Archive | March, 2017

Dental Extraction Complications in Patients on Double Antiplatelet Therapy

An interesting article titled “Hemorrhagic Complications of Dental Extractions in 181 Patients Undergoing Double Antiplatelet Therapy” written by Olga Olmos-Carrasco and et al. appears in the 2015 Journal of Oral and Maxilofacial Surgery (vol. 73, pp. 203-210). The study sought to explore if dental extractions can be done safely on patients with double antiplatelet therapy. Double antiplatelet therapy is the combination of 100 mg per day of acetylsalicylic acid and a second antiplatelet agent. This type of therapy is done to prevent blood cells from forming a clot in certain types of patients who have a history of coronary artery disease, or have had a heart attack or stroke. A total of 181 patients with a mean age of roughly 67 were included in the study.  Most of the patients (76.8%) were male. A total of 217 teeth were extracted in the study which was conducted in Madrid. During the course of extraction, a total of 165 patients  had light hemorrhage which lasted less than 30 minutes. In 15 patients (8.3%) the hemorrhage continued for more than 30 minutes. After 24 hours, 162 patients reported an absence of bleeding, while 15 patients (8.3%) had light hemorrhage, and 4 patients (2.2%) […]

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Filing Billing for Dentists to Help Patients

An interesting article titled “You want me to do what?” written by Douglas Auld appears in the March 2016 issue of JADA. The article discusses a patient who has an an abscess on a mandibular right third molar which requires extraction. The treatment was done in December and the patient had already used their full benefits from their dental insurance for the year. So the patient suggested to the dentist to bill for the extraction in January and also suggested to file it as a surgical extraction and apply the difference to his balance. The article asks if it is ethical for dentists to do any of this. The article states that a dentist has a duty to communicate truthfully with third parties. It says “A dentist who submits a claim form to a third party reporting incorrect treatment dates for the purpose of assisting a patient in obtaining benefits under a dental plan, which benefits would otherwise be disallowed, is engaged in making an unethical, false or misleading representation to such third party.” Therefore the dentist should file the claim with the correct date of service or wait until January to perform the treatment. The article says “A dentist who incorrectly describes on […]

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What Can a Surgeon Do to Prevent Opioid Abuse

An interesting article titled “The Surgeon’s Roles in Stemming the Prescription Opioid Abuse Epidemic” written by James Hupp appears in the 2016 Journal of Oral and Maxilofacial Surgery (vol. 74, pp. 1291-1293). The article describes the current challenges oral and maxilofacial surgeons are facing when it comes to prescribing opioids. This is because regulators and politicians are getting involved due to their perception of an opioid abuse problem. He mentions that Congress is considering legislation to address prescription drug addiction problems. The author wants surgeons to remember that there are legitimate reasons for giving patients who have had oral surgery such as wisdom tooth extractions an opioid medication.  Pain that interferes with a patient’s usual routines, their ability to consume enough fluids and calories, or their ability to sleep often requires a narcotic until the pain subsidizes. As such these patients should be prescribed opioids and surgeons ability to do so should not be taken away. Even so the author encourages surgeons to raise one’s threshold for using very potent narcotics, and potentially limit the number of doses prescribed to patients. In the article the author says “First, there is more and more data showing that many patients receive more potent and more doses of opioid medications than they need […]

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Can Playing Baseball in Youth Lead to Better Surgeons?

An interesting article by Thomas Dodson titled “Everything I Ever Needed to Know About Oral and Maxillofacial Surgery, I Learned Playing Baseball” appears in the 2016 Journal of Oral and Maxillofacial Surgery (vol. 74, pp. 1709-1710). In the article the author tries to tie in how the game of baseball can teach oral and maxillofacial surgeons much of what they need to know. The author opens by talking about how he is saddened by the lost of Dr. William Harrison Bell who was a prominent surgeon in the field. He then explains that himself and the doctor who passed were both very big into baseball as youths. Dr. Dodson played first base in college and Dr. Bell was a minor league player. Dr. Dodson said that all the doctors he has worked with at various institutions all have been enthusiastic about baseball. He wonders if there is something that causes oral and maxillofacial to like baseball. The author says “While baseball may seem to the unindoctrinated to be a bunch of players randomly chasing a ball, in fact, the flight of a hit is remarkably predictable based on the type of pitch being thrown. Fielders know exactly where to stand and how to execute a double-play with reflexive precision.” He […]

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