Wisdom Teeth

Avoiding Nerve Injuries with Lower Wisdom Teeth

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A study (in press) appears in the International Journal of Oral and Maxillofacial Surgery (2012) titled “Early extraction: a silver bullet to avoid nerve injury in lower third molar removal?” by Q. B. Zhang and Z. Q. Zhang. At the beginning of the article the authors discuss how lower third molars show the highest incidence of impaction and are responsible for pathology such as pericoronitis, periodontitis, pain, cysts, tumors, and second molar-tooth crown resorption. I have discussed the risks of keeping wisdom teeth in over here http://www.teethremoval.com/risks_of_keeping_wisdom_teeth.html The authors also discuss the complications associated with removal of third molars which I have elaborated on in great detail here http://www.teethremoval.com/complications.html. In this study two groups of patients from China were grouped: A) those less than 23 and with immature teeth, and B) those greater than 23 and with mature teeth. Group … Read more

Dental Plaque May Trigger Blood Clots

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Oral bacteria that escape into the bloodstream are able to cause blood clots and trigger life-threatening endocarditis. Streptococcus gordonii is a normal inhabitant of the mouth and contributes to plaque that forms on the surface of teeth. However, if these bacteria enter into the blood stream through bleeding gums they can start to wreak havoc by masquerading as human proteins. Researchers from the University of Bristol and the Royal College of Surgeons in Ireland (RCSI) have discovered that S. gordonii is able to produce a molecule on its surface that lets it mimic the human protein fibrinogen — a blood-clotting factor. This activates the platelets which then clump inside blood vessels. These unwanted blood clots will then encase the bacteria, protecting them from the immune system and from antibiotics that might be used to treat infection. Platelet clumping can lead to … Read more

Oral Surgeon Investigated for Reusing Needles and Syringes

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The Colorado Department of Public Health has released a lengthy document regarding an oral surgeon regarding unsafe injections. The document is from July 20, 2012, and is located over at http://www.cdphe.state.co.us/dc/Epidemiology/dentistFAQs.pdf. The document states: “Between September 1999 and June 2011, syringes and needles were re-used for multiple patients to give intravenous (IV) medications, including sedation. The IV medications were given during oral and facial surgery procedures. Needles and syringes were used repeatedly, often for days at a time. Because there can be a small amount of blood that remains in syringes and needles after an injection through an IV line, there is a risk of spread of bloodborne viruses, such as HIV, hepatitis B, and hepatitis C, between patients.” Patients who saw the oral surgeon in question were sent a mailing if they could be identified via medical records and … Read more

Third Molars (aka Wisdom Teeth): Kandasamy vs White and Proffit

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Like usual there are often heated exchanges over the management of wisdom teeth (third molars). Back in November 2011, in the American Journal of Orthodontics and Dentofacial Orthopedics (vol. 140, issue 5)  there was an exchange regarding two previous articles that had appeared and consequent exchange (White RP Jr, Proffit WR. Evaluation and management of asymptomatic third molars: lack of symptoms does not equate to lack of pathology. Am J Orthod Dentofacial Orthop 2011;140:10-6; and Kandasamy S. Evaluation and management of asymptomatic third molars: watchful monitoring is a low-risk alternative to extraction. Am J Orthod Dentofacial Orthop 2011;140:11-7) The articles in question I am referring to here are “Third molars” by Raymond P. White, Jr, and William R. Proffit in the American Journal of Orthodontics and Dentofacial Orthopedics (vol. 140, issue 5, pages 600-601) and Author’s response by Sanjivan Kandasamy … Read more

Review of the Wisdom Behind Third Molar Extractions

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Back in 2009, an article titled  The wisdom behind third molar extractions” by “S Kandasamy and DJ Rinchuse appeared in the Australian Dental Journal (54. pages 284-292. 2009) I discussed some of the provocative comments in this article in the post Bringing About Healthcare Change. To reiterate he states “…in the 21st century, the routine removal of asymptomatic pathology- free third molars has become a dated practice that is rapidly running out of valid excuses, and it has no justification in contemporary dentistry and medicine.” Earlier this year an article titled “Patient Specific Variables are a Consideration in the Decision to Extract Asymptomatic Third Molars” by Katerine W. L. Vig appeared in the J Evid Base Dent Pract. (2012 12 pp. 92-94) The conclusion of this article is “The removal of third molars to avoid lower incisor crowding is not justified. … Read more