Oral Jewelry and Piercing: Risks to Health.

What appears to be a decorative fad, pursued by people of all ages, is, for the most part, an invasion of the body by poorly trained individuals. Simple-to-complex, the insertion of body jewelry is embarked upon on a whim with little concern for health, including the possibility of infection. Many of those who opt for piercings have outcomes that are unremarkable and relatively trouble free. Others, less fortunate, end up with irreversible scars, serious infections, torn anatomic structures and teeth that are fractured, disfigured or have drifted out of line.

What it means to be a doctor. Sensitizing the dentist and the student to professionalism.

Professional demeanor and the inter-personal behavior of the dentist play a large part in building the trust patients measure as they gain confidence in their choice of practitioner. Most of the time, patients experience comfort through the competent, compassionate care of a genuinely respected provider. That important im- age is determined by the ethical and proper relationships every patient encounters. The following discussion brings to the forefront image-damaging episodes that have occurred as a result of unwise or unthinking circumstances playing out not only in the office, but in the community and in private life as well. Can a professional shield the public from disappointing legal, unprofessional entanglements that could cast doubt on the good judgment and safety expected of the doctor? What effects on a practice may be seen?

Debatable evidence for the adverse drug reactions to local anaesthetics.

DATA SOURCES: Medline, Embase, Chinese National Knowledge Infrastructure VIP Database for Chinese Technical Periodicals (and Chinese Biomedical Literature Database. STUDY SELECTION: Randomised controlled trials (RCTs), non-RCTs, case-control studies, case reports, case series and cross-sectional studies that focused on adverse drug reactions of local anaesthetics were considered. DATA EXTRACTION AND SYNTHESIS: Data abstraction was conducted independently by two reviewers, and summary data and a meta-analysis presented. RESULTS: One hundred and one studies reporting 1645 events were included. Seven of these were deaths. Lidocaine (43.17%) and bupivacaine (16.32%) were the most often involved local anaesthetics. According to the meta-analysis, the risk of using LA alone was lower than when combined with epinephrine. CONCLUSIONS: The present study demonstrated that the adverse drug reactions of local anaesthetics could not be ignored, especially in oral and ophthalmologic treatments. Some adverse drug reactions could be avoided by properly evaluating the conditions of patients and correctly applying local anaesthetics.

The New York State postgraduate fifth-year dental residency as a new licensure path: concerns for public protection.

The recently enacted law creating an alternative pathway to dental licensure in New York state is benchmark legislation. Along with the positive effects of dental education that may ensue, the author has serious concerns that the strongly emotional and political debate occurring during the bill's consideration obscured important considerations for public safety and the erosion of standards for licensure in New York. In addition, this pathway has potential to negatively affect freedom of movement and licensure by credentials for practice in other jurisdictions.

A response from the American Association of Dental Examiners.

The American Association of Dental Examiners supports a testing environments that include supervision of patient care. Extensive steps are taken in licensure examinations to ensure content validity through standardization by practice surveys, standards of competency, common core content, dental school curricula, and the limitations of practical constraints. Examining agencies report consistent, high collaboration among examiners. The examining community has developed comprehensive standards that compare favorably with standards in the testing community generally. When more reliable and valid alternatives to existing testing methods become available, they will be employed.