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Biomedical subjects

M J Wahl

Publications and source records attributed to M J Wahl.

18 recordsLinked to original sources
PubMed1996

Altering anticoagulation therapy: a survey of physicians.

Patients who take antithrombotic medications, such as warfarin sodium or aspirin, are more likely than others to experience bleeding problems after some dental treatments. Withdrawing the medication before treatment, however, may place these patients at risk of medical complications. The authors surveyed physicians about the conditions under which such pharmacotherapies should be altered. They not only found a difference of opinion among the respondents, but also learned that many respondents misunderstood the nature of certain dental procedures and the likelihood that those procedures would cause significant postoperative bleeding.

Anticoagulants↗
PubMed1995

Myths of dental-induced prosthetic joint infections.

The overwhelming majority of orthopedists and dentists surveyed recommend antibiotic prophylaxis for dental procedures to prevent late prosthetic joint infection. It is time to stop this practice, which is not based on scientific evidence but rather on "myths" of prosthetic joint infections after dental procedures. The first myth is that there are close similarities between late prosthetic valve endocarditis and late prosthetic joint infection. The second myth is that dental treatment is the probable cause of a large percentage of prosthetic joint infections. The third myth is that results of animal experiments have shown that transient bacteremia due to dental procedures can cause prosthetic joint infections in humans. The fourth myth is that the benefits of antibiotic prophylaxis for patients with prosthetic joints outweigh the risks and costs. The fifth and final myth is that clinicians should recommend antibiotic prophylaxis before dental treatment for patients with prosthetic joints to protect themselves legally.

Animals↗
PubMed1995

Clinical issues in the prevention of dental-induced endocarditis and prosthetic joint infection.

No issue in medicine or dentistry is the subject of more misunderstanding than the prevention of infective endocarditis and late prosthetic joint infections. To resolve some of the confusion, national medical groups have published guidelines for the prevention of these infections, including the use of antibiotic prophylaxis for certain dental procedures and certain at-risk patients. While these guidelines are helpful, there still are clinicians who either do not recommend antibiotics when indicated or recommend antibiotics without indication. An understanding of these issues helps to prevent not only the infections but also the adverse antibiotic effects and associated legal problems. The learning objective of this article is to educate clinicians on the prevention of dental-induced endocarditis and prosthetic joint infections.

American Heart Association↗
PubMed1994

Myths of dental-induced endocarditis.

Although the latest (1990) American Heart Association recommendations for the prevention of bacterial endocarditis are by far the simplest yet, many physicians and dentists still do not comply with them. One of the reasons for this low compliance is that many clinicians rely on "myths" of dental-induced endocarditis prevention. To educate clinicians on endocarditis and its prevention, the myths of dental-induced endocarditis prevention are analyzed. Myth 1: For the most part, physicians and dentists are aware of and comply with American Heart Association guidelines on antibiotic prophylaxis for prevention of infective endocarditis. Myth 2: Most cases of bacterial endocarditis of oral origin are caused by dental procedures. Myth 3: American Heart Association antibiotic regimens give almost total protection against endocarditis after dental procedures. Myth 4: Antibiotics should be administered for any dental procedure that causes bleeding. Myth 5: If a patient was receiving recent antibiotic therapy before the dental procedure, there is no need to change the dose or the antibiotic before the dental procedure. Myth 6: The risk of endocarditis is almost always greater than the risk of antibiotic toxic effects. Myth 7: Parenteral antibiotics before dental procedures are preferable for most patients with high-risk conditions (eg, prosthetic heart valves and previous history of endocarditis). Myth 8: All patients with mitral valve prolapse should routinely receive antibiotic prophylaxis for dental procedures. Myth 9: Clinicians should err on the positive side of antibiotic prophylaxis to prevent lawsuits.

American Heart Association↗
PubMed1994

Clinical issues in the prevention of dental-induced endocarditis and prosthetic joint infection.

No issue in medicine or dentistry is the subject of more misunderstanding than the prevention of infective endocarditis and late prosthetic joint infections. To resolve some of the confusion, national medical groups have published guidelines for the prevention of these infections, including the use of antibiotic prophylaxis for certain dental procedures and certain at-risk patients. While these guidelines are helpful, there still are clinicians who either do not recommend antibiotics when indicated or recommend antibiotics without indication. An understanding of these issues helps to prevent not only the infections but also the adverse antibiotic effects and associated legal problems. The learning objective of this article is to to educate clinicians on the prevention of dental-induced endocarditis and prosthetic joint infections.

American Heart Association↗
PubMed1993

Prevention of infective endocarditis: an update for clinicians. American Heart Association.

Infective endocarditis is a rare, serious, and sometimes fatal heart disease that can be caused by bacteremia from the mouth, especially by Streptococcus viridans. As a result, dental procedures have often been blamed for cases of infective endocarditis but poor oral health and hygiene may actually cause more cases of infective endocarditis than do dental procedures. The American Heart Association and other groups have published recommendations for the prevention of infective endocarditis in dental patients and advise specific antibiotic regimens for certain dental procedures in cardiac-abnormal patients. The most recent (1990) American Heart Association recommendations are the most conservative yet, reflecting concern about the prevention of not only infective endocarditis, but also problems resulting from the antibiotics themselves. Clinicians should carefully consider not only the patient's medical history, but also the types of dental procedures planned.

Anti-Bacterial Agents↗
PubMedDate not supplied

Dental surgery in anticoagulated patients.

Continuous oral anticoagulant therapy has been used to decrease the risk of thromboembolism for more than half a century, prolonging the lives of thousands of patients. Many physicians recommend interrupting continuous anticoagulant therapy for dental surgery to prevent hemorrhage. In reviewing the available literature, there are no well-documented cases of serious bleeding problems from dental surgery in patients receiving therapeutic levels of continuous warfarin sodium therapy, but there were several documented cases of serious embolic complications in patients whose warfarin therapy was withdrawn for dental treatment. Many authorities state that dental extractions can be performed with minimal risk in patients who are at or above therapeutic levels of anticoagulation. There are sound legal reasons to continue therapeutic levels of warfarin for dental treatment. Although there is a theoretical risk of hemorrhage after dental surgery in patients who are at therapeutic levels of anticoagulation, the risk appears to be minimal, the bleeding usually can be easily treated with local measures, and this risk may be greatly outweighed by the risk of thromboembolism after withdrawal of anticoagulant therapy.

Administration, Oral↗
PubMedDate not supplied

Myths of single-visit endodontics.

There has been much controversy about the safety and efficacy of initiating and completing endodontic therapy in a single visit. The literature concerning single- and multiple-visit endodontics is reviewed, and advantages and disadvantages of single-visit endodontics are discussed. Single visit endodontic therapy is shown to be a safe, effect alternative to multi-visit treatment for most vital and nonvital teeth.

Episode of Care↗