16 Year Old Female Dies After Wisdom Teeth Removal

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I was very saddened to recently hear about the death on May 5, 2011, of a young 16 year old girl who was a sophomore in high school in a suburb of Pittsburgh, Pennsylvania. She was in the ROTC program and had aspirations to join the Army. Miciah Bonzani went into cardiac arrest while under anesthesia to have her wisdom teeth removed. She was taken to a hospital, placed on life support, and then died 2 days later. She was born with a heart defect which had required two surgeries before her first birthday. What is also troubling to me about this unfortunate death is that one of the media organizations that covered the story WPXI/Pittsburgh.com, did not even mention that it occurred while having wisdom teeth extracted.  They simply called it “dental work” and an “outpatient medical procedure”, although … Read more

Adverse Sedation Events and Impact on Provider Specialty in Pediatrics

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Recently an article was published in Pediatrics titled Impact of Provider Specialty on Pediatric Procedural Sedation Complication Rates with authors Kevin G. Couloures, Michael Beach, Joseph P. Cravero, Kimberly K. Monroe and James H. Hertzog.   (2011, 127, pages e1154-e1160).  The conclusion presented in the abstract of the article is “In our sedation services consortium, pediatric procedural sedation performed outside the operating room is unlikely to yield serious adverse outcomes. Within this framework, no differences were evident in either the adjusted or unadjusted rates of major complications among different pediatric specialists.” The authors mentioned in this article another study conducted in Pediatrics which found over a 27 year period there were 60 cases identified in which death or severe neurological injury occurred of children 0.08 years to 20 years old. However, this study presented different conclusions in the abstract of the … Read more

Patient Consultations for Wisdom Teeth Removal

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In my last post on the Well Informed Patient I discuss how Dr. Thomas B. Dodson talks about “…a new brand of well-informed patient.” In that post I attempted to make that case that many patients are not being well informed at all when it comes to wisdom teeth extractions and is partially due to the current model of informed consent in the U.S but also failure to provide their patients with current scientific evidence and information. In this post I will look specifically at 2 examples of patients who have in the past few years visited oral surgeons to discuss the possibility of having wisdom teeth removed and/or had wisdom teeth removed. From their writing one can make the case that they may have benefited from being better informed and aware of the fact that no current evidence supports … Read more

The Well Informed Patient

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In a recent editorial in the Journal of Oral and Maxillofacial surgery (vol. 69. page 1263, 2011),  titled “Shouldn’t All Clinical Research Be Scientific?”, Dr. Thomas B. Dodson,  talks to his fellow oral surgeon colleagues and says “Not only do we face rapid advances in science and technology, but we have new accountability from economic, legal, and regulatory challenges, as well as a new brand of well-informed patient.” I personally would hope that the well-informed patient are patients who are being informed by oral and maxillofacial surgeons and dentists. However, I do not believe that is really the case here. One question to ask is why patients in the past were not well informed? The other and more pressing question to ask is why are these patients still not being properly informed today? (This also applies to other doctors and … Read more

How does Flouride really Protect Teeth from Cavities?

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A recent study that appeared in the journal Langmuir looked into the role of fluoride and their protection on teeth. The researchers who published the journal article found the protective shield fluoride forms on teeth is up to 100 times thinner than what was previously thought. It is well known that fluoride is found in toothpaste, mouthwash, and public drinking water in many areas in the world. The use of fluoride of course is to help prevent tooth decay which causes cavities to form. Researchers found the fluorapatite layer created by fluoride on the hard white substance covering teeth’s surface called enamel is only 6 nanometers thick. This layer is very small and over 10 times thinner than what was indicated in any prior studies. Hence the researchers raise questions about how a layer so thin can protect teeth from … Read more