Archive | August, 2012

Oral Surgeon Investigated for Reusing Needles and Syringes

The Colorado Department of Public Health has released a lengthy document regarding an oral surgeon regarding unsafe injections. The document is from July 20, 2012, and is located over at http://www.cdphe.state.co.us/dc/Epidemiology/dentistFAQs.pdf. The document states: “Between September 1999 and June 2011, syringes and needles were re-used for multiple patients to give intravenous (IV) medications, including sedation. The IV medications were given during oral and facial surgery procedures. Needles and syringes were used repeatedly, often for days at a time. Because there can be a small amount of blood that remains in syringes and needles after an injection through an IV line, there is a risk of spread of bloodborne viruses, such as HIV, hepatitis B, and hepatitis C, between patients.” Patients who saw the oral surgeon in question were sent a mailing if they could be identified via medical records and told to be tested for HIV, hepatitis B, and hepatitis C. The document states: “People infected with viruses such as HIV, hepatitis B, and hepatitis C may not have symptoms for many years. It is possible you might have been infected and not know it.” The document has lists several ways that patients can protect themselves and says “It is […]

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Third Molars (aka Wisdom Teeth): Kandasamy vs White and Proffit

Like usual there are often heated exchanges over the management of wisdom teeth (third molars). Back in November 2011, in the American Journal of Orthodontics and Dentofacial Orthopedics (vol. 140, issue 5)  there was an exchange regarding two previous articles that had appeared and consequent exchange (White RP Jr, Proffit WR. Evaluation and management of asymptomatic third molars: lack of symptoms does not equate to lack of pathology. Am J Orthod Dentofacial Orthop 2011;140:10-6; and Kandasamy S. Evaluation and management of asymptomatic third molars: watchful monitoring is a low-risk alternative to extraction. Am J Orthod Dentofacial Orthop 2011;140:11-7) The articles in question I am referring to here are “Third molars” by Raymond P. White, Jr, and William R. Proffit in the American Journal of Orthodontics and Dentofacial Orthopedics (vol. 140, issue 5, pages 600-601) and Author’s response by Sanjivan Kandasamy in the American Journal of Orthodontics and Dentofacial Orthopedics (vol. 140, issue 5, pages 601-602) . In the “Third molars” article the authors provide 5 points which are what they feel are inaccuracies and unsupported opinions which appeared in the prior July 2011 article by Dr. Kandasamy (“Evaluation and management of asymptomatic third molars: watchful monitoring is a low-risk alternative […]

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Review of the Wisdom Behind Third Molar Extractions

Back in 2009, an article titled  The wisdom behind third molar extractions” by “S Kandasamy and DJ Rinchuse appeared in the Australian Dental Journal (54. pages 284-292. 2009) I discussed some of the provocative comments in this article in the post Bringing About Healthcare Change. To reiterate he states “…in the 21st century, the routine removal of asymptomatic pathology- free third molars has become a dated practice that is rapidly running out of valid excuses, and it has no justification in contemporary dentistry and medicine.” Earlier this year an article titled “Patient Specific Variables are a Consideration in the Decision to Extract Asymptomatic Third Molars” by Katerine W. L. Vig appeared in the J Evid Base Dent Pract. (2012 12 pp. 92-94) The conclusion of this article is “The removal of third molars to avoid lower incisor crowding is not justified. Clear indications exist for removal of third molars associated with pathology. Asymptomatic partially or fully erupted third molars are best retained and monitored regularly for periodontal maintenance, especially those with associated pockets greater than 4mm. Risks with retaining third molars should be put in the context of the overall medical condition of the patient with the potential for systemic involvement.” […]

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Management of Wisdom Teeth without Symptoms

An article by Raymond P. White and William R. Proffit titled “Evaluation and management of asymptomatic third molars: Lack of symptoms does not equate to lack of pathology” appeared in the July 2011 issue of the American Journal of Orthodontics and Dentofacial Orthopedics (Vol 140, Issue 1). The article states “Some patients have third molars that are “symptom free and pathology free.” More often, however, third molars are “symptom free, and pathology exists,” requiring a clinical or radiographic examination for confirmation.” The authors state that a recent report suggests that limited periodontal examination in the United States in the National Health and Nutrition Estimates Survey…”underestimated the prevalence of periodontal disease.” A study carried out at the University of North Carolina and the University of Kentucky is mentioned which included 409 healthy young adults who averaged 25 years old and had 4 retained asymptomatic third molars. Mention is made of 106 of these patients were periodontally healthy in the wisdom tooth region at baseline and after a median of 4.1 years, 40 (37.7%) had at least 1 periodonal probing depth in the wisdom tooth region of greater than or equal to 4 mm. Other studies using this data sample are mentioned […]

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