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High-Level Evidence to Identify Diseases and Disorders Associated with Periodontal Disease

Posted on 19. Apr, 2014 by .

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An interesting article appears in J Can Dent Assoc, 2012, 78:c25, titled ” Separating Fact from Fiction: Use of High-Level Evidence from Research Syntheses to Identify Diseases and Disorders Associated with Periodontal Disease,” by Amir Azarpazhooh and Howard C. Tenenbaum. The article describes how it is known that periodontitis has been correlated with several diseases and attempts to look at the more robust associations.

In the risks of keeping wisdom teeth page http://www.teethremoval.com/risks_of_keeping_wisdom_teeth.html this has been mentioned and several studies are cited. This page states

“These potential systemic diseases that may be associated with periodontal disease include premature delivery of low-birth weight infants, coronary artery disease, coronary heart disease, renal vascular disease, stroke, diabetes, bacterial pneumonia, chronic obstructive lung disease, and Alzheimer’s disease.”

The article discussed above uses meta-analyses and systematic reviews available up to June 2011. This article states

“This high-level evidence indicates that individuals with periodontitis have a significantly higher risk of various other problems, including cardiovascular disease, diabetes mellitus, respiratory disease and preterm low-birth-weight deliveries….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. On the basis of an initial scan of the literature for high-level evidence, data were analyzed for only a selection of these conditions: CVD, diabetes, adverse outcomes of pregnancy, preeclampsia and respiratory disease.”

The author then goes into a more detailed analysis of 1) cardiovascular disease, 2) diabetes mellitus, 3) adverse outcomes of pregnancy, 4) preeclampsia, and 5) respiratory diseases. Many articles and possible implications are discussed in brief.

The author concludes by saying

“..it remains important to recommend periodontal treatment for all patients, whether or not they have other established general health problems, primarily to improve periodontal health in its own right. Despite some evidence for reversibility, it cannot be guaranteed that treatment of periodontitis will reduce patients’ risk for other diseases. However, the role of periodontal disease as a “risk indicator” or “marker” should not be ignored, since the presence of this condition may serve as a warning to the dentist or dental hygienist that the patient is at risk for other diseases, especially CVD, diabetes, respiratory disease and preterm and/or low-birth-weight delivery.”

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The Curious Case of a Wisdom Tooth Growing in Old Age

Posted on 12. Apr, 2014 by .

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An interesting article titled “Dentist shocked by Mary’s new wisdom,” appears in an article in This is Kent, http://www.thisiskent.co.uk/Dentist-shocked-Mary-s-new-wisdom/story-17958765-detail/story.html, January 25, 2013.

The article describes a 75 year old woman who had a wisdom tooth grow in at the age of 75. A picture of the woman with her dentist is provided in the article.

The dentist was taken a back by such a finding since it is vary rare. He decided to look up other cases on the internet and did find a case where an 84 year old man in New Zealand where a man had a wisdom tooth come in.

In the case of the 75 year old man the dentist and woman have decided to just manage the wisdom tooth and leave it in in order to avoid possible complications.

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Teenagers Turn to Strangers for Legal Advice Online After Wisdom Teeth Extractions

Posted on 05. Apr, 2014 by .

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Previously, I have posted numerous user written experiences of wisdom teeth removal. For example, you can see One Star Yelp Reviews on Wisdom Teeth, Successful and Positive Wisdom Teeth Removal Experiences, Wisdom Teeth Surgery Survey, and Wisdom Teeth Extraction Survey. Many of these experiences of wisdom teeth extractions were sent to me in a survey I have been conducting for quite some time on wisdom teeth removal. Other experiences were found from other sources such as reviews on Yelp. It has long been known by those who search for wisdom teeth (but not much discussed) that teenage patients who have wisdom teeth extracted often go online afterwards if things don’t go as planned.

It appears that some patients are hurt and injured from the extraction and turn for advice on the internet. One such website where I have seen this occur is WorldLawDirect which is a forum for people online about legal issues. I have seen 2 such cases on WorldLawDirect where teenage patients have posted their wisdom teeth story and asked for legal advice, see http://www.worldlawdirect.com/forum/consumer-complaints/71293-can-i-sue-my-dentist-17-mouth-pains.html and http://www.worldlawdirect.com/forum/medical-malpractice/51622-can-i-sue-dentist-my-nerves-were-damaged-after-recieving-local-anesthesia.html.

I will now review these 2 cases to compare and contrast the similarities. In the first case a 17 year old female had four wisdom teeth removed during spring break. She complained that she did not receive antibiotics after surgery and states her parents looked online and found information to suggest antibiotics should be taken after surgery. I have explored the issue of taking antibiotics after wisdom teeth before such as over at http://www.teethremoval.com/antibiotic_resistance.html In this I currently refer to 2 studies in the Journal of Oral and Maxillofacial Surgery which suggests taking antibiotics before surgery may be more effective than after but also suggests that prophylactic antibiotics before surgery may not be universally needed. Carrying on with the explanation, the girl states that she suffered from lock jaw after the surgery and had significant pain. She states that upon consultation with another doctor it was determined she developed dry socket and an infection. She further states

“Here I am, two months later, and part of my lip goes numb, I have tooth fragments behind my upper right extraction site, with part of my gum missing. I have a soreness that will partly go away, but I can’t bite my top lip, or smile without the gums under my top lip hurt to the point of tears, and the sides of my gums as well, and I cannot chew on my left side due to the fact my back tooth feels like it’s going to pop out of my mouth.”

She also states that she had 11 unnecessary fillings before the four wisdom teeth were extracted bringing the total amount of surgery and fillings to around $33,000 which was paid by insurance. She simply wants to know if this is malpractice and if she can sue. Several users on the post then give some brief comments about whether or not a legal case can be brought and their suggestions.

In case 2 an 18 year old (sex unclear) reports having local anesthesia while having wisdom teeth removed and then developing double vision. He also states he developed nerve damage other his complaints are not clear. Again several users on the forum comment with their suggestions.

So overall, it appears that some teenagers after wisdom teeth removal are going online for legal advice from strangers. The strangers then offer a few comments about the merits of the case and what they suggest. I suppose this practice will continue….

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Recent Stories on Wisdom Teeth Removal Death

Posted on 29. Mar, 2014 by .

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I have recently posted about 2 potential deaths from wisdom teeth removal that occurred this year in 2014. The first one is an 18 year old man in Maine (see Eighteen Year Old Music Student in Portland Dies After Wisdom Teeth Removal). The second is a 24 year old woman who went into a coma in Hawaii (see Mother of Two in Hawaii in a Coma After Wisdom Teeth Surgery).

These stories got some play in various media outlets. For example, Mike Adams of NaturalNews.com wrote an article titled “Wisdom teeth surgery a deadly dental scam: Young mother falls into coma following visit to dentist” see  http://www.naturalnews.com/044415_wisdom_teeth_extraction_dental_scam_death_risk.html#ixzz2xOPQYbzy. In the article Mike says

“Across virtually the entire industry of conventional dentistry, this dangerous surgery scam is pushed on patients with unethical fear tactics that claim asymptomatic wisdom teeth — teeth with no symptoms, pain or problems — must be surgically removed “because they are there.””

Mike then goes on to mention the two recent death cases and says that dentists put profits over the safety of their patients and are unethical.  He does say

“Finally, I’m not saying that all surgeries or wisdom teeth extraction procedures are unnecessary.”

He however, doesn’t really go into the reasons for what would make removing wisdom teeth necessary. He does say that dentists don’t fully disclose all the risks and says you should look into this yourself. However, I would argue it would be difficult to look into all the risks yourself without access to medical journal articles and the knowledge to do so which for a teenager would pose a large challenge.

An opinion letter appears in the Forecaster, March 24, 2014, titled “Letter: The problem is there may not be a problem,” see http://www.theforecaster.net/news/print/2014/03/24/letter-problem-there-may-not-be-problem/192331 which also discusses the recent wisdom teeth death of the 18 year old man. This letter is written by an orthopedic surgeon who knows little about wisdom teeth surgery. He does speculate that removing many wisdom teeth is unnecessary citing some studies and guidelines.  He states

“As a practicing orthopaedic surgeon, I can relate that a number of techniques and practices I was taught in good faith 20 years ago are now known to be ineffective or even harmful. This is true across the field of medicine. After all, 300 years ago common practice included “bloodletting” patients when they were sick, leading to the death of our first president, George Washington.”

Why I think it is useful for these articles to say that many wisdom teeth surgeries are unnecessary citing studies and guidelines by other groups, it is important to remember that some wisdom teeth surgeries are needed and necessary even when their are risks with the surgery. Being able to better define this gray area is important so that one can better make an informed decision.

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Eighteen Year Old Music Student in Portland Dies After Wisdom Teeth Removal

Posted on 20. Mar, 2014 by .

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An eighteen year old male high school student planning to study music in college died last February in Portland, Maine, after having his wisdom teeth removed. The story is from Portland Press Herald, by Matt Byrne, posted February 26, 2014, titled “Love, sorrow, questions after Cheverus student’s death,” and accessed March 21, 2014. See http://www.pressherald.com/news/Cheverus_senior__budding_musician__dies_after_routine_oral_surgery_.html. The article describes the eighteen year old man as independent and compassionate and able to play the trumpet, bassoon, saxophone and English concertina. In this particular case the man had wisdom teeth extracted on a Wednesday in February. He then went home and two days later on Friday night his condition deteriorated. He is said to have died in the early hours Saturday in his mother’s arms at home.

In the article Dr. Thomas Dodson, who now is with the University of Washington in Seattle is quoted and his thoughts are expressed. He says

“I’m trained as an epidemiologist, and I can’t say I’ve even ever read (about a death) anywhere… It’s kind of one of these things that, when we do studies and we enroll 10,000 patients, death doesn’t happen. You’d need to probably enroll hundreds of thousands of patients to assess the rate of death”

He means that in actual medical studies that are reported in journal articles. Typically the deaths one hears about are just in news stories. In the article Dr. Dodson says “… in 20 years of surveys completed by every oral surgeon in Massachusetts – 150 to 200 surgeons in all – not a single death was recorded among patients who had wisdom teeth extracted.” I have previously reviewed these studies which are cited over here http://www.teethremoval.com/mortality_rates_in_dentistry.html. These are the studies by Edward M. D’Eramo and others.

The current president of the American Association of Oral and Maxillofacial Surgeons is also quoted in the article and says “There’s not many ways that this type of surgery can go wrong.”

For other cases of people unfortunately dieing shortly after having wisdom teeth surgery see http://www.teethremoval.com/death.html.

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