as well as continuing education for practitioners concerning the public health risks related to the over-prescription of antibiotics are needed.

Maxillofacial prosthodontics for the pediatric patient: "an eye-opening experience".

The following case report describes the expanding role of pediatric dentists in treating children with craniofacial pathology. Retinoblastoma is the most common intraocular malignancy in childhood and is approximately the tenth most common pediatric cancer in the United States. Treatment consists of enucleation, or removal of the entire globe followed by placement of orbital implants. Un-restored anopthalmic sockets exhibit growth retardation and can lead to facial disfigurement. Maxillofacial prosthetic (MFP) rehabilitation can be especially challenging in younger, pre-cooperative or behaviorally compromised children and requires the skills and participation of a pediatric dental specialist as part of the MFP team. The following case report involving a 3 yr-old girl with retinoblastoma describes such challenges. The objective of the maxillofacial prosthetic team was to provide custom-built, acrylic, bilateral ocular prostheses in as comfortable and atraumatic manner as possible. The case was a success and underscores the value of a multidisciplinary dental approach for the treatment of children with very special needs.