Considerations For the Cost of Wisdom Teeth

In a recent post, I discussed the cost of wisdom teeth management based on an article that appeared earlier this year in the Journal of Oral and Maxillofacial Surgery (see http://blog.teethremoval.com/the-costs-of-third-molar-wisdom-teeth-management/) Another article discussing wisdom teeth costs also appeared in the Journal of Oral and Maxillofacial Surgery in 2012 (see http://blog.teethremoval.com/the-costs-associated-with-third-molars-wisdom-teeth/). In both articles the authors conclude the costs of non-operative management of asymptomatic, disease-free, wisdom teeth exceeds the cost of operative management. I take issue with their conclusions as I believe they make too many simplifications in their analysis. I argue that the authors are ignoring the real risks of having wisdom teeth extracted that are not going to likely occur with non-operative management. Removing wisdom teeth has complications that can result. Some of these can be serious, permanent, and lasting, and cause considerable cost to both the patient and society. For example over at http://www.teethremoval.com/dental_malpractice.html a case from the 1980’s is discussed of a 36 year woman who was given an overdose of anesthesia while having her wisdom teeth removed that left her with permanent brain damage and unable to care for herself. Due to a damage cap in the state of Indiana she only received $500,000 from a […]

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The Costs of Third Molar (Wisdom Teeth) Management

I have previously commented on the costs associated with wisdom teeth in a 2013 blog post that was based on a 2012 article appearing in the Journal of Oral and Maxillofacial Surgery (see http://blog.teethremoval.com/the-costs-associated-with-third-molars-wisdom-teeth/). More recently, another article discussing the costs of wisdom teeth has appeared in the 2014 Journal of Oral and Maxillofacial Surgery titled “The Cost of Third Molar Management” written by Gino Inverso, Ronald Heard, and Bonnie L. Padwa (issue 72, pp. 1038-1039). This article takes the position that most previous studies focused on discussing wisdom teeth costs when taking the position from the cost of billing to private insurance companies. Their article attempts to use the true cost which they feel should help promote discussion of the topic of retaining or removing healthy disease free wisdom teeth and possibly increase access to care. In their analysis they determine the approximate time spent with an oral surgeon and their staff for a patient for a consultation, an operative visit, and a post-operative visit. They then determine the estimate annual cost associated with an oral surgeon, a surgery assistant, and a receptionist in a private oral and maxillofacial surgeon office in 2013. This total cost for all 3 comes in at […]

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New Legislation In California Proposed to Increase Medical Malpractice Damage Caps: Why It is Important if you Are Having Wisdom Teeth Extracted

A recent piece over on DrBicuspid.com titled “Dentists fight Calif. malpractice insurance ballot measure” draws attention to new proposed legislation in California (California Proposition 46) see http://www.drbicuspid.com/index.aspx?sec=log&URL=http%3a%2f%2fwww.drbicuspid.com%2findex.aspx%3fsec%3dsup%26sub%3dbai%26pag%3ddis%26ItemID%3d316366. The article discusses the previous medical malpractice legislation in California called the Medical Injury Compensation Reform Act (MICRA) which placed a $250,000 cap on noneconomic damage awards. The act did allow for unlimited economic damages and out of pocket costs. The article then discusses Proposition 46 in California written as “The Troy and Alana Pack Patient Safety Act,” to quadruple MICRA’s cap on noneconomic damages to $1.1 million. This actually simply changes the original $250,000 non-economic damage cap established in 1975 to what it would be today if it was indexed for inflation. I have previously discussed this over at http://www.teethremoval.com/legal_standpoint.html. The article goes on to get commentary from a past California Dental Association president and why dentists should vote no on Prop. 46 come November. The dentist is quoted as saying “Proposition 46 was written by trial lawyers who stand to profit from medical lawsuits. They have thrown in other provisions under the guise of so-called patient safety, but this is really about lawsuit profits.” The dentist encourages people to visit the noon46.com […]

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The Culture of Safety in Oral and Maxilofacial Surgery

Previously in a post over at http://blog.teethremoval.com/upcoming-changes-to-joms-and-aaoms-in-2014/, I discussed how the Journal of Oral and Maxillofacial Surgery is introducing a new perspectives section which “…will offer essays written on topics of interest to our specialty, including health policy, clinical controversies, and education and research matters, as examples.” On of the first perspectives section is written by Suzanne Morse Buhrow and titled “Promoting a Culture of Safety in Oral and Maxillofacial Surgery: The Time Is Now!” in the February 2014 Journal of Oral and Maxilofacial Surgery, pp. 239-240. The article opens by discussing the origins of the patient safety movement in the 1980s after the Institute of Medicine said 98,000 patients will die and 1.5 million will be injured every year from preventable medical errors in the United States. The article mentions how the National Practitioner Data Bank in the U.S. shows over 10% of all malpractice payments are from dental procedures. The article mentions a study from 2010 which said only 43% of oral and maxillofacial surgeons have reported a wrong site tooth extraction, mentioned as a leading preventable error. Further the article says only 60% of physicians share and report adverse events. The article applauds the American Association of […]

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More Dental Patients Warned of Potential HIV and Hepatitis Exposure in Pennsylvania

Back in July, 2014, I discussed a case in Pennsylvania where dental patients where made aware of possible HIV and hepatitis exposure due to infection control lapses by a dentist. This led to a 74 year old dentist having his license suspended. A video interview of several students who were treated by the dentist said that sometimes the dentist didn’t wear gloves and didn’t wash his hands between patients. See the blog post located over at http://blog.teethremoval.com/dental-patients-warned-of-possible-hiv-and-hepatitis-exposure-in-pennsylvania/. An additional case of infection control lapses has also occurred in Pennsylvania. The dentist had his license temporarily suspended due to an investigation by Pennsylvania’s department of health. A press release issued said the dentist “…did not follow appropriate procedures to properly clean, disinfect, or sterilize dental tools used at his…office.” The investigation showed the dentist admitted that he and his staff do not send out samples for biological spore testing which to make sure that sterilization is occuring. Furthermore it is not clear when the dental instruments were last sterilized including metal impression trays and dental tools. As such the health officials have encouraged former and current patients of the practice to get tested for potential hepatitis and HIV. A few of the […]

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