Wisdom Teeth

Dentist suspended after patient died after teeth extraction

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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

Using Imaging to Help Treat a Fused Wisdom Tooth

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An interesting article titled “Endodontic Management of a Fused Mandibular Third Molar with Supernumerary Tooth Using Cone-Beam Computed Tomography: A Case Report” appears in the American Journal of Case Reports written by W. Almutairi and M. Alduraibi (2022; 23: e937224). The article discusses a case report of a 26 year old man that had a wisdom tooth fused with with a supernumerary tooth. In the article discussion is made of the 26 year old man man with good oral hygiene who arrived at the author’s college in Saudia Arabia after having two days of severe pain on his lower jaw. An exam showed a large, mesially tilted, irregular wisdom tooth fused with a fourth molar. The fused tooth was tender to touch and responded to pain when a cold stimulus was used. The clinical findings suggested symptomatic irreversible pulpitis with … Read more

Factors that Influence Opioid Prescribing After Teeth Removal

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An interesting article titled “Factors influencing opioid prescribing after tooth extraction,” appears in the  Journal of the American Dental Association written by Douglas R. Oyler and et al. (published June 9, 2022). The article seeks to look at specific characteristics that infuence opioid prescribing after tooth extractions to help potentially lead to less opioid that are uncessarily prescibed. The subect of opioids and wisdom teeth extractions has been covered on this site frequently before, see for example the posts, Record Numbers Predicted to Die from Opioids in the US and Dentists Overprescribing Opioids to Adults in the U.S.. Patients in the U.S. are often first exposed to an opioid prescription from a dentist or dental care provider. Even so nowadays many dentists recommend nonopioid analgesics as the first option against pain reflief. In the article the authors reviewed records from … Read more

Shared Medical Appointments for Wisdom Teeth Informed Consent

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In the past informed consent for wisdom teeth surgery has been discussed on this site, see for example the post Informed Consent in Dentistry: Can Change Impact Personal Injury Cases? Often when it comes to have wisdom teeth surgery patients are shown a video discussing risks and benefits and treatment options related to wisdom teeth, then have an opportunity to discuss with their surgeon and ask any questions, and then sign a document acknowledging that they understand the risks and benefits. Such interaction typically places in a one on one setting with just the patient and the doctor. The patient is of course then billed for this appointment and must either pay out of pocket or pay what is remaining from their insurance plan and after meeting any insurance plan deductibles. There are some ways to possibly decrease the cost … Read more

Incorrect Tooth Extraction Protocol

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An interesting article titled “Incorrect tooth extraction – Never say never?” written by McKernon et al. appears in Oral Surgery in 2017 (vol. 10, pp. 30-35). The article discusses development of a protocol for dealing with cases of extracting the wrong tooth. Extracting the wrong wisdom tooth is a possible complication of removal and has occurred before, see http://www.teethremoval.com/complications.html. In the article the authors discuss how checklists are now used during surgery in an attempt to decrease medical errors. Even with these checklists reports of wrong tooth extraction still occur. The authors state that cases of wrong tooth extraction occur about once a week among all dentists in the U.K. The most common reasons for extracting the wrong tooth include cognitive failure and miscommunication. The authors state “We suggest…as human error can never be completely eradicated, a protocol must be … Read more