Archive | Wisdom Teeth

Comparing Ibuprofen and Etodolac on Swelling and Pain After Wisdom Teeth Removal

An interesting article titled “Comparative Assessment of the Effect of Ibuprofen and Etodolac on Edema, Trismus, and Pain in Lower Third Molar Surgery: A Randomized Clinical Trial” appears in the 2016 Journal of Oral an Maxilofacial Surgery written by Julio Cesar Silva de Oliveira and et al. (vol. 74, pp. 1524-1530). The authors set out to explore if ibuprofen or etodolac is more effective in managing pain, swelling, and trismus after wisdom teeth removal. After wisdom teeth removal symptoms such as swelling, pain and limited mouth opening (trismus) can present. Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed for the rapid relief of moderate pain in inflammatory conditions and soft tissue trauma. The mechanism of action of NSAIDs is the inhibition of the release of cyclooxygenase (COX), an enzyme that is responsible for the production of prostaglandins (PGs). Ibuprofen is an NSAID which inhibits COX-1 and COX-2. Etodolac differs from other NSAIDs by being […]

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Avoiding Amoxicillin During Wisdom Teeth: What are the Possible Problems

An interesting article titled “Dental Care Professionals Should Avoid the Administration of Amoxicillin in Healthy Patients During Third Molar Surgery: Is Antibiotic Resistence the Only Problem?” appears in the 2016 Journal of Oral and Maxilofacial Surgery written by Othoniel H. Aragon-Martinez and et al. (vol. 74, pp. 1512-1513). The authors attempt to explain why amoxicillin should not be used during wisdom teeth surgery. Amoxicillin is commonly used to prevent infections. Information from high quality clinical trials has shown that amoxicillin is not effective to reduce the risk of wound infections when it is received both preoperatively and postoperatively.  Recent evidence has shown that the administration of 250 mg of amoxicillin in healthy volunteers every 8 hours for 7 days produces  antibiotic resistance. The authors also discuss the topic of dysbiosis. Dysbiosis is a detrimental modification in the composition of the microbiome alongside altered microflora functions, which can be produced by antibiotic exposure, […]

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Are There Differences in Complications After Wisdom Teeth Surgery Depending on the Sedation Received?

An interesting article titled “Complications of Moderate Sedation Versus Deep Sedation/General Anesthesia for Adolescent Patients Undergoing Third Molar Extraction” appears in the 2016 Journal of Oral and Maxilofacial Surgery written by Gino Inverso and et al. (vol. 74, pp. 474-479).  The authors set out to determine if there is any difference in complications occurring after wisdom teeth surgery when patients are given either moderate sedation or deep sedation. For patients undergoing wisdom teeth surgery they may have some say in what level of sedation they receive and it may also be based on the desires of the surgeon. Specifically the authors examined the complications resulting from moderate sedation versus deep sedation/general anesthesia for adolescent patients undergoing wisdom teeth extraction. They sought to determine if any differences in complication risk exist between the two levels of sedation. The authors explored a database commissioned by the the American Association of Oral and Maxillofacial Surgeons […]

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Using Dexmedetomidine For Wisdom Teeth Surgery

An interesting article titled “Sedation Protocol Using Dexmedetomidine for Third Molar Extraction” appears in the 2016 Journal of Oral and Maxilofacial Surgery written by Dae-Seung Ryu and et. al. (vol. 74, pp. 926.e1-926.e7). The article seems to determine a sedation protocol for dexmedetomidine. The authors state that IV sedation is often given in cases of wisdom teeth surgery with midazolam being a medication commonly used. When midazolam is combined with opioids it can cause respiratory depression. Dexmedetomidine is an alpa2-agonist acting on adrenoceptors in many tissues, including those in the nervous, cardiovascular, and respiratory systems. Compared with midazolam, the major advantage of dexmedetomidine is its minimal effect on the respiratory system. It also produces an analgesic effect which can help alleviate the sensation of pain after tooth extraction. The authors set out to study the pain, patient satisfaction, sedation depth, and adverse effects after wisdom teeth extraction using dexmedetomidine and to compare IV and intranasal (IN) routes of administration. The […]

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Retrieving a Broken Dental Needle Using a Minimally Invasive Technique

An interesting article titled “Use of Intraoperative Navigation for Minimally Invasive Retrieval of a Broken Dental Needle” appears in the 2015 Journal of Oral and Maxillofacial Surgery and written by Kyle M. Stein (vol. 73, pp. 1911-1916). The article describes retrieving a broken dental needle using a Medtronic StealthStation S7 surgical navigation system. The use of disposable needles in dentistry has rendered the occurrence of needle breakage an extremely rare event. However, this complication continues to occur, and can be caused by improper technique, inappropriate armamentarium, and unexpected patient movement. I have described a few cases of this occuring on the wisdom teeth complications page at http://www.teethremoval.com/complications.html. In almost every case, needle breakage occurs when an inferior alveolar nerve block is administered with 30-gauge short needles. In the article a case of a 13 year old female had a broken dental […]

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