Archive | May, 2014

How Evolution Sold Us Short As it Relates to Wisdom Teeth

I came across an interesting article titled “‘Not tonight, I have toothache’: how evolution sold us short” published in February 16, 2013, in the Times in London and written by Hannah Devlin. The article talks about evolution and how it relates to wisdom teeth, which is a topic I don’t usually bring up on this site/blog since it is controversial. The idea goes that wisdom teeth were important for our ancestors because their diets consisted of a lot of tough and chewy foods. As their other teeth wore down, the third molars, played an important back up role as additional teeth to use. In addition, the idea is that as humans evolved their brains became larger and their laws became smaller leaving less room available for teeth to grow. Earlier hominids (our ancestors) had very large back teeth in long jaws; however, evolution began selecting for increasing brain size. Since the jaws have shrunk over time as a result, wisdom teeth often become impacted. In the article Professor Alan Mann, an anthropologist at Princeton University, describes how impacted wisdom teeth, in which the wisdom tooth remains partially buried in the gum, are a result of changes in the shape of […]

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Ethical Issues for Consent in Dentistry

An article appears in the Journal of Medical Ethics, vol. 39, pp. 59-61, January 2013, titled “Consent in dentistry: ethical and deontological issues,” written by Adelaide Conti, Paola Delbon, Laura Laffranchi, and Corrado Paganelli. The authors are from Italy and so the focus of the article is a discussion of some of the ethical issues in dentistry. I have previously discussed some ethical issues in medicine and dentistry. See for example, Attending to the Patient in the Informed Consent Process and Are Dentists Ethical or Scam Artists?. In the article the authors say “The right of patients to make decisions about their healthcare has been enshrined in legal statements: in Italy the National Constitution establishes that personal liberty is inviolable and that no one may be obliged to undergo any given health treatment except under the provisions of the law…In addition, the Charter of fundamental rights of the European Union and the Council of Europe’s ‘Convention on human rights and biomedicine’ establish the general rule of free and informed consent in the health field.” The authors touch on how it is possible that some treatment options provided by dentists may be considered a disfigurement in some cultures but a sign […]

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Patient Safety and the Culture of Cover-Up

An interesting article was written by George Lundberg titled “A culture of cover-up has slowed the patient safety movement” on December 1, 2012, on KevinMd.com located at http://www.kevinmd.com/blog/2012/12/culture-coverup-slowed-patient-safety-movement.html. In the article Dr. Lundberg says “Promoting patient safety, preventing medical error, preventing physician error, preventing errors in diagnosis, preventing nurse error, preventing surgical error, preventing communication error, preventing health illiteracy error, preventing errors from language barriers, preventing laboratory error, preventing computer error, preventing patient mix-ups, preventing right and left side of body mix-ups, preventing mistakes, since mistakes are the stepping stones to failure. Recognizing human frailty, recognizing physician humanity, recognizing system fallibility, owning up to problems, eliminating cover-up, acting out professionalism, recognizing that professionalism means self governance, individually and as groups. Self criticism, peer criticism, a culture of peer review, honesty, truth, disclosure, fairness, and negotiated settlements. Objective evaluation and commitment to quality. Quality improvement by preventing error. Systematic error, systematic prevention of error. An error caught before an action is taken based upon that error is, in effect, not an error. These are the fundamental truths that the patient safety movement is all about.” Dr. Lundberg later says “However, sad to say, improvement in documented actual patient safety has lagged […]

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Blood Levels in Fat Cells May Help Predict Migraine

A new study appearing in the journal Headache: The Journal of Head and Face Pain, looks at people experiencing two to twelve migraine headaches a month. In this study researchers found that measuring a fat-derived protein called adiponectin before and after migraine treatment is useful in revealing if headache patients felt pain relief or not. The researchers of the study are hopeful that finding this potential biomarker for migraine of adiponectin may be used for developing new and better migraine treatment options. Finding better treatment options for migraine sufferers is lucrative because roughly 36 million Americans suffer from migraine headaches which can last longer than 4 hours at a time. Women are three times to get migraines when compared to men. In the study the researchers collected blood from 20 women who visited 3 different headache clinics for an acute migraine attack during a period of a few years. The women had their blood taken before treatment with sumatriptan or naproxen sodium or a placebo. The researchers drew blood at 30, 60, and 120 minutes after the drug was given. The researchers then looked at blood levels of adiponectin along with two subtypes or fragments of total adiponectin in circulation: […]

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Ingestion of Foreign Body During Dental Procedures

In the complications of wisdom teeth page on this site http://www.teethremoval.com/complications.html I have discussed cases of teeth being displaced into various places of the body. A tooth can also either be aspirated and end up in the respiratory tract or ingested and likely pass several days after being swallowed. Dental instruments can also break off during surgery and end up in various places of the body. Some recent studies and cases have emerged for other dental procedures where foreign bodies were ingested. An article titled ” Precautions for accidental ingestion of a foreign body,” appears in J Can Dent Assoc 2013;79:d5, located over at http://www.jcda.ca/article/d5. This article describes a case where a 58 year old man underwent treatment for a dental crown and accidentally ingested a 20 mm stainless steel post intended to support the prosthesis. An imaging study revealed the post in the mid-abdomen and the patient, since he was not in distrust, was told to monitor for it to be passed. The patient never saw the post pass in his GI tract but subsequent imaging studies did not reveal it so it is presumed to have passed. This of course, opens up the possibility that maybe there is a […]

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