Wisdom Teeth

Management of Wisdom Teeth without Symptoms

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An article by Raymond P. White and William R. Proffit titled “Evaluation and management of asymptomatic third molars: Lack of symptoms does not equate to lack of pathology” appeared in the July 2011 issue of the American Journal of Orthodontics and Dentofacial Orthopedics (Vol 140, Issue 1). The article states “Some patients have third molars that are “symptom free and pathology free.” More often, however, third molars are “symptom free, and pathology exists,” requiring a clinical or radiographic examination for confirmation.” The authors state that a recent report suggests that limited periodontal examination in the United States in the National Health and Nutrition Estimates Survey…”underestimated the prevalence of periodontal disease.” A study carried out at the University of North Carolina and the University of Kentucky is mentioned which included 409 healthy young adults who averaged 25 years old and had … Read more

The Evidence Base for Third Molar (Wisdom Teeth) Decisions

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An excellent editorial appears in the Journal of Oral and Maxillofacial Surgery in the August 2012 edition titled “Those Who Ignore the Evidence Are Doomed to Misuse It” by Dr. Thomas B. Dodson (70, pages 1765-1767). Dr. Dodson explains how the debate regarding whether or not to either 1) remove asymptomatic, disease-free third molars, or 2) retain asymptomatic, disease-free third molars has become highly controversial. He argues that there are an assortment of viewpoints that play a role here. A) Payer-based clinical decision making: “The payer is the invisible hand in the operatory, influencing the treatment plan with a bold line that determines whether a service is covered or not. With PBCD, there is little regard or sympathy for what the OMS perceives about the individual patients and their circumstances. Thus, PBCD risks moral hazard by pre-empting services that the … Read more

Gum Disease More Common With Old Age

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A recent study which appeared in Nature Immunology shows that the deterioration in gum health which occurs with increasing age is associated with a drop in the level of a chemical called Del-1. Periodontitis is a disease of the gums which causes bleeding and bone loss which can, over time, lead to loss of teeth. Periodontitis  is caused by an over-active immune response to bacteria that grow in the mouth. As people age they are more likely to suffer from inflammatory diseases, including gum disease. The new research investigated gum disease in young and old mice and found that an increase in gum disease in the older animals was accompanied by a drop in the level of Del-1. Del-1 is known to restrain the immune system by stopping white blood cells from sticking to and attacking mouth tissue. In mice that had … Read more

Fish Oil to Help Periodontal Disease

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I have previously discussed in this post http://blog.teethremoval.com/omega-3-fatty-acids-inversely-proportional-to-periodontitis/ that you should be taking omega 3 fatty acids such as fish oil regularly. This is because omega 3 fatty acids have been found to be inversely associated with periodontitis which is inflammation of the tissue surrounding the teeth. Recently researchers in Australia reviewed evidence from eight unique studies that involved humans to evaluate whether fish oil supplementation could be an adjunct therapy for periodontitis. Their review of these studies showed that improvements in clinical measures were common in all studies, but were scientifically significant in two that used a combination of fish oil and aspirin. Although not conclusive, intake of fish oil is recommended for health benefits which extend beyond just your teeth. Dr. Alison Coates from the University of South Australia says: “I would recommend that people ensure they have a … Read more

Reconsideration of decision making for third molar extraction

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An article recently appeared in the Journal of the Korean Association of Oral and Maxillofacial Surgery titled “Reconsideration of decision making for third molar extraction, “(vol. 37, pages  343-348, 2011) by Wonse Park and et al. I am unable to read the article since it is in Korean but the abstract is in English. The introduction of the article states “Third molar extraction is one of the most common procedures in oral and maxillofacial surgery. The impacted third molar causes many pathological conditions, such as pericoronitis, caries, periodontitis, resorption of adjacent teeth, and cyst or tumors associated with impacted teeth. Extraction is often considered the treatment of choice for impacted lower third molars. On the other hand, imprudent extraction of deeply impacted third molars can cause permanent complications, such as inferior alveolar nerve damage. Therefore, guidelines for the extraction of … Read more