Heart Infections on the Rise in Dental Patients After Antibiotic Reductions

In March 2008, the National Institute for Health and Care Excellence issued guidelines recommending that dentists should no longer give antibiotics before invasive treatments to people who are considered at risk of developing a life threatening heart infection. The life threatening heart infection is known as infective endocarditis and 40% of all cases are caused by bacteria in the mouth. Researchers at the University of Sheffield set out to explore the impact of these guidelines. It was found that an increase in cases of infective endocarditis was observed above what was expected. In March 2013, this increase accounted for an extra 35 cases of infective endocarditis per month. The researchers found that the number of  prescribed antibiotic prophylaxis fell by 89% from 10,900 prescriptions per month, before the 2008 NICE guidelines, to 1,235 a month by March 2008. The researchers … Read more

Periodontal Disease Can Lead to More Risk of Kidney Disease

As previously discussed on this website periodontal disease is something one should be aware of when considering whether or not to have wisdom teeth removed as periodontal disease can develop when wisdom teeth are maintained. This is discussed over at http://www.teethremoval.com/risks_of_keeping_wisdom_teeth.html. Many previous studies have looked at periodontal disease and how having it can lead to increased risk for other diseases. See for example http://blog.teethremoval.com/high-level-evidence-to-identify-diseases-and-disorders-associated-with-periodontal-disease/, http://blog.teethremoval.com/periodontal-disease-and-pregnancy-risks/, and http://blog.teethremoval.com/periodontal-disease-may-associate-with-breast-cancer/. In the first post mentioned above it was said “The diseases for which an association with periodontitis has been reported include cardiovascular disease (CVD), stroke, respiratory disease, rheumatoid arthritis, pancreatic cancer, diabetes mellitus (types 1 and 2), preterm delivery, low-birth-weight delivery, preeclampsia, osteoporosis and osteoarthritis.” A new study  has now associated periodontitis with an increased risk of kidney disease. The article looked at 699 African American adults who underwent complete dental examinations … Read more

Differing Views in Medicine and Dentistry Applied to Wisdom Teeth

An interesting article appears in the 2014 version of the Journal of Oral and Maxillofacial Surgery titled “Asymptomatic Third Molars Under Nominalist and Essentialist Lenses,” written by V. Wallace McCarlie and Daniel L. Orr II, pp. 658-659.  The authors define two differente views: 1) essentialism and 2) nominalism and then try to apply them to the management of wisdom teeth. The authors state “Essentialism is the notion that underlying every properly defined disease is an unchanging reality causing illness. Conversely, nominalism is not concerned with underlying causes, but rather with signs and symptoms of illness.” In the article the authors mention a study which says that dentists detect rather than diagnose. The authors later say that detection implies nominalism and diagnosis implies essentialism. The authors give some downsides to both points of view. For example, they say essentialism is less … Read more

Should the NICE Guidelines for Management of Wisdom Teeth (Third Molars) be Reevaulated?

An article titled “Changes in Demographics of Patients Undergoing Third Molar Surgery in a Hospital Setting Between 1994 and 2012 and the Influence of the National Institute for Health and Care Excellence Guidelines,” written by Vahe Petrosyan and Phillip Ameerally appears in the February 2014 issue of the Journal of Oral and Maxillofacial Surgery, pp. 254-258. The article discusses how National Institute for Health and Care Excellence (NICE) and the Scottish Intercollegiate Guidelines Network (SIGN) were published around 2000 recommending against prophylactic removal of wisdom teeth. This led to a reduction in surgeries performed. In the article the authors question whether or not the NICE guidelines on wisdom teeth should be updated. They mentioned a 2009 study which said 27% of previously symptom free wisdom teeth can become symptomatic after 1 year, especially those that are distoangularly impacted. In the … Read more

Periodontal Disease and Cardiovascular Risk

In a post many years ago I discussed Patients With Moderate To Severe Periodontitis Need to Be Evaluated For Cardiovascular Problems. In a new study, periodontal disease has again been looked at as a risk factor for cardiovascular disease. In the study conducted, more than 15,000 patients with chronic coronary heart disease gave information on their dental health with results showing periodontal disease indicators were common. The study included self reported dental health information from the STABILITY trial, a clinical trial with 15,828 participants from 39 countries all with chronic coronary heart disease and a risk of cardiovascular disease.  All study participants had a physical exam and blood work up, and completed a lifestyle questionnaire. They reported their remaining number of teeth and frequency of gum bleeding. The results indicated a high prevalence of tooth loss with 16% reporting having no … Read more