Archive | February, 2012

Using Computed Tomograph (CT) To Lower the Incidence of Wisdom Teeth Removal Nerve Injuries

A question that everyone who has wisdom teeth wants to know these days is the following: “If you use Computed Tomography (CT) can it lower the risk of developing a nerve injury from having wisdom teeth removed?” Three authors from Spain (Sanmarti-Garcia, Valmaseda0-Castellon, Gay-Escoda) recently conducted a study asking this question titled “Does Computed Tomography Prevent Inferior Alveolar Nerve Injuries Caused by Lower Third Molar Removal?” appearing in the Journal of Oral and Maxillofacial Surgery (vol 70, pages 5-11, 2012). The issue is as stated by the authors is that “panoramic radiography alone cannot identify the buccolingual position of the mandibular canal and the 3M roots.” Computed tomography (CT) is able to show this information. Even so an estimated 40% of cases show superposition of the roots and the mandibular canal. Hence many of the potential CTs performed may potentially add additional costs and exposes patients to additional radiation without in some cases adding any clinically useful information to the pre-surgical picture. The authors state “the utility of CT in the extraction of a 3M is questionable because in most cases it does not modify the surgical technique, it seems to have a low positive predictive value for IAN injury […]

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Potential Alternatives to the Current Medico-Legal System in the United States

On my site I discuss numerous issues with the current legal system and how this relates to the medical system with a focus on third molar (wisdom teeth) removal. See,, and One issue is that there are a host of different damage caps (non-economic ‘pain and suffering’ awards) in different states throughout the United States. This can sometimes limit the amount a patient can receive even if there was gross negligence by the dentist or oral surgeon. Hence this can prevent fair compensation from being awarded. Another issue with the legal system is that sometimes when patients suffer complications and problems due to negligence they will not be able to sue due to the case not being able to get a very large settlement amount. In addition, these legal cases can drag on for years and years and take a toll on the health of the patient and the doctor. Unlike in the airline industry for pilots, doctors don’t have their own skin in the game so to speak. If a pilot crashes a plane then the pilot may be seriously injured or even die along with the passengers. When a doctor performs a poor surgery that […]

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Perioperative Information for Third Molar (Wisdom Teeth) Removal

A recent study titled “An Evaluation of Patients’ Knowledge About Perioperative Information for Third Molar Removal,” appears in the Journal of Oral and Maxillofacial Surgery (vol. 70, pages 12 – 18, 2012). The study attempts to look at what patients know about third molar (wisdom teeth) removal before having surgery performed. The study was conducted by authors in Brazil and Kentucky (United States). The study explains on being nervous and anxious before having wisdom teeth removed can actually cause a longer surgery, more potential swelling, and even more pain. Hence there is incentive for the surgeon and the surgical team to help produce a calming environment for patients to help reduce anxiety which can lead to potentially better outcomes. The study had 67 patients which included 43 female and 24 males who had 1 or more wisdom tooth removed. The patients presented to an ambulatory environment between August 2009 and April 2010 in Brazil. One surgeon interviewed each patient and this surgeon was blinded as in did not know about the patient’s past tooth extraction experience(s). In this study 25 of the patients had previous tooth extraction experience. Most of the wisdom teeth were extracted for orthodontic reasons. Other reasons […]

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Ed Leedskalnin on Education

Here is a very intersting quote by Ed Leedskalnin on education I came across from  “You know we receive an education in the schools from books.  All those books that people became educated from twenty-five years ago, are wrong now, and those that are good now, will be wrong again twenty-five years from now.  So if they are wrong then, they are also wrong now, and the one who is educated from the wrong books is not educated, he is misled.  All books that are written are wrong, the one who is not educated cannot write a book and the one who is educated, is really not educated but he is misled and the one who is misled cannot write a book which is correct. The misleading began when our distant ancestors began to teach their descendants.  You know they knew nothing but they passed their knowledge of nothing to the coming generations and it went so innocently that nobody noticed it.  That is why we are not educated. Now I will tell you what education is according to my reasoning.  An educated person is one whose senses are refined.  We are born as brutes, we remain and die […]

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One Star Yelp Reviews on Wisdom Teeth

In this post I will examine some recent 1 star reviews of a dental and/or oral surgery practice on Yelp and some of the comments received. At an office in Seattle, Washington, a women writes in her review on Yelp ” I am still upset about what happened. It is a very long and disturbing story. Basically – [the doctor] performed the surgery in a very cold room [on my 19 year old daughter] and seriously damaged a muscle in her jaw. Within 24 hours after surgery she could not open her mouth more than a quarter inch….the doctors determined that she had a massive infection in her jaw and immediately put her on IV antibiotics….it took FOUR months for the damage to heal & for her to be able to open her mouth normally!” At a dental center in Virginia a male says in his review on Yelp “…they recommended I have 4 wisdom teeth removed, claiming that there ‘was not room in my mouth to accommodate them and that they were going to cause teeth to twist.’ My wisdom teeth came in years ago and it’s ridiculous to say that they could cause my teeth to get worse in […]

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