Association Between Partially Erupted Mandibular Third Molar and Caries in Distal Second Molar

An interesting article titled “Association between the presence of a partially erupted mandibular third molar and the existence of caries in the distal of the second molars,” appears in the International Journal of Oral and Maxilofacial Surgery by S. G. M. Falci and et. al. (October 2012, pp. 1270-1274). The article mentions how previous studies have shown that caries on the mandibular second molar due to the presence of partially erupted third molars has varied between 7% and 32%. The article criticizes prior work where studies based their prevalence data on panoramic radiographs which is not as good as periapical radiographs when diagnosing caries. The authors state “The lack of sample characterization, the absence of sample calculation, the deficient or inadequate statistical analysis and the absence of a description of the eligibility criteria, discredits the scientific evidence of these previous studies.” The authors performed an aprior sample size calculation and determined they needed 246 radiographs for adequate statistical type I and type II errors I presume. Some key findings are found in the results section of the paper. The authors state “The univariate logistical regression analysis showed that male patients, and patients aged 23–57 years, are the most likely to […]

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Washington Dentist Troubles

Recently, a few articles appeared on DrBicuspid talking about Washington dentists. One of the dentists is a Washington state dentist, the other is a Washington D.C. dentist. The first article talks about how a now retired Washington state dentist must pay $35 million to 29 former patients. The reason for this is because the court determined that the former dentist had performed numerous unnecessary root canals over a long period of time.   The article discusses how the retired dentist performed over 2,000 root canals on about 500 patients over a five year span several years ago. The dentist who purchased the retired dentists practice said that a lot of failing root canals and railing crowns were being noticed by the patients coming in. The court in this case found that the dentist was negligent, failed to obtain informed consent from patients, and committed fraud. The $35 million will be split among the 29 patients in different amounts and both the retired dentist and his insurer will be on the hook for the money. The patient’s in this case feel betrayed because they trusted their dentist. In a previous article titled Are Dentists Ethical or Scam Artists? I discussed how different […]

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Slit Throat During Wisdom Teeth Extraction

A recent story has appeared in ABC Action News (Tampa, Florida, U.S.) titled “Patient says dentist accidentally slit throat while pulling wisdom teeth: Patient expected refund after accident” by Jackie Callaway, July 9, 2013. The story described a man who had three wisdom teeth extracted earlier this year. The man had the first two wisdom teeth removed successfully. According to the man, on the third wisdom tooth, the dentist slipped and came down to near his tonsil and cut his throat. The man says the swelling and pain was unbearable and he lost 12 pounds. The man was interested in getting a refund for the $180 he paid for the dental visit; however, the refund was not made. In addition, the man’s wife had an upcoming appointment with the dentist office, which they canceled and were charged a $25 cancellation fee. The man reached out to ABC Action News and they contacted the dental office who then wrote them a check for the treatment fees and cancellation fee. The full video segment (around 2 minutes) is embeded from ABC Action News below. It is also available on their website along with the full story. It is not clear as to […]

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Marketing the Services of Oral and Maxillofacial Surgeons

An interesting article appears in the Journal of Oral and Maxillofacial Surgery titled “Marketing—Preparing the Soil for Success” by James Hupp vol. 71, pp. 1-2, 2013. The article discusses how the general public does not know much about the possible health care services that an oral and maxillofacial surgeon can provide. It also is a bit of a reality check of how health care is practiced in the United States article. The article talks about a new marketing initiative and says “To me, this represents the association’s wish to start a new time of planning and laying the groundwork for a new season of better educated consumers seeking our care.” The author discusses how the image of oral and maxillofacial surgeons by the general public is not that well understood. Most would know that they remove teeth and have much expertise in this area as well as knowing that they provide sedation and anesthesia in their offices. Beyond this though, it is not clear what is known by the general public. This sounds to me like a reasonable belief and assumption. The article says “…despite our long history of providing care for patients with routine and complex facial fractures, craniomaxillofacial […]

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The Costs Associated with Third Molars (Wisdom Teeth)

An interesting articled by George M. Koumaras titled “What Costs Are Associated With the Management of Third Molars?” appears in the 2012 J Oral Maxillofac Surg vol. 70, pp. 8-10, supp. 1. The article attempts to look at the costs associated with asymptomatic, disease-free, third molars (wisdom teeth). Three scenarios were explored by the author: scenario 1 (nonoperative management): retention of asymptomatic, disease-free third molars and monitoring for 20 years from age 18 to 38 years scenario 2 (operative management): removal of 2 asymptomatic, disease-free, bony impacted third molars for 18-year-old patients using general anesthesia (30 minutes) in an office-based ambulatory setting scenario 3 (failure of nonoperative management): removal of 1 previously asymptomatic, disease-free, bony impacted third molar after 10 years of follow-up in a now 28-year-old patient using general anesthesia (30 minutes) in an office-based ambulatory setting.” The author used claims data from Delta Dental of Virginia in 2009 to assess the financial scenarios. In scenario 1, the author assumed a patient retained his wisdom teeth and visited an oral surgeon every 2 years to assess the teeth. A total of $2,342 for this treatment plan was arrived at including 10 office visits and panoramic radiograph examinations. In scenario […]

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