Denise van Diermen | Academic centre Dentistry Amsterdam (original) (raw)
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Papers by Denise van Diermen
Huisarts En Wetenschap, Jul 1, 2013
Nieuwe richtlijnen dienen volgens een vast ontwikkelschema te worden gemaakt. Vanuit de huisartsg... more Nieuwe richtlijnen dienen volgens een vast ontwikkelschema te worden gemaakt. Vanuit de huisartsgeneeskunde is daarmee al veel expertise opgebouwd. Anno 2014 komt ook binnen de tandheelkunde de richtlijnenontwikkeling in Nederland aarzelend op gang. In dit artikel wordt ingegaan op het ontstaan van de medisch-tandheelkundige richtlijn Beleid bij tandheelkundige ingrepen tijdens antitrombotische behandeling en op de inhoud van deze richtlijn.
European Journal of Oral Sciences, 2019
Dental students and dental‐care providers should be able to prescribe drugs safely and effectivel... more Dental students and dental‐care providers should be able to prescribe drugs safely and effectively. As it is unknown whether this is the case, we assessed and compared the prescribing competence of dental students and dental‐care providers in the Netherlands. In 2017, all Dutch final‐year dental students and a random sample of all qualified general dental practitioners and dental specialists (oral and maxillofacial surgeons and orthodontists) were invited to complete validated prescribing knowledge‐assessment and skills‐assessment instruments. The knowledge assessment comprised 40 multiple‐choice questions covering important drug topics. The skills assessment comprised three common clinical case scenarios. For the knowledge assessment, the response rates were 26 (20%) dental students, 28 (8%) general dental practitioners, and 19 (19%) dental specialists, and for the skills assessment the response rates were 14 (11%) dental students, eight (2%) general dental practitioners, and eight...
Thrombosis and Haemostasis, 2017
SummaryPatients on vitamin K antagonists (VKA) often undergo invasive dental procedures. Internat... more SummaryPatients on vitamin K antagonists (VKA) often undergo invasive dental procedures. International guidelines consider all dental procedures as low-risk procedures, while bleeding risk may differ between standard low-risk (e. g. extraction 1–3 elements) and extensive high-risk (e.g. extraction of >3 elements) procedures. Therefore current guidelines may need refinement. In this cohort study, we identified predictors of oral cavity bleeding (OCB) and evaluated clinical outcome after low-risk and highrisk dental procedures in patients on VKA. Perioperative management strategy, procedure risk, and 30-day outcomes were assessed for each procedure. We identified 1845 patients undergoing 2004 low-risk and 325 high-risk procedures between 2013 and 2015. OCB occurred after 67/2004 (3.3 %) low-risk and 21/325 (6.5 %) high-risk procedures (p=0.006). In low-risk procedures, VKA continuation with tranexamic acid mouthwash was associated with a lower OCB risk compared to continuation with...
Objective: To assess the opinion and present management of Dutch dentists in planning the treatme... more Objective: To assess the opinion and present management of Dutch dentists in planning the treatment of patients using oral antithrombotic medication and requiring invasive dental treatment. Methods: An Internet-based questionnaire with 18 questions was distributed among 1442 Dutch Dentists in November 2008. Questions addressed 4 different dental treatments (endodontic treatment, dental cleaning, tooth extraction of 1-3 elements and multiple tooth extractions of more than 3 elements) and two different oral antithrombotics (acetylsalicylic acid (ASA) and acenocoumarol (AC)). Results: 487 dentists returned the questionnaire (response rate 34%). Respondents were 77% male, mean age 47.0 years (range 23-62 yrs) with mean clinical experience of 22 years (range 1-39 yrs). In patients using ASA, 84% of dentists would perform endodontic procedures, 69% would do extensive dental cleaning, 28% would extract 1-3 elements and 6 % would extract > 3 elements without interrupting the oral antithr...
Nederlands tijdschrift voor tandheelkunde, 2012
Corticosteroids are used incidentally in dentoalveolar surgical treatments to reduce possible pos... more Corticosteroids are used incidentally in dentoalveolar surgical treatments to reduce possible postsurgical problems. Natural corticosteroids are produced in the adrenal cortex. Synthetic corticosteroids are known to have anti-inflammatory effects when they are administered in doses exceeding the normal physiological amounts which the body produces. Several contraindications and side effects are known. Administration of corticosteroids for dentoalveolar surgical treatments shows a reduction of edema and pain. When using corticosteroids, the risk of infections is not known to be higher than usual and the risk of adverse effects is minimal. According to the literature, there is no clear recommendation to use corticosteroids as a standard for dentoalveolar surgical treatments.
Nederlands tijdschrift voor tandheelkunde, 2008
What treatment is appropriate for a patient who has to undergo an invasive dental procedure if th... more What treatment is appropriate for a patient who has to undergo an invasive dental procedure if that patient is using medication that influences the blood coagulation system? Should the medication be stopped before the invasive procedure, with the risk of complications involving re-thrombosis? Or should the procedure be carried out without adjusting the medication? What is the risk of bleeding complications? Recent studies appear to indicate that temporarily stopping medication is in many cases unnecessary and can even harm the patient. In recent decades dentists have received a great number of diverse recommendations. In this article recent research in this field is summarized and evaluated. The authors advocate the development of evidence-based clinical guidelines.
Nederlands tijdschrift voor tandheelkunde, 2006
Mandibular block anaesthesia is frequently used in dentistry. The technique is more susceptible t... more Mandibular block anaesthesia is frequently used in dentistry. The technique is more susceptible to failure than local anaesthesia by infiltration. Two cases of patients who were afflicted by transient paresis of (branches of) the facial and vagus nerves after mandibular block anaesthesia have been analysed. With reference to both these cases advice is given on how to react in case of a misdirected mandibular block anaesthesia.
Nederlands tijdschrift voor tandheelkunde, 2004
The records of 68 adult patients, referred to a Department of Oral and Maxillofacial Surgery for ... more The records of 68 adult patients, referred to a Department of Oral and Maxillofacial Surgery for extraction of one or more teeth, have been studied with regard to the complexity of the treatment and the postoperative course. In 11 patients surgical removal had to be performed, while in the remaining 57 patients treatment consisted of simple extractions. Forty-six patients of these 57 patients returned a questionnaire about postoperative problems and use of analgesics. These patients were divided into two groups, one consisting of 17 healthy patients without any medical disorder and/or use of drugs, and a second consisting of 29 medically compromised patients. The postoperative course did not differ between both groups. Four patients (1 healthy, 3 medically compromised) experienced postoperative complaints during more than 6 days. Remarkably, the number of patients who experienced pain but did not use analgesics was considerably higher in the healthy group (29%) compared with the med...
Nederlands tijdschrift voor tandheelkunde, 2001
International Journal of Oral and Maxillofacial Surgery, 2013
Mondziekten, kaak- en aangezichtschirurgie, 2009
ABSTRACT Onder een medisch complexe patiënt wordt in de tandheelkunde een patiënt verstaan van wi... more ABSTRACT Onder een medisch complexe patiënt wordt in de tandheelkunde een patiënt verstaan van wie de algehele gezondheidstoestand ten gevolge van ziekte en/of het gebruik van medicijnen zou kunnen interfereren met het tandheelkundig handelen. Ziekteprocessen in de mond kunnen een duidelijke invloed hebben op de algehele gezondheid en vice versa. Zowel het effect van een ziekte of aandoening op de mondgezondheid (zoals het ontstaan van orale ulcera bij patiënten met een inflammatoire darmziekte) als het effect van de ziekte op het tandheelkundig behandelplan (het uitstellen van een tandheelkundige behandeling kort na een hartinfarct) alsook het effect van een orale aandoening op het verloop van een ziekte of ziekteproces (orale ontstekingen die de plasmaglucosespiegel bij diabetespatiënten kunnen beïnvloeden) kan worden gerekend tot medisch-tandheelkundige interactie (MTI). Mensen worden ouder en daarmee wordt het aantal medisch complexe patiënten groter. Enerzijds is er een toename van de levensverwachting en de intensivering van de algemeen medische zorg van belang, anderzijds neemt de tandheelkundige vraag – ook bij ouderen – toe. De toename van de tandheelkundige vraag wordt onder andere veroorzaakt door toegenomen tandheelkundige mogelijkheden, grotere tandheelkundige bewustwording en verbeterde tandheelkundige preventie, waardoor tot op hoge leeftijd de eigen dentitie behouden blijft.
Huisarts en wetenschap, 2013
Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 2002
Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 2009
British Dental Journal, 2007
Nederlands tijdschrift voor tandheelkunde, 1996
This article describes the 'Feedback Post AZIG', an institute to which dentists can turn ... more This article describes the 'Feedback Post AZIG', an institute to which dentists can turn for advice on medical questions. The frequency as well as the content of these questions, posed between 1991 and 1994, are considered. Dentist clearly have a need for medical feedback and this need increases every year. Given the expected increase of the number of medically compromised patients in the dental practice, the importance of both medical training to dentists and feedback possibilities should not be underestimated.
Huisarts En Wetenschap, Jul 1, 2013
Nieuwe richtlijnen dienen volgens een vast ontwikkelschema te worden gemaakt. Vanuit de huisartsg... more Nieuwe richtlijnen dienen volgens een vast ontwikkelschema te worden gemaakt. Vanuit de huisartsgeneeskunde is daarmee al veel expertise opgebouwd. Anno 2014 komt ook binnen de tandheelkunde de richtlijnenontwikkeling in Nederland aarzelend op gang. In dit artikel wordt ingegaan op het ontstaan van de medisch-tandheelkundige richtlijn Beleid bij tandheelkundige ingrepen tijdens antitrombotische behandeling en op de inhoud van deze richtlijn.
European Journal of Oral Sciences, 2019
Dental students and dental‐care providers should be able to prescribe drugs safely and effectivel... more Dental students and dental‐care providers should be able to prescribe drugs safely and effectively. As it is unknown whether this is the case, we assessed and compared the prescribing competence of dental students and dental‐care providers in the Netherlands. In 2017, all Dutch final‐year dental students and a random sample of all qualified general dental practitioners and dental specialists (oral and maxillofacial surgeons and orthodontists) were invited to complete validated prescribing knowledge‐assessment and skills‐assessment instruments. The knowledge assessment comprised 40 multiple‐choice questions covering important drug topics. The skills assessment comprised three common clinical case scenarios. For the knowledge assessment, the response rates were 26 (20%) dental students, 28 (8%) general dental practitioners, and 19 (19%) dental specialists, and for the skills assessment the response rates were 14 (11%) dental students, eight (2%) general dental practitioners, and eight...
Thrombosis and Haemostasis, 2017
SummaryPatients on vitamin K antagonists (VKA) often undergo invasive dental procedures. Internat... more SummaryPatients on vitamin K antagonists (VKA) often undergo invasive dental procedures. International guidelines consider all dental procedures as low-risk procedures, while bleeding risk may differ between standard low-risk (e. g. extraction 1–3 elements) and extensive high-risk (e.g. extraction of >3 elements) procedures. Therefore current guidelines may need refinement. In this cohort study, we identified predictors of oral cavity bleeding (OCB) and evaluated clinical outcome after low-risk and highrisk dental procedures in patients on VKA. Perioperative management strategy, procedure risk, and 30-day outcomes were assessed for each procedure. We identified 1845 patients undergoing 2004 low-risk and 325 high-risk procedures between 2013 and 2015. OCB occurred after 67/2004 (3.3 %) low-risk and 21/325 (6.5 %) high-risk procedures (p=0.006). In low-risk procedures, VKA continuation with tranexamic acid mouthwash was associated with a lower OCB risk compared to continuation with...
Objective: To assess the opinion and present management of Dutch dentists in planning the treatme... more Objective: To assess the opinion and present management of Dutch dentists in planning the treatment of patients using oral antithrombotic medication and requiring invasive dental treatment. Methods: An Internet-based questionnaire with 18 questions was distributed among 1442 Dutch Dentists in November 2008. Questions addressed 4 different dental treatments (endodontic treatment, dental cleaning, tooth extraction of 1-3 elements and multiple tooth extractions of more than 3 elements) and two different oral antithrombotics (acetylsalicylic acid (ASA) and acenocoumarol (AC)). Results: 487 dentists returned the questionnaire (response rate 34%). Respondents were 77% male, mean age 47.0 years (range 23-62 yrs) with mean clinical experience of 22 years (range 1-39 yrs). In patients using ASA, 84% of dentists would perform endodontic procedures, 69% would do extensive dental cleaning, 28% would extract 1-3 elements and 6 % would extract > 3 elements without interrupting the oral antithr...
Nederlands tijdschrift voor tandheelkunde, 2012
Corticosteroids are used incidentally in dentoalveolar surgical treatments to reduce possible pos... more Corticosteroids are used incidentally in dentoalveolar surgical treatments to reduce possible postsurgical problems. Natural corticosteroids are produced in the adrenal cortex. Synthetic corticosteroids are known to have anti-inflammatory effects when they are administered in doses exceeding the normal physiological amounts which the body produces. Several contraindications and side effects are known. Administration of corticosteroids for dentoalveolar surgical treatments shows a reduction of edema and pain. When using corticosteroids, the risk of infections is not known to be higher than usual and the risk of adverse effects is minimal. According to the literature, there is no clear recommendation to use corticosteroids as a standard for dentoalveolar surgical treatments.
Nederlands tijdschrift voor tandheelkunde, 2008
What treatment is appropriate for a patient who has to undergo an invasive dental procedure if th... more What treatment is appropriate for a patient who has to undergo an invasive dental procedure if that patient is using medication that influences the blood coagulation system? Should the medication be stopped before the invasive procedure, with the risk of complications involving re-thrombosis? Or should the procedure be carried out without adjusting the medication? What is the risk of bleeding complications? Recent studies appear to indicate that temporarily stopping medication is in many cases unnecessary and can even harm the patient. In recent decades dentists have received a great number of diverse recommendations. In this article recent research in this field is summarized and evaluated. The authors advocate the development of evidence-based clinical guidelines.
Nederlands tijdschrift voor tandheelkunde, 2006
Mandibular block anaesthesia is frequently used in dentistry. The technique is more susceptible t... more Mandibular block anaesthesia is frequently used in dentistry. The technique is more susceptible to failure than local anaesthesia by infiltration. Two cases of patients who were afflicted by transient paresis of (branches of) the facial and vagus nerves after mandibular block anaesthesia have been analysed. With reference to both these cases advice is given on how to react in case of a misdirected mandibular block anaesthesia.
Nederlands tijdschrift voor tandheelkunde, 2004
The records of 68 adult patients, referred to a Department of Oral and Maxillofacial Surgery for ... more The records of 68 adult patients, referred to a Department of Oral and Maxillofacial Surgery for extraction of one or more teeth, have been studied with regard to the complexity of the treatment and the postoperative course. In 11 patients surgical removal had to be performed, while in the remaining 57 patients treatment consisted of simple extractions. Forty-six patients of these 57 patients returned a questionnaire about postoperative problems and use of analgesics. These patients were divided into two groups, one consisting of 17 healthy patients without any medical disorder and/or use of drugs, and a second consisting of 29 medically compromised patients. The postoperative course did not differ between both groups. Four patients (1 healthy, 3 medically compromised) experienced postoperative complaints during more than 6 days. Remarkably, the number of patients who experienced pain but did not use analgesics was considerably higher in the healthy group (29%) compared with the med...
Nederlands tijdschrift voor tandheelkunde, 2001
International Journal of Oral and Maxillofacial Surgery, 2013
Mondziekten, kaak- en aangezichtschirurgie, 2009
ABSTRACT Onder een medisch complexe patiënt wordt in de tandheelkunde een patiënt verstaan van wi... more ABSTRACT Onder een medisch complexe patiënt wordt in de tandheelkunde een patiënt verstaan van wie de algehele gezondheidstoestand ten gevolge van ziekte en/of het gebruik van medicijnen zou kunnen interfereren met het tandheelkundig handelen. Ziekteprocessen in de mond kunnen een duidelijke invloed hebben op de algehele gezondheid en vice versa. Zowel het effect van een ziekte of aandoening op de mondgezondheid (zoals het ontstaan van orale ulcera bij patiënten met een inflammatoire darmziekte) als het effect van de ziekte op het tandheelkundig behandelplan (het uitstellen van een tandheelkundige behandeling kort na een hartinfarct) alsook het effect van een orale aandoening op het verloop van een ziekte of ziekteproces (orale ontstekingen die de plasmaglucosespiegel bij diabetespatiënten kunnen beïnvloeden) kan worden gerekend tot medisch-tandheelkundige interactie (MTI). Mensen worden ouder en daarmee wordt het aantal medisch complexe patiënten groter. Enerzijds is er een toename van de levensverwachting en de intensivering van de algemeen medische zorg van belang, anderzijds neemt de tandheelkundige vraag – ook bij ouderen – toe. De toename van de tandheelkundige vraag wordt onder andere veroorzaakt door toegenomen tandheelkundige mogelijkheden, grotere tandheelkundige bewustwording en verbeterde tandheelkundige preventie, waardoor tot op hoge leeftijd de eigen dentitie behouden blijft.
Huisarts en wetenschap, 2013
Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 2002
Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 2009
British Dental Journal, 2007
Nederlands tijdschrift voor tandheelkunde, 1996
This article describes the 'Feedback Post AZIG', an institute to which dentists can turn ... more This article describes the 'Feedback Post AZIG', an institute to which dentists can turn for advice on medical questions. The frequency as well as the content of these questions, posed between 1991 and 1994, are considered. Dentist clearly have a need for medical feedback and this need increases every year. Given the expected increase of the number of medically compromised patients in the dental practice, the importance of both medical training to dentists and feedback possibilities should not be underestimated.