Archive | June, 2013

Biostatistical Knowledge of Oral and Maxillofacial Surgery Residents

I found an interesting and critical study titled “Oral and Maxillofacial Surgery Residents Have Poor Understanding of Biostatistics,” by Al M. Best and Daniel M. Laskin appearing in the J Oral Maxillofac Surg vol. 71, pp. 227-234, 2013. The article discuss how the three main oral and maxillofacial surgery (OMS) journals have low quality evidence and how some of the articles can’t be taken at face value. Hence, the purpose of this study was to evaluate residents’ understanding of biostatistics and the interpretation of research results to see if the curricula of training programs should be changed to better prepare clinicians to practice evidence-based dentistry. In the study a 6 question survey was developed for OMS residents and compared to results for a similar survey of medical residents. Further, questions looking into demographic characteristics, the methodologic courses residents may have taken previously, their attitudes about statistics, and their confidence about interpreting and assessing statistical concepts was assessed. The survey was administrated online and sent to all OMS residents in the United States in 2009. Even so only 112 participated in the survey. From these participants approximately 53% of the residents in OMS had taken a course in epidemiology, 49% had […]

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Looking at Evidence Supporting Dental Procedures from Cochrane Systematic Reviews

An interesting article titled “Is the Evidence Supporting Dental Procedures Strong? A Survey of Cochrane Systematic Reviews in Oral Health” by Clovis Mariano Faggion Jr. appears in J Evid Base Dent Pract, vol. 12, pp. 131-134, 2012. The article sets out to explore Cochrane systematic reviews and whether or not they provide useful information for use in dentistry. The author set out to look at the quality of evidence for Cochrane systematic reviews published in dentistry. The evidence was considered inadequate when authors described weak or insufficient evidence or when no studies were selected for the review. A total of 120 systematic reviews were looked at for 20 topics. The author did have some creative interpretation to assess the reviews. He states: “The full text of articles was, however, scrutinized to assess the risk of bias of included primary studies; methodological issues, such as allocation concealment and blinding, were usually not reported or were performed in a part of the primary studies sample. Some can argue that using stricter criteria would probably categorize almost all systematic reviews as providers of inadequate evidence. In other words, for some reviews, the attitude when scoring evidence as adequate was optimistic.” The author states: “Over […]

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Planning Intravenous Sedation for Wisdom Teeth Surgery

An article (in press at the time of writing this -2012) appears in the International Journal of Oral and Maxilofacial Surgery titled “Does planned intravenous sedation affect preoperative anxiety in patients?” by M. Seto, Y. Sakamoto, H. Takahashi, R. Kita, and T. Kikuta. The authors set out to evaluate The Spielberger’s State-Trait Anxiety Inventory (STAI) which can be used to evaluate levels of state and trait anxiety. State anxiety is defined as a subjective feeling of nervousness, whereas trait anxiety is defined as an individual’s underlying tendency to perceive a situation as stressful or threatening. One hundred and eleven (111) Japanese patients who were scheduled to have wisdom teeth extracted under local anesthesia were evaluated. STAI evaluates the degree anxiety based on 5 stages. The article states “The authors assessed preoperative anxiety using STAI at the initial visit and recommended intravenous sedation for patients whose level of state anxiety was above stage IV. They also recommended the sedation procedure to patients who anticipated high surgical invasion.” The article further states “The level of dental anxiety is considered to have a strong influence on the development of complications such as tachycardia, fluctuations in blood pressure, and vasovagal reactions. Intravenous sedation is […]

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Improving Patient Safety: Updates on Oral and Maxillofacial Surgery

In a recent blog post I discussed how a few new videos have appeared in recent months related to oral and maxillofacial surgery Videos Related to Oral and Maxillofacial Surgery. The American Association of Oral and Maxillofacial Surgeons (AAOMS) has also updated several sections of their website in the last year or so. They now have a section titled Orthodontics and Oral Surgery where they have videos related to showcasing various techniques that oral and maxillofacial surgeons and orthodontists perform. In addition they have updated and written a new page titled “Culture of Safety“. The page is a welcome addition and discusses how safety is the number one priority in the oral and maxillofacial surgery office. Now I wanted to take a moment to respond to this page and some other developments I have seen lately across the blogosphere. 1) The first point to address relates to the issue of safety versus appropriate treatment. Much of the of the motivation for my website was based on the fact that it was never discussed to me back in 2006 that no scientific evidence supported or refuted third molar extraction. In addition, many of the complications that can occur from wisdom teeth […]

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Herbs in Dentistry

In a previous blog post I talked about Using Adaptogens to Help Reduce Stress and discussed 8 different herbs that were reviewed in a 2010 journal article to help reduce stress. The use of herbs is also beneficial for migraine, for example, see this post Daily Preventative Therapies Can Reduce Migraine. Recently I came across the article “Herbs in Dentistry: Evidence-based herbal medicine” appearing in Dental Abstracts, vol. 57, issue 6, pp. 305-307, 2012. The article mentions the use of echinacea mouthwash which when combined with peppermint oil, sage, menthol, and chamomile is effective in gingivitis and periodontal disease. Further, this combination has shown to be effective against colds and flu. The article mentions the possible use of aloe vera  “Aloe vera gel is as effective as prednisolone and indomethacin, without these agents’ long-term toxicity… Uses of aloe vera include direct application to periodontal surgery sites, traumatized gum tissues, chemical burns caused by aspirin, extraction sites, acute mouth lesions, chronic oral disease manifestations (including lichen planus, benign pemphigus, and gingival problems related to acquired immunodeficiency syndrome or leukemia), soreness related to dentures, and inflamed areas around dental implants. It offers promise for many dental applications.” The article suggests that sage […]

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