No Drill Dentistry Can Prevent Tooth Decay

Research published in Community Dentistry and Oral Epidemiology has shown that the need for fillings can be reduced by 30 to 50% through preventative oral care. This means that many previous fillings are not needed when dental decay occurs. As such a preventative approach can be beneficial when compared to current dental practices. Dentistry has been traditionally practiced with the believe that tooth decay rapidly progressed and the best way to manage it was to identify early decay and remove it quickly to prevent the tooth surface form developing cavities. After the decay is removed the tooth is restored with a filling material. Fifty years of research studies have shown that decay is not always progressive and develops more slowly than previously thought. It can take an average of four to eight years for decay to progress from the tooth’s outer layer to the tooth’s inner layer. As such quickly moving in to make a filling may not be the best approach.   The study’s author Wendell Evans and his team developed the Caries Management System which is a set of protocols which cover the specific treatment of early decay, the assessment of decay risk, and the interpretation of dental X-rays. The ‘no-drill’ treatment […]

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Should Patients Be Told Of Trainee Role in Their Surgery?

An interesting article titled “Should Patients Be Told of Resident Role in Their Surgery?” appears in the Journal of Oral and Maxillofacial Surgery written by James R. Hupp (2015, vol., 73, pp. 2071-2073). The article discusses how early July is the beginning of a new academic year in most hospital-based medical and dental residency programs. During this time many new doctors obtain clinical education. Hospital based dental residency programs often involved a lot of surgical procedures. The article questions if patients should be told of the residents potential role (and lack of experience) in their own surgery. The saying goes that one should try to avoid going to the emergency room or have surgery the first week of July or even all of July. The common thought is that the large amount of new trainees increases the chances of patient problems. In actuality, most first-year residents are given limited or no surgical responsibilities in the first few months of training. The author states “Most of us would want to know who will be in charge of our procedure and what role residents will play. Should this information always be shared with our patients? This is where informing the patient can enter a gray area.” Of course if one goes to a teaching hospital they may […]

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Complications Associated with Coronectomy

An interesting article titled “What Are the Types and Frequencies of Complications Associated With Mandibular Third Molar Coronectomy? A Follow-Up Study,” appears in the 2015 Journal of Oral and Maxillofacial Surgery (vol. 73, pp. 1246-1253) and written by Giuseppe Monaco. The article explores the likelyhood of complications occuring with coronectomy procedures. Coronectomy is an alternative surgical procedure to extract wisdom teeth with roots that are close to the mandibular canal. The article describes a research study  to determine whether coronectomy decreased neurologic damage in cases of mandibular third molars in close proximity to the inferior alveolar nerve. The study looked at 94 healthy patients with a mean age of ~30 who had 116 mandibular third molars (wisdom teeth) treated with coronectomy. A total of 28 patients dropped out of the study during the 3 year follow up period. Of the 116 wisdom teeth treated, 56 (48.3%) were totally impacted and 60 (51.7%) were partially impacted. The teeth were treated by coronectomy due to having pericoronitis (47.4%), periodontal disease (18.1%), or both of the mentioned diseases (32.9%). No neurological injuries occurred to the inferior alveolar nerve or to the lingual nerve with the coronectomy procedures. A total of 30 complications occurred […]

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Reputation of Oral and Maxillofacial Surgery

An interesting article titled “Reputation of Oral and Maxillofacial Surgery in the UK:the patients’ perspective,” appears in the 2015 British Journal of Oral and Maxillofacial Surgery (vol. 53, pp. 321–325) and written by M. Abu -Serriah and et al. The article seeks to explore the reputation of oral and maxillofacial surgery (OMFS). The authors state “One of these is the fact that professional reputations are gifted by salient stakeholders rather than being controlled directly by the professionals themselves, and an important group of stakeholders that has been reported (in publications on professions in medicine) to cause feelings of deprofessionalisation is made up of patients.” In the U.K. the OMFS has shifted to a medical base. OMFS overlaps with other surgical specialties, such as plastic surgery, ear, nose, and throat (ENT), and dentistry. Patients and the public can be confused by the inconsistent use of names, since OMFS is sometimes referred to as oral surgery, oral and facial surgery, and oral and craniomaxillo-facial surgery. The authors conducted focus groups of 5 to 10 patients and lasting no more than 90 minutes to gain insights into their perception of OMFS. A total of 17 patients participated in such focus groups. Some things pointed out in the […]

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Anxiety in Dental Patients Before and After Tooth Extraction

An interesting article titled “Assessment of general pre and post operative anxiety in patients undergoing tooth extraction a prospective study,” appears in the British Journal of Oral and Maxillofacial Surgery and written by Pia López-Jornet and et al. (vol. 52, pp. 18-23, 2014). The article sought to explore the amount of anxiety and fear before, immediately after, and one week after dental extraction. The researchers included 70 patients in their study. It is known that fear and anxiety in dentistry is usually associated with poor oral health and poor oral health related quality of life. Some studies have shown that those with lower socioeconomic status and with less education have more anxiety but others have shown those with more education have more anxiety. The researchers believe that oral surgery is stressful for patients and that anxiety fluctuates over time. They feel dental anxiety can be assessed with self-reported scales including the Spielberger’s State-Trait Anxiety Inventor (STAI), the Modified Dental Anxiety Scale (MDAS), and the Dental Fear Survey (DFS). The patients included in the study were healthy, with no serious medical conditions or blood dyscrasias. Patients who presented with acute infections were excluded, as well as those with psycho-organic or behavioural disorders, or those with language or cognitive problems. The teeth were extracted under normal conditions (local […]

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