Archive | April, 2013

Oklahoma Dentist Disciplinary Database

A lot of media publicity has occurred regarding a case that appeared last month where patients of an oral surgeon in Oklahoma were asked to get tested for HIV and hepatitis after it was found that potentially lax sterilization procedures were used. More on this case is discussed over at Dental Patients Warned of Possible HIV and Hepatitis Exposure Due to Oral Surgeon’s Practices for example. The Tulsa World has been prompted to publish a searchable database of all disciplinary actions taken against dentists, in the state of Oklahoma from January 2000, to January 2013, after the case involving lax sterilization procedures came to light. In that case one patient had four third molars (wisdom teeth) removed and was allegedly given sedation by a dental assistant who should not have been giving sedation. She later developed an infection and liver problems. The Tulsa Word seems to be publishing the database to allow patients to better research dentists and make determinations of who they may decide to see to perform their dental work. Most cases that involve disciplinary actions against a dentist by a State Board of Dentistry do not receive quite the amount of media scrutiny as the case did […]

Continue Reading 0

Looking at the Concept of Prevention in Dentistry

An interesting article written by Jay W. Friedman, DDS, MPH, appears in J Evid Base Dent Pract, vol. 12, pp. 53 – 54, 2012. In the article a discussion of three different types of prevention is made. primary prevention secondary prevention tertiary prevention Primary prevention is described as the well known prevention in which one attempts to not have any dental caries, not have any periodontal disease, and not have any loss of teeth. This form of prevention is when one regularly brushes their teeth, flosses, has a dental cleaning, and radiographs performed. The author discusses how typically dentists recommend 6 month intervals between examinations and cleanings. He then says “Patients who form minimal calculus and have no periodontal disease likewise do not need semiannual prophylaxis, or additional service…Lacking evidence of need, this is not prevention but rather FUN (functionally unnecessary) treatment.” The author defines secondary prevention as the treatment of what cannot be prevented and needs to be treated. Secondary prevention can sometimes of course help teeth be maintained for a lifetime. The author states the problem with secondary prevention is when the treatment goes beyond the definition and results in the replacement of functional fillings and prophylactic removal […]

Continue Reading 0

Bupa Ends Covering Wisdom Teeth Extractions Deeming Them Unnecessary

There is a lot of debate regarding removing asymptomatic third molars (wisdom teeth). Those who argue against removing asymptomatic wisdom teeth (retaining) are often accused of trying to save the insurance industry money (See for example Rogue Dentist’s Crusade), while those who argue for extracting asymptomatic wisdom teeth for preventative purposes are often accused of being interested in making more money due to the commonly used fee for service health care system. Somehow in the hoopla the patient’s health seems to take a back seat to some party making (or saving) money. Recently an article came out in London in the Times titled “Health insurer’s chief takes the knife to ‘unnecessary surgery” by Nic Fildes and Andrew Clark, March 13, 2013. The article opens by saying “Want to get your wisdom teeth extracted? Don’t ask Bupa, which is cutting back on what it deems unnecessary surgery in an attempt to improve profits in its ailing British business.” The article states that the CEO of Bupa says that it won’t pay for wisdom teeth extractions for patient’s who aren’t in pain. The CEO is quoted as essentially saying that there is no reliable research that suggests that removing healthy teeth have health […]

Continue Reading 1

Systematic Review of Prophylactic Extraction of Third Molars: From Brazil

Many reviews have been conducted in recent years to determine if healthy third molars (known as wisdom teeth) should be prophylacticly extracted as in removed before causing problems. A new study by Moacir Guilherme da Costa and four other researchers titled “Is there justification for prophylactic extraction of third molars? A systematic review,” appears in Braz Oral Res., (São Paulo) 2013 Mar-Apr;27(2):183-8. The article discusses how in the United States roughly 10 million wisdom teeth are extracted from around 5 million individuals each year. The article discuss how several reasons are usually given for extracting wisdom teeth pericoronitis periodontal defects in the distal region of the second molar caries in the third or second molars different types of odontogenic cysts and tumors crowding of the lower incisors indications for orthodontic, prosthetic or restorative purposes The authors state how the majority of dental surgeons feel when there is clinical, radiological or laboratorial evidence of acute or chronic periodontitis, caries, pericoronitis, harmful effects on second molars or disease the removal of third molars is justified. The authors mentioned how several controversies arise surrounding removing healthy asymptomatic wisdom teeth including inadequate study designs small sample size insufficient monitoring time methodological flaws Hence the […]

Continue Reading 0

The Correlation of Mandibular Incisor Crowding and Third Molars in Brazilians

An article written by Lilian-Harumi Karasawa and 4 others titled ” Cross-sectional study of correlation between mandibular incisor crowding and third molars in young Brazilians,” appears in Med Oral Patol Oral Cir Bucal (currently in press the version I have looked at but was accepted in November 2012). The article sets out to examine the correlation between lower incisor crowding and the mandible third molar (lower wisdom tooth).  The ability of a lower wisdom tooth to have lower incisor crowding has been debated and looked at by many researchers over the years. See for example Review of the Wisdom Behind Third Molar Extractions. The possibility that a lower wisdom tooth can cause crowding is often given as a justification for removing a lower wisdom tooth to prevent abnormal orthodontic conditions. In this study the researchers took 300 healthy Brazilian young adults which include 134 men with mean age 20.4±2.40 years-old and 166 women with mean age 20.5±2.43 years-old. The young adults filled out forms regarding their age, gender, and characteristics of their wisdom teeth such as if they were present or absent. This information was confirmed by oral examination and a recent panoramic radiography. Those in the study wearing prothesisis, […]

Continue Reading 0

Powered by WordPress. Designed by Woo Themes