Using the sedative Remimazolam for oral surgery

An interesting article titled “Can Remimazolam Be a New Sedative Option for Outpatients Undergoing Ambulatory Oral and Maxillofacial Surgery?” appears in the Journal of Oral and Maxillofacial Surgery written by Zijian Guo and et. al. (Available online 16 September 2022). The article discusses the sedative remimazolam and its possibility to sedate in oral surgery as effectively as midazolam. In the article the authors discuss how patients can receive dental treatment with more comfort using sedation. Midazolam is widely used in oral and maxillofacial surgery but has side effects of increased accumulation and respiratory depression. Remimazolam has similar pharmacological effects to midazolam but has rapid onset, fast metabolism, less potential adverse effects. Remimazolam has a a mean half-life of between 0.5 and two minutes and a terminal half-life in plasma of 37 to 53 minutes.  The authors conducted the first ever … Read more

Woman in Singapore Dies After Wisdom Tooth Removal

A 24 year old woman in Singapore died after having four wisdom teeth extracted in 2019. The woman had visited the National Dental Centre Singapore first in August 2018. At another visit in April 2019 she complained of severe pain in the upper and lower right side of her mouth. While at the appointment, it was determined that the pain could be due to her four impacted wisdom teeth. The woman decided to have wisdom teeth surgery under general anaesthesia. The woman had no known drug allergies and had previously been given general anaesthesia without any side effects. In May 2019, the woman was admitted to a hospital where she was given a pre-anaesthetic assessment where nothing out of the ordinary was noted. However it was noted the woman was obsese and had a skin condition known as hidradenitis suppurativa. … Read more

Oral Surgeon Opioid Prescribing Habits in the US during 2016 to 2019

An interesting article titled “Opioid prescribing by oral and maxillofacial surgeons in the United States, 2016–2019” written by Tumader Khouj, Deborah E. Polk, and Katie J. Suda, appears in the October 9th, 2022, issue of the Journal of Public Health Dentistry. The article describes opioid prescribing trends among oral and maxillofacial surgeons (OMFS) in the United States during 2016 to 2019. In the past on this site several articles have covered opioid prescribing habits, see for example Assessing the Impact of Three Day Opioids Limits for Dentists, Insurance Companies Limiting Access to Opioids After Wisdom Teeth Surgery, Reducing Opioids in Oral and Maxillofacial Surgery, and Dentists Overprescribing Opioids to Adults in the U.S.. In the article, the authors conducted a retrospective analysis of IQVIA Longitudinal Prescription Dataset (LRx) from January 1, 2016, to December 31, 2019, that includes 92% of … Read more

World record set by nine year old’s wisdom tooth extraction

Recently, a nine year old in Virginia has become the youngest person according to Guinness World Records to have a wisdom tooth extracted. The nine year old boy was 9 years and 327 days old when he had the wisdom tooth extracted. The boy learned that he needed the extraction when his orthondontist in Virginia noticed on a 3D x-ray that he had a wisdom tooth and a molar growing on top of each other. This was in the upper left area of his mouth. The boy said he could not feel the tooth growing but his orthodontist wanted it removed so that the molar could drop in his mouth properly. The boy was referred to an oral surgeon in Virginia. The oral surgeon confirmed wha the orthondotist had said, the wisdom tooth needed to be removed in order to … Read more

Dentist suspended after patient died after teeth extraction

A dentist in the state of Washington has had their dentistry license suspended over allegations of unsafe practices after a patient died while having multiple teeth removed in 2022. The patient had a significant medical history and was having teeth extracted in June 2022 in advance of a scheduled heart valve surgery. The patient was under moderate sedation for abot five minutes before a drop in oxygen-saturation level, heart rate and blood pressure. The patient had hypertensive cardiovascular disease, valvular heart disease, congestive heart failure, pulmonary emphysema, chronic disease, diabetes, and obesity. In advance of the extractions the dentist had received medical clearance from the patient’s primary care provider but the dentist had not talked to any other doctors treating the patient. During the day of the extractions, the patient was given articaine, lidocaine, triazolam, midazolam, decadron, and cefazolin. Roughly … Read more